Adolescent medicine also known as adolescent and young adult medicine is a medical subspecialty that focuses on care of patients who are in the adolescent period of development. This period begins at puberty and lasts until growth has stopped, at which time adulthood begins. Typically, patients in this age range will be in the last years of middle school up until college graduation (some doctors in this subspecialty treat young adults attending college at area clinics, in the subfield of college health). In developed nations, the psychosocial period of adolescence is extended both by an earlier start, as the onset of puberty begins earlier, and a later end, as patients require more years of education or training before they reach economic independence from their parents.
Medicine is often categorized most simply as pediatric and adult, with the pediatric category covering from infancy through both childhood and adolescence. However, such categorization is further divided in some contexts, such that adolescent medicine can be a more specific focus within pediatrics and geriatrics can be a more specific focus within adult medicine.
Issues with a high prevalence during adolescence are frequently addressed by providers. These include:
Unintended pregnancy (working with specialists in adolescent obstetrics and gynecology, especially in neonatology and maternal-fetal medicine; many – though not all – are medically risky or high-risk cases or to those with psychosocial, environmental, and socioeconomic challenges)
Birth control (access to prescription or non-prescription contraceptive methods)
Certain mental illnesses (especially personality disorders, anxiety disorders, major depression and suicide, bipolar disorder, and certain types of schizophrenia; in concert with mental health counselors, clinical psychologists, and pediatric psychiatrists specializing in adolescent health care)
Adolescents who are gay, lesbian or bisexual tend to demonstrate more risky health behaviors and have worse health outcomes compared to heterosexual youth, including:
Eating disorders and body image
Sexual behaviors, including unintended pregnancy involvement (Contrary to assumptions, gay, bisexual or lesbian youth are more likely to report involvement in pregnancy compared to their heterosexual peers)
Homelessness, which affects health and access to care
The rising dominance of chronic conditions over acute conditions, along with dramatic improvement in life expectancy, has made the management of such chronic conditions in adolescence of greater importance: Chronic conditions and adolescent development are mutually impactful.
Chronic conditions often cause delay in onset of puberty and temporary or permanent impediments to growth; conversely the growth and hormonal changes can destabilize treatment for the chronic condition. An increase in independence can lead to gaps in self-management, for example, in the decreased management of diabetes.
Marginalised young people’s access is affected by their ability to recognize and understand health issues; service knowledge and attitudes toward help seeking; structural barriers; professionals' knowledge, skills, attitudes; service environments and structures; ability to navigate the health system; youth participation; and technology opportunities. Marginalised young people’s healthcare journeys can be supported by advocates that help them navigate the health system.
Adolescent medicine providers are generally drawn from the specialties of pediatrics, internal medicine, med/peds or family medicine. The certifying boards for these different specialties have varying requirements for certification, though all require successful completion of a fellowship and a passing score on a certifying exam. The American Board of Pediatrics and the American Board of Internal Medicine require evidence of scholarly achievement by candidates for subspecialty certification, usually in the form of an original research study.
List of adolescent health centers in the United States
Many subspecialists practice as part of general specialty clinics or practices, or in high school or college clinics. In addition, many major metropolitan areas have clinics that offer adolescent-specific care. A partial list includes:
In the United States, the subspecialty of college health is closely affiliated with adolescent medicine. Many adolescent medicine fellowships include rotations in college-based student health clinics and many adolescent medicine physicians work in college health clinics.
In addition to membership in the organizations for their various specialties, adolescent medicine providers often belong to The Society for Adolescent Health and Medicine and/or The North American Society for Pediatric and Adolescent Gynecology.
Founded in 1987, the International Association for Adolescent Health (IAAH) is a multidisciplinary, non-government organization with a broad focus on youth health.
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Office of Adolescent, U.S. Department of Health, Health and Human Services
Adolescent Medicine: State of the Art Reviews
The Society for Adolescent Health and Medicine
International Association for Adolescent Health
The North American Society for Pediatric and Adolescent Gynecology