My first exposure to pediatric rheumatology came during my adult rheumatology fellowship, when pediatric rotations were part of our curriculum. This experience brought home for me the many differences between childhood and adult rheumatic diseases and the important role pediatric rheumatologists play in patient outcomes. This role has long been appreciated by the ACR/ARP, where a range of initiatives support pediatric rheumatologists and rheumatology professionals.
Increasing the Workforce
The main challenge faced by pediatric rheumatologists lies in the numbers. It is estimated that juvenile rheumatic disease affects more than 300,000 children. Although the demand for pediatric rheumatologists has already surpassed the supply, this is projected to worsen by 2030. Families who have a child with a rheumatic illness may have to travel long distances to receive care. The ACR seeks not only to improve numbers, but also to bring training programs into areas of unmet need by collaborating with institutions and communities to develop new fellowships. Since 2023–24, three pediatric training programs have received accreditation, and one new pediatric program will launch in 2025–26.
- The Pediatric Rheumatology Residents Program motivates residents to pursue subspecialty training in pediatric rheumatology by providing an opportunity to attend ACR Convergence. This program is designed to introduce pediatric residents to the subspecialty early in their residency, with the aim of addressing workforce challenges in pediatric rheumatology.
- The ACR/CARRA Mentoring Program (AMIGO) supports career development in pediatric rheumatology through a nine-month program consisting of educational services, facilitated networking and a one-on-one mentoring program through which mentees are matched with mentors at other institutions. AMIGO promotes a valuable culture of mentoring across pediatric rheumatology and fosters cross-institutional connections.
In collaboration with the Workforce Solutions Committee, the Committee on Pediatric Rheumatology is leading efforts to address the pediatric rheumatology workforce crisis. Projects exploring flexibility in the length of pediatric rheumatology training and addressing burnout have been launched. The committee also seeks to collaborate with other pediatric and pediatric subspecialty organizations, such as the Association of Medical School Pediatric Department Chairs and the Council of Pediatric Subspecialties and their extensive workforce initiatives.
Other Committees
Pediatric engagement is actively sought throughout all ACR, ARP and Rheumatology Research Foundation volunteer opportunities. The College invites pediatric rheumatologists and professionals to consider participating in a volunteer position because your voices are needed.
Education
ACR Convergence
Programming of pediatric scientific sessions at Convergence is planned by a dedicated pediatric team within the Annual Meeting Planning Committee. In addition to the broad range of abstract categories, pediatric original research is the specific focus of two ACR abstract categories for basic and clinical science, and one ARP abstract category.
PRSYM
The Pediatric Rheumatology Symposium (PRSYM) provides up-to-date, practical clinical information and basic science knowledge on the diagnosis and management of pediatric patients with rheumatic diseases and immune disorders. PRYSM is a three-day conference that includes invited lecturers and presentations of original science from accepted abstracts in poster and oral concurrent sessions. PRYSM occurs every three years and will next be held March 18–21, 2026.
Advocacy
ACR advocacy encompasses a number of initiatives that support pediatric rheumatologic care. Three objectives of particular interest are:
- Increasing funding for the Pediatric Subspecialty Loan Repayment Program (PSLRP). The PSLRP can encourage more pediatric residents to pursue specialty training in rheumatology. This past year, the ACR was able to secure $10 million for the PSLRP and is working to increase this amount in annual appropriations.
- Increasing Medicaid reimbursement for pediatric services at the federal and state levels. Medicaid and the Children’s Health Insurance Program (CHIP) cover care for uninsured children living with rheumatic disease. Close to 40% of all American children are enrolled in Medicaid. The low level of Medicaid reimbursement challenges the ability of pediatric rheumatologists to provide care that is financially feasible. The ACR is working to raise Medicaid payments that will sustain pediatric specialty medicine and children’s access to care.
- Investing in the National Institutes of Health. The ACR recognizes and is actively advocating for the critically important role that federally funded research plays in the medical and economic health of children and adults with chronic rheumatic disease.
Patient Care Tools
Care Transition Toolkits
The ACR has created transition toolkits for patients with juvenile idiopathic arthritis (JIA) and pediatric lupus to assist in the transition of young adults phasing out of a pediatric rheumatologist’s practice to an adult rheumatologist.
Guidelines & Guidance
The ACR clinical practice guidelines cover a spectrum of rheumatic diseases of specific interest to pediatric rheumatologists, including JIA and Kawasaki disease. The ACR also has clinical guidance documents focused on autoinflammatory and hyperinflammatory diseases.
Criteria
Criteria development projects have received support from the ACR, many of which interface with pediatric rheumatology. Projects generally focus on classification, response and remission criteria.
ARP
The ARP serves a diverse range of professionals who have a focus on pediatric rheumatology. These professionals represent essential leaders and partners in the clinical and research teams that advance care for patients with pediatric rheumatic disease.
Rheumatology Research Foundation
The Foundation supports pediatric rheumatology through career development and innovative research awards, both general and pediatric specific, supporting recruitment, education and training.
- Pediatric Rheumatology Fellow Research Award: This award recognizes outstanding scientific abstracts submitted by pediatric rheumatology fellows to ACR Convergence.
- Pediatric Visiting Professorship: This award supports a board-certified professor of pediatric rheumatology to visit an academic institution that lacks expertise in the field.
- Education & training: Approximately 28% of Foundation workforce programs have supported pediatric fellowship programs and pediatric practices over the past five years. Award opportunities include the Fellowship Training Awards, Fellowship Training Awards for Workforce Expansion and the Mentored Nurse Practitioner/Physician Assistant Award for Workforce Expansion.
In Sum
The ACR’s mission is to empower rheumatology professionals to excel in their specialty. Through support of pediatric rheumatology, the ACR/ARP will continue to advance this mission across the entire spectrum of rheumatic disease affecting both children and adults.
Carol A. Langford, MD, MHS, is the director of the Center for Vasculitis Care and Research in the Department of Rheumatic and Immunologic Diseases at Cleveland Clinic, where she is professor of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, and holds the Harold C. Schott endowed chair in rheumatic and immunologic diseases.
