We applaud the efforts highlighted by the author regarding their experience in PEM since 1997 at Madras Medical College and the Institute of Child Health. They have created a well-regarded course in PEM and most importantly, their results have been validated in peer-reviewed literature — which is the ultimate test for legitimacy. Recognition of faculty post in PEM by the state of Tamil Nadu is the right step in the right direction to establish PEM as a super specialty in India. However, it is not even the tip of the iceberg of what is the actual need at the national level.

We recognize that the efforts for recognition of PEM are being made at some of the institutes in India, but these need to be done at a larger level. The intent of this white paper [1] is to provide a curriculum as the basis for creation of PEM as a super-specialty at academic institutes. The compare-and-contrast approach using the PEM curriculum in the United States, is a suggestion because in many instances we do not have to reinvent the wheel and the positives from well-established programs can be emulated. Furthermore, the curriculum has been modified based on the needs and resources of our country. There is a need to have a "standardized" curriculum across the country keeping in mind the local epidemiology to drive the education and training. Well-established institutions with substantial resources could expose PEM trainees to education by simulators which may be impossible in resource-constrained settings. Similarly, research requirement during PEM training need not be to the tune of 12-18 months as mandated in the US.

Ultimate goal is to bring together various stakeholders in emergency medicine, pediatrics, nursing, hospital administration, compliance agencies as well as policy makers and government officials to not only create a federal office of emergency medical services but engage everyone in a meaningful manner to develop and sustain a robust infrastructure to deliver high quality PEM care to children in India.

We anticipate and indeed invite other members of the pertinent communities to be major contributors to this effort. Academic authorities like National Board of Examination and Medical Council of India will certainly help in recognition of well- structured super-specialty course.