I congratulate the INDO-US group for advocating the need for Pediatric Emergency Medicine (PEM) as a super-specialty in India. The document states that "the concept of PEM is virtually non-existent in India [1]." I wish to share an experience that is contrary to this statement.

The 180-year-old, Madras Medical College, to which the Institute of Child Health (ICH) is affiliated, has an annual intake of 250 under-graduates and 54 pediatric post graduates. Established in 1997, our Pediatric Emergency Department (PED) was equipped by Japan’s International Cooperation Agency [2]. To sustain the project, the Tamil Nadu government sanctioned a faculty position in PEM. Over, the next 18 years, an overwhelming number of seriously ill and injured children were managed [3]. As septic shock was the commonest cause of mortality, a shock protocol was tested [4]. Lessons learnt were video-taped and conducted as the "Paediatric Emergency Medicine Course" [5]. In 2010, our University made completion of this course compulsory for house officers during their internship. Since 2011, a post-doctoral fellowship course is being conducted under the auspices of the University.

Under-five mortality due to infections is high in developing countries and emergency care reduces mortality. Despite significant differences in the morbidity profile of emergency visits in India [3], the INDO-US group reports that "PED in India is not an ED in the true sense". Denying PEM’s existence in India is self-defeating in the pursuit of recognition of super-specialty status. Acknowledging that academic PEM in India might be different from the US, and engaging local expertise could help in achieving the much needed recognition for PEM super-specialty training.

1. Mahajan P, Batra P, Shah B, Saha A, Galwankar S, Aggrawal P, et al. The 2015 Academic College of Emergency Experts in India’s INDO-US Joint Working Group white paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India. Indian Pediatr. 2015;52:1061-71.

2. Improvement of Medical Equipment for ICH. Ex-post Evaluation V Evaluation by Overseas Offices. Available from: www.jica.go.jp. Accessed January 06, 2016.

3. Santhanam I, Pai M, Kasthuri KR, Radha MM. Mortality after admission in the pediatric emergency department: A prospective study from a referral children’s hospital in Southern India. Pediatr Crit Care Med. 2002;3:358-63.

4. Santhanam I, Sangareddi S, Venkataraman S, Kissoon N, Thiruvengadamudayan V, Kasthuri RK. A prospective randomized controlled study of two fluid regimens in the initial management of septic shock in the emergency department. Pediatr Emerg Care. 2008;24:647-55.

5. Santhanam I. Septic shock. In: Santhanam I, editor. Pediatric Emergency Medicine Course. 2nd ed. New Delhi: Jaypee Brothers; 2013. p. 143-57.