General Pediatrics

Content Outline

In-Training, Certification, and

Maintenance of Certification Exams

Effective for all examinations administered October 15, 2024, and after

THE AMERICAN BOARD of PEDIATRICS

Table of Contents
Overview ................................................................................................................................................................................. 1
Development of the General Pediatrics Content Outline ................................................................................................ 1
Content Domains and Subdomains .................................................................................................................................. 1
Universal Tasks .................................................................................................................................................................. 2
Development and Classification of Exam Questions ....................................................................................................... 3
Exam Weights ......................................................................................................................................................................... 4
Detailed Content Outline ....................................................................................................................................................... 5
Domain 1: Preventive Pediatrics/Well-Child Care............................................................................................................ 5
Domain 2: Fetal and Neonatal Care ................................................................................................................................. 5
Domain 3: Adolescent Care ............................................................................................................................................... 5
Domain 4: Infectious Diseases ......................................................................................................................................... 6
Domain 5: Mental and Behavioral Health ........................................................................................................................ 6
Domain 6: Psychosocial Issues ......................................................................................................................................... 6
Domain 7: Emergency and Critical Care ........................................................................................................................... 7
Domain 8: Child Abuse and Neglect ................................................................................................................................. 7
Domain 9: Orthopedics and Sports Medicine .................................................................................................................. 7
Domain 10: Eye, Ear, Nose, and Throat ........................................................................................................................... 7
Domain 11: Cardiology ...................................................................................................................................................... 8
Domain 12: Pulmonology .................................................................................................................................................. 8
Domain 13: Gastroenterology ........................................................................................................................................... 9
Domain 14: Neurology ....................................................................................................................................................... 9
Domain 15: Skin/Dermatology ......................................................................................................................................... 9
Domain 16: Hematology-Oncology................................................................................................................................. 10
Domain 17: Allergy and Immunology ............................................................................................................................. 10
Domain 18: Endocrinology ............................................................................................................................................. 10
Domain 19: Nephrology, Fluids, and Electrolytes ......................................................................................................... 10
Domain 20: Genitourinary System ................................................................................................................................. 11
Domain 21: Genetics, Dysmorphology, and Metabolic Disorders ............................................................................... 11
Domain 22: Rheumatology ............................................................................................................................................. 11
Domain 23: Ethics........................................................................................................................................................... 11
Domain 24: Patient Safety, Quality Improvement, and Research Methods ............................................................... 11
Overview
This content outline was developed to serve as the blueprint for the general pediatrics in-training, initial
certification, and maintenance of certification examinations. This outline identifies for all important stakeholders
(eg, prospective candidates, diplomates, the public, training programs, professional associations) the knowledge
areas being measured by these exams.

This outline takes effect on October 15, 2024. All general pediatrics examinations administered after this date
will adhere to the specifications within this outline.

DEVELOPMENT OF THE GENERAL PEDIATRICS CONTENT OUTLINE

The initial draft of this content outline was developed by a diverse, representative panel of 16 practicing general
pediatricians.

The panel started by reviewing the Entrustable Professional Activities (EPAs) that apply to general pediatrics
(GP). 1 EPAs are the activities that patients need from their physicians and, collectively, the 17 GP EPAs define
the practice of general pediatrics. Example EPAs include EPA 2: “Provide recommended pediatric health
screening,” EPA 4: “Manage patients with acute, common diagnoses in an ambulatory, emergency, or inpatient
setting,” and EPA 9: “Assess and manage patients with common behavior/mental health problems.” Because
the EPAs were designed by the GP community to reflect the activities needed for safe and effective practice,
they served as a useful starting point in the development of the GP Content Outline.

During their review of the EPAs, the panel discussed recent changes to practice, identified critical elements of
practice, and developed a comprehensive list of the tasks performed by general pediatricians. Using that list of
tasks as a reference, the panel reviewed the previous version of the GP Content Outline and determined where
updates were necessary. The panel was instructed only to include knowledge areas that were deemed
“testable” in a written exam format (ie, multiple-choice questions with a single correct answer supported by
literature). Those testable knowledge areas were organized into content domains and subdomains and served
as the draft content outline. A large number of board-certified general pediatricians (N = 77,599) were invited
to provide feedback through an online survey. A total of 9,780 (12.6%) pediatricians responded to at least a
portion of the survey, with 5,299 (6.8%) completing the entire survey. Respondents were asked to rate the
frequency, criticality, and/or relevance of the content domains and subdomains, and they were also able to
provide open-ended comments to identify any important content areas that were not included in the draft.

The survey results were used to make final revisions to the outline and to establish the exam weights (ie, the
percentage of exam questions associated with each content domain – see page 4). The content domains that
were rated higher on relevance, frequency, and criticality have been weighted more heavily than domains with
lower ratings on those rating scales. Establishing the exam weights in this manner helps to ensure that ABP’s
GP exams are measuring the full breadth of knowledge required for practice, while also placing an appropriate
amount of emphasis on those knowledge areas that were identified by practicing general pediatricians as being
most important for practice.

CONTENT DOMAINS AND SUBDOMAINS

The knowledge for safe and effective practice as a general pediatrician has been categorized into 24 content
domains, presented in the table below. Within each domain, a set of subdomains has been identified that provides
a more detailed breakdown of the knowledge areas that may be assessed (see page 5). Each exam question
included on a GP exam (in-training, initial certification, and maintenance of certification) is classified according
to the content domain and subdomain to which it is most closely aligned. If an exam question does not align with
one of the content subdomains within this outline, it is removed from the question pool and is not included on an
exam.

1
For more information about EPAs and their purpose, please visit the ABP website at https://www.abp.org/content/entrustable-
professional-activities-general-pediatrics
1
 General Pediatrics Content Domains
Foundational knowledge
1. Preventative Pediatrics/Well-Child Care
2. Fetal and Neonatal Care
3. Adolescent Care
4. Infectious Diseases
5. Mental and Behavioral Health
6. Psychosocial Issues
7. Emergency and Critical Care
8. Child Abuse and Neglect
9. Orthopedics and Sports Medicine
10. Eye, Ear, Nose, and Throat
11. Cardiology
12. Pulmonology
13. Gastroenterology
14. Neurology
15. Skin/Dermatology
16. Hematology-Oncology
17. Allergy and Immunology
18. Endocrinology
19. Nephrology, Fluids, and Electrolytes
20. Genitourinary System
21. Genetics, Dysmorphology, and Metabolic Disorders
22. Rheumatology
23. Ethics
24. Patient Safety, Quality Improvement, and Research Methods

UNIVERSAL TASKS

To help ensure the clinical relevance of the ABP’s GP examinations, the panel also identified a set of four
categories referred to as Universal Tasks, described below, that reflect the primary ways in which general
pediatric knowledge can be applied in clinical practice. By classifying exam questions to a universal task
category, an appropriate number of questions from each category can be included on all exams. The four
Universal Task categories are:

1. Physiology and Pathophysiology - Understanding physiology, pathophysiology, and foundational pediatric

knowledge, including normal and abnormal function of the body and mind in an age-specific
development context
2. Epidemiology and Risk Assessment - Recognizing patterns of health and disease and understanding the
variables that influence those patterns
3. Diagnosis - Using available information (eg, patient history, physical examination findings, etc.) to
formulate differential diagnoses, choose appropriate tests, and interpret test results to reach a likely
diagnosis
4. Management and Treatment - Formulating a comprehensive management and/or treatment plan,
including reevaluation and long-term follow-up, taking into account best practices and clinical guidelines
as part of care and management

Please note that most, but not all, exam questions that appear on an exam receive a universal task
classification. There are some knowledge areas in the content outline where the Universal Task categories do
not apply. For example, it is likely that a question from Domain 23 (Ethics), Subdomain C (Professionalism,
cross-cultural issues, and institutional ethics) would not receive a Universal Task classification.
2
SAMPLE QUESTION
The sample question below helps to illustrate the types of questions that may appear on an exam and how
questions are classified. The question, which comes from Domain 4 (Infectious Diseases), is classified to both
a domain/subdomain and to a universal task category.

A 12-year-old girl is brought for evaluation because of fever, nausea, and vomiting of 1 day's duration.
Physical examination shows a moderately ill girl with temperature of 39.5°C and blood pressure of
80/40 mm Hg. There is generalized macular erythema, a 2.5-cm furuncle in the right axilla, and a
paronychia of the right great toe. The tongue is erythematous, and the conjunctival vessels are injected.
The remainder of the physical findings are normal.

Which of the following is the most likely diagnosis?

A. Scarlet fever Item Classification

B. Toxic shock syndrome* Content 4. Infectious Diseases
C. Kawasaki disease Domain/ A. Specific pathogens
D. Erythema infectiosum Subdomain† 1. Bacterial and
mycobacterial
Correct answer = B
Universal Task 3. Diagnosis

†Note: Content domain/subdomain 4.A.1 can be found on page 6 of

this document (within the detailed content outline section).

DEVELOPMENT AND CLASSIFICATION OF EXAM QUESTIONS

Although the field of general pediatrics is continually changing, the content domains and subdomains within
this outline should be viewed as broad categories of knowledge that are likely to remain relatively stable over
time. The detailed knowledge within the content domains and subdomains, however, is likely to evolve as the
field continues to advance. Because exam questions may assess a general pediatrician’s knowledge of a specific
element within a content domain/subdomain, it is important to note that it is the responsibility of the test taker
to ensure that their knowledge within each knowledge area is up to date.

To ensure the exam questions are current and relevant, the ABP follows a rigorous development and approval
process. Each exam question is written by a board-certified practitioner or academician who has received training
on how to write high quality exam questions. Each question is classified according to the content
domain/subdomain to which it is most closely aligned. Questions that do not align with a content
domain/subdomain are removed from the question pool and are not included on an exam. In most cases, items
are also classified according to the universal task to which they most closely align.

Once a question has been written, it is then discussed and revised, if necessary, by members of the ABP’s General
Pediatrics Exam Committee, a large, diverse panel of practicing general pediatricians. For a current listing of
committee members, visit https://www.abp.org/content/current-committees. During the revision process, each
question is also reviewed by a medical editor to ensure accuracy and by staff editors who standardize question
style, format, and terminology; correct grammar; and eliminate ambiguity and technical flaws, such as cues to
the answer.

Once the committee has approved a question, it is included in the question pool and is made available for future
exams. All approved questions in the pool, including questions that have been used previously on an exam, are
reviewed periodically for accuracy, currency, and relevance.

3
Exam Weights
The tables below indicate the exam weights (ie, the percentage of exam questions associated with each content
domain) for the ABP’s GP examinations. Please note that the weights reflect the content of a typical exam and
are approximate; actual content may vary.

Exam
Content Domain Weight
1. Preventative Pediatrics/Well-Child Care 12%
2. Fetal and Neonatal Care 4%
3. Adolescent Care 5%
4. Infectious Diseases 7%
5. Mental and Behavioral Health 6%
6. Psychosocial Issues 3%
7. Emergency and Critical Care 4%
8. Child Abuse and Neglect 3%
9. Orthopedics and Sports Medicine 4%
10. Eye, Ear, Nose, and Throat 6%
11. Cardiology 5%
12. Pulmonology 5%
13. Gastroenterology 5%
14. Neurology 4%
15. Skin/Dermatology 4%
16. Hematology-Oncology 3%
17. Allergy and Immunology 3%
18. Endocrinology 3%
19. Nephrology, Fluids, and Electrolytes 3%
20. Genitourinary System 3%
21. Genetics, Dysmorphology, and Metabolic Disorders 2%
22. Rheumatology 2%
23. Ethics 2%
24. Patient Safety, Quality Improvement, and Research Methods 2%
Total 100%

4
Detailed Content Outline

Domain 1: Preventive Pediatrics/Well-Child Care

A. Normal growth and development
1. Physical
2. Social
3. Emotional
4. Language
5. Gross motor
6. Fine motor
B. Nutrition
1. Newborn and infant feeding
2. Age-specific nutritional needs
3. Patient population-specific nutritional needs (eg, vegetarian, vegan)
4. Condition-specific nutritional needs (eg, food allergies, hypertension)
5. Obesity
6. Failure to thrive
C. Immunizations
1. Current recommendations
2. Special circumstances (eg, contraindication, lapsed immunizations, vaccine hesitancy)
D. Screening and disease prevention
1. Age-appropriate medical screenings
2. Age-appropriate mental health and psychosocial screenings (eg, learning disabilities, autism,
depression, intelligence testing)
E. Anticipatory guidance
1. Safety and injury prevention (eg, gun safety, drowning, car seats, helmet use, secondhand
smoke exposure, social media, safe sleep)
2. Common behavioral issues (eg, eating, sleeping, toileting, aggression/acting out, discipline)

Domain 2: Fetal and Neonatal Care

A. Fetal care
1. Prenatal screenings
2. Prenatally diagnosed fetal conditions
3. Special maternal conditions
B. Neonatal care
1. Stabilization and transitioning
2. Routine care (eg, universal newborn screening)
3. Diseases, disorders, and conditions (eg, small for gestational age [SGA], birth injuries,
ambiguous genitalia, respiratory distress, jaundice, cyanosis, hypoglycemia, congenital
anomalies)

Domain 3: Adolescent Care

A. Growth and development
1. Pubertal
2. Cognitive
3. Emotional
B. Sex and sexuality
1. Sexual behavior (eg, contraception, pregnancy)
2. Sexual orientation

5
 3. Gender identity and care for nonbinary and transgender patients
C. Transition to adult care

Domain 4: Infectious Diseases

A. Specific pathogens
1. Bacterial and mycobacterial
2. Viral
3. Fungal
4. Parasitic
B. Special considerations
1. Prenatally acquired infections
2. Vector-borne infections
3. Immunocompromised host
4. Sexually transmitted infections
5. International adoption, immigration, and refugeeism
6. Toxin-mediated disease
7. Infection control (eg, childcare center, school, hospital/clinic)
8. International travel

Domain 5: Mental and Behavioral Health

A. Cognition, language, learning, and neurodevelopment disorders and conditions
1. Learning differences
2. ADHD
3. Autism spectrum disorders
B. Psychologic/psychiatric disorders
1. Anxiety
2. Depression
3. Psychogenic
4. Delinquency and asocial behavior
5. Other psychologic/psychiatric disorders (eg, post-traumatic stress disorder, obsessive
compulsive disorder, oppositional defiant disorder)
C. Substance use/abuse (eg, stimulants, depressants, hallucinogens, prescription medications)
D. Tobacco use and vaping/e-cigarettes
E. Childhood/adolescent mental and behavioral issues
1. Risk-taking and self-harm
2. Eating disorders
3. Violence and bullying

Domain 6: Psychosocial Issues

A. Family (eg, divorce, death, adoption, foster care)
B. Impact of illness (eg, chronic illness, disability)
C. Social determinants of health
1. Socioeconomic
2. Violence (eg, bullying, physical, gun)
3. Cultural differences (eg, language barriers, alternative medicine)
4. Immigration
5. Adverse childhood events (ACEs)
D. Equity/inequity and racism in medicine
E. Social media (eg, cyberbullying, influence, self-esteem)

6
Domain 7: Emergency and Critical Care
A. Emergency medicine
1. Respiratory distress
2. Acute abdomen
3. Trauma/burns
4. Statis epilepticus
5. Altered mental status
6. Poisoning/toxic exposure
7. Foreign body aspiration and ingestion
8. Diabetic ketoacidosis (DKA)
9. Concussion/head injury
10. Hypertensive crisis
11. Submersion injury
B. Critical Care
1. Shock (eg, anaphylactic, septic, cardiogenic, neurogenic, hypovolemic)
2. Organ failure
3. Impending respiratory failure
4. Resuscitation and stabilization

Domain 8: Child Abuse and Neglect

A. Categories of abuse
1. Physical abuse
2. Sexual abuse and assault
3. Psychological abuse
4. Neglect
5. Caregiver-fabricated illness
B. Provider roles and responsibilities (eg, mandated reporting, family support)

Domain 9: Orthopedics and Sports Medicine

A. Orthopedic disorders and conditions
1. Genetic and congenital anomalies (eg, developmental hip dysplasia)
2. Head/neck (eg, clavicle fracture, closed head injury)
3. Spine (eg, scoliosis, spondylosis, spondylolisthesis)
4. Upper extremities (eg, nursemaid elbow, fracture)
5. Hips/lower extremities (eg, Osgood-Schlatter, septic joint, slipped capital femoral epiphysis
[SCFE])
B. Sports medicine
1. Pre-participation evaluation
2. Injury prevention
3. Conditions and injuries (eg, concussion, heat illness)
4. Return to play (eg, rehabilitation, concussions)
5. Athlete wellness (eg, nutrition, supplements, performance-enhancing drugs)

Domain 10: Eye, Ear, Nose, and Throat

A. Diseases, disorders, and conditions of the eye
1. Inflammatory/infectious
2. Structural/anatomic
3. Trauma/injury
B. Diseases, disorders, and conditions of the ear
7
 1. Inflammatory/infectious
2. Structural/anatomic
3. Trauma/injury
C. Diseases, disorders, and conditions of the nose and sinuses
1. Inflammatory/infectious
2. Structural/anatomic
3. Trauma/injury
D. Diseases, disorders, and conditions of the mouth, oropharynx, and throat
1. Inflammatory/infectious
2. Structural/anatomic
3. Trauma/injury
E. Diseases, disorders, and conditions of the neck
1. Inflammatory/infectious
2. Structural/anatomic
3. Trauma/injury

Domain 11: Cardiology

A. Syncope
B. Abnormal blood pressure and heart rate (eg, hypertension, postural orthostatic tachycardia
syndrome [POTS], orthostatic hypotension)
C. Structural heart disease
1. Cyanotic congenital
2. Acyanotic congenital
3. Evaluation of benign versus pathologic murmurs (et, Stills murmur, peripheral pulmonary
stenosis [PPS], patent ductus arteriosus [PDA], patent foramen ovale [PFO])
D. Dysrhythmias
E. Cardiomyopathies
F. Infection/inflammatory
G. Vasculitis (eg, multisystem inflammatory syndrome in children [MIS-C], Kawasaki syndrome)
H. Dyslipidemias

Domain 12: Pulmonology

A. Upper airway
1. Infectious (eg, croup, epiglottitis)
2. Laryngomalacia, tracheomalacia, and vocal cord dysfunction
3. Foreign body
B. Lower airway
1. Asthma
2. Pneumonia
3. Foreign body
4. Other lower airway (eg, pulmonary artery sling, bronchitis, bronchiolitis, aspiration pneumonia)
C. Parenchymal, extrapulmonary, pulmonary hypertension, and cor pulmonale
D. Chronic lung disease
1. Prematurity/BPD
2. Congenital lung malformations
3. Cystic fibrosis

8
Domain 13: Gastroenterology
A. Diseases, disorders, and conditions
1. Oral cavity
2. Esophagus
3. Stomach and intestines
4. Exocrine and pancreas
5. Liver and biliary system
6. Peritoneum
B. Systemic disorders
1. Celiac disease
2. Inflammatory bowel disease
C. Functional disorders
1. Irritable bowel syndrome and functional abdominal pain
2. Constipation

Domain 14: Neurology

A. Brain disorders
1. Headache and migraine syndromes
2. Post-concussion syndrome
3. Seizure disorders
4. Hydrocephalus
5. Static encephalopathy
6. Stroke
7. Vascular anomalies
8. Inflammatory/infectious
B. Spinal cord disorders
1. Inflammatory/infectious
2. Anatomic
C. Peripheral nervous system disorders
D. Sleep disorders
E. Muscular dystrophies
F. Neurocutaneous disorders
G. Degenerative neurologic disorders
H. Movement disorders
I. Cerebral palsy

Domain 15: Skin/Dermatology

A. Congenital/neonatal disorders and conditions
1. Infectious
2. Non-infectious
B. Acquired disorders and conditions
1. Infections
2. Infestations
3. Inflammatory
4. Immune-mediated
5. Traumatic
6. Pigment changes
7. Papules/nodules

9
 8. Vascular lesions
9. Acne
C. Dermatologic manifestations of systemic disease

Domain 16: Hematology-Oncology

A. Hematologic diseases, disorders, and conditions
1. Erythrocyte disorders
2. Leukocyte disorders
3. Platelet disorders
4. Neutropenia
5. Coagulation disorders
6. Immune-mediated blood disorders
7. Sickle cell anemia
B. Malignancies
1. Hematologic/lymphatic
2. Central and peripheral nervous systems
3. Ocular
4. Renal
5. Reproductive
6. Musculoskeletal/dermal
C. Special considerations
1. General complications of treatment and transfusions
2. Oncologic emergencies

Domain 17: Allergy and Immunology

A. Allergic disorders
1. Allergic rhinitis
2. Urticaria and angioedema
3. Anaphylaxis
4. Hypersensitivity reaction
5. Food allergy and oral allergy syndrome
B. Disorders of immune function (eg, B cell, T cell, combined B- and T-cell defects, phagocytes,
complement deficiencies)

Domain 18: Endocrinology

A. Adrenal, pituitary, and parathyroid disorders
B. Thyroid disorders
C. Diabetes insipidus
D. Type 1 diabetes
E. Type 2 diabetes/metabolic syndrome
F. Growth disorders (eg, tall stature, short stature, growth hormone deficiency)
G. Pubertal development (normal and abnormal)

Domain 19: Nephrology, Fluids, and Electrolytes

A. Renal physiology (eg, acid-base balance, electrolytes)
B. Diseases, disorders, and conditions
1. Inflammatory
2. Dysfunctional
3. Genetic
10
C. Hematuria
D. Proteinuria
E. Dehydration and fluid resuscitation

Domain 20: Genitourinary System

A. Disorders and conditions
1. Abnormalities of collecting system, bladder, and urethra
2. Infectious/inflammatory
3. Stones
4. Trauma
B. Gynecology
1. Routine care
2. Diseases, disorders, and conditions (eg, menstrual, breast, abdominal and pelvic pain, vaginal
discharge, polycystic ovary syndrome)
C. Male genitalia
1. Routine care
2. Diseases, disorders, and conditions (eg, hydroceles, hypospadias, epididymitis, scrotal mass,
torsion)

Domain 21: Genetics, Dysmorphology, and Metabolic Disorders

A. Genetic inheritance patterns (mendelian and non-mendelian)
B. Syndromes
1. Chromosomal abnormalities (eg, trisomies, sex chromosome disorders)
2. Gene abnormalities
3. Associations
C. Inborn errors of metabolism (eg, carbohydrate metabolism, lysosomal storage disorders, amino acid
disorders, organic acidemias, urea cycle disorders, fatty acid oxidation disorders)

Domain 22: Rheumatology

A. Postinfectious/reactive arthritis
B. Juvenile idiopathic arthritis (JIA)
C. Psoriatic arthritis, sarcoidosis, fibromyalgia, ankylosing spondylitis
D. Connective tissue diseases
E. Systemic lupus erythematosus (SLE)
F. Dermatomyositis
G. Rheumatic fever, cyclic fever, and periodic fever syndrome

Domain 23: Ethics

A. Shared decision-making (eg, allocation of resources, informed consent)
B. Patient-parent-pediatrician relationship
C. Professionalism, cross-cultural issues, and institutional ethics
D. Pain, palliative, and end-of-life care
1. Communication (eg, delivery of difficult news, assessing goals of care, advance care planning)
2. Grief (eg, developmental understanding of death, anticipatory grief, bereavement)

Domain 24: Patient Safety, Quality Improvement, and Research Methods

A. Patient safety and adverse events
1. Causes
2. Barriers to detecting and reporting
11
 3. Methods for reduction
B. Quality Improvement
1. Goals
2. Methods
C. Research methods
1. Clinical studies
2. Basic statistics

12