Old school

In the last decade, the American Board of Pediatrics has reduced the number of required intensive care rotations. The Accreditation Council for Graduate Medical Education has established guidelines that limit on-call nights to 24 h and the work week to 80 h. This has had a positive impact on housestaff training and patient safety. Inadequate experience can reduce proficiency, especially in the acute management of a sick newborn. New guidelines and evidence-based standards need to assure competency without compromising work hours and broad-based exposure. Times change, but the passion and privilege of caring for sick newborns does not.