To become a pediatrician in the US, you'll earn a bachelor's degree, complete four years of medical school for an M.D. or D.O., then train in an accredited pediatrics residency with three levels, R-1 through R-3. You'll need a state medical license, and to become board certified you'll pass the American Board of Pediatrics certifying exam.
Pediatricians care for infants, children, teenagers and young adults, so the training builds broad general skills before any subspecialty. Here's the route and the board rules worth knowing early.
Figures come from the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook and the American Board of Pediatrics (ABP), read on 26 October 2026.
How to become a pediatrician, step by step
- Finish a bachelor's degree. No specific major is required, though applicants usually study biology, physical science or a health-related field.
- Take the MCAT and apply to medical school. Admission is highly competitive.
- Earn your M.D. or D.O. Medical school takes four years. The ABP requires graduation from a school accredited by the LCME, the AOA or, in Canada, the Royal College of Physicians and Surgeons.
- Complete a pediatrics residency. The ABP defines three levels of general pediatrics training, R-1 to R-3, and you must perform satisfactorily at each to move up.
- Get a medical license. All states require one. The ABP also requires a valid, unrestricted license in a US state or territory or a Canadian province before you can sit its exam.
- Pass the ABP certifying exam. Your program director must verify that you completed training satisfactorily.
The seven-year window people miss
Here's the rule that catches doctors out. Since the 2014 exam, the ABP requires that you completed your general pediatrics training within the previous seven years. Its example: for exams given in 2024, training must have been finished in 2017 or later. If you let that window close, you'll face extra requirements before you can certify.
Two more details matter. Leave beyond one month, or rotations not completed successfully, extend your residency. And training in ACGME-I programs outside the US doesn't count toward ABP certification. So plan your exam soon after residency, and check with the ABP before you change your training path.
What pediatricians earn
| Measure | Figure (May 2025) |
|---|---|
| Median pay, general pediatricians | $210,040 a year |
| Median pay, pediatric surgeons | $559,030 a year |
| Median pay, all physicians and surgeons | $275,930 a year |
| General pediatricians employed in 2025 | 42,200 |
| Projected growth, all physicians 2025 to 2035 | 4% |
Those figures are as of October 2026. General pediatricians earn less than the physician median, while pediatric surgeons, a much smaller group of 1,300, earn the most of any specialty BLS lists.
What pediatricians do
BLS says pediatricians specialize in diagnosing and treating problems specific to younger people. Most give vaccinations and treat common illnesses, minor injuries and infectious diseases, while some focus on serious conditions that affect younger patients, such as autoimmune disorders. Like all physicians, they take histories, examine patients, order and review tests and design treatment plans.
The qualities BLS highlights for physicians include compassion, communication and attention to detail, and in pediatrics you're communicating with both the child and the parents. If you're weighing other routes into children's health, compare the physician assistant route, and for mental health, see how to become a psychiatrist.
Three things to decide early
- Do I want general practice or a subspecialty? Subspecialties add a fellowship of 1 to 3 years.
- Am I good with families as well as patients? Parents are part of every consultation.
- Can I plan my boards right after residency? The seven-year window rewards it.
What medical schools look for
Getting into medical school is the first big hurdle. BLS says applicants usually submit transcripts, MCAT scores and letters of recommendation, and schools also weigh personality, leadership and extracurricular activities. Most require an interview with the admissions committee. Some schools offer combined undergraduate and medical programs that last 6 to 8 years.
If you already know you want to work with children, volunteering or working with young people builds the experience and the stories that admissions committees want to hear. Physicians work in both clinical settings, such as offices and hospitals, and nonclinical ones, such as government agencies and nonprofits, so pediatric training can lead to more than one kind of career.
My verdict
Becoming a pediatrician takes college, four years of medical school and a three-level residency, so it's a long but clear path. Choose an accredited program, keep your license unrestricted and sit your ABP exam soon after training so the seven-year window never becomes a problem. It pays less than many specialties, but few jobs in medicine are as rewarding day to day.
Frequently asked questions
How long does it take to become a pediatrician?
Four years of college, four years of medical school and a pediatrics residency with three levels of training, R-1 through R-3.
How much do pediatricians make?
BLS reports a median of $210,040 a year for general pediatricians in May 2025.
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Do pediatricians need to be board certified?
A state license is required to practice. ABP board certification is how pediatricians show they've met the specialty's standards.
Is there a time limit to take the pediatrics board exam?
Yes. The ABP requires that you completed your general pediatrics training within the previous seven years.
Can you take the ABP exam without a license?
No. The ABP requires a valid, unrestricted medical license in the US or Canada.
How many pediatricians are there?
BLS counted 42,200 general pediatricians in 2025.
Does training outside the US count?
Training in ACGME-I programs doesn't count toward ABP certification. The ABP has a waiver process for some training outside the US and Canada.
Is getting into medical school hard?
Yes. BLS says medical schools are highly competitive and look at grades, MCAT scores, recommendations and interviews.
Can pediatricians work outside hospitals and clinics?
Yes. Physicians also work in nonclinical settings, such as government agencies and nonprofit organizations.
Where do pediatricians train?
In an accredited general pediatrics residency, moving through three levels of training, R-1 to R-3.
What do pediatricians treat?
Common illnesses, minor injuries and infectious diseases in children and young people, plus vaccinations. Some focus on serious conditions such as autoimmune disorders.
Are there combined college and medical school programs?
Yes. BLS says some medical schools offer combined programs that last 6 to 8 years.
Do pediatricians need a fellowship?
Not for general pediatrics. A fellowship of 1 to 3 years is for subspecialty training.
