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Health & Exercise Forum

An Introduction to Adolescent Medicine: Part 1 of 3

Jan 6, 2014
Cara Lyle

Cara Lyle

The 2013 Commonwealth Medical College Healthcare Journalism Award: Congratulations to Cara A. Lyle, as the recipient of the 2013 TCMC Healthcare Journalism Award by Dr. Paul Mackarey! The award recognizes Cara’s excellence and dedication as a medical student and healthcare journalist.

Cara A. Lyle is a 4th year medical student and a member of the second class at The Commonwealth Medical College (TCMC). She was born in Pittsburgh, PA and raised in Ford City, PA.  She earned a Bachelor of Science in Biology with a Minor in Chemistry at The University of Pittsburgh.  She is currently applying for a residency in General Surgery.  She enjoys spending time with her family, art and art history, traveling and staying active by working-out, going for walks or playing sports.  Writing has also been a special interest of hers throughout her education and she is excited to continue to pursue this interest while in medical school.

What is Adolescent Medicine?

Parents, you know the feeling of a hug from your young child.  Though their arms barely reach beyond your shoulders, they throw their light weight on you and you feel their heavy love.  There’s nothing quite like it.  This love and admiration continues to grow as they do and a great bond is built between you and your child.  Then…they become teenagers.

I am very familiar with this transformation despite being a childless twenty-something.  Not too long ago I made this transition myself… we all have.  Beyond this commonality we all share, I have developed a special interest in the needs and care of adolescents.

I grew up in a small town in Western Pennsylvania.  Most of mother’s family lives within a few miles of each other, which allows for my aunts, uncles and cousins to be a constant presence in my life.  As one of the older cousins in a group of 20, I loved babysitting for my younger cousins.  I have had many of those love-filled hugs and have watched a few of them transition into adolescents and young adults.  Through their difficult times, I’ve tried my best to help in a role mixed of friend, sibling and parent.  Now, as a medical student, I recognize the importance of bringing awareness to adolescence. My history as a confused teen and study of medicine at TCMC have sparked a keen interest in adolescent medicine because I hope to make the journey a little easier and healthier for the next parent – teen conflict.


For many parents, their teen takes on an alien form, a direct opposition to that adorable, loving child.  Hugs are repulsing and painful behaviors and admiration for parents is an uncomfortable and disturbing feeling.  In the world of a teenager, the planet can be as complicated as their form:  filled with desires for social acceptance, or the emptiness of social isolation, adjustment to a changing body, positive or negative body image, peer pressures, the journey to self-acceptance and more.

Recognizing such manners in our past adolescent selves, or in the adolescents among us, makes it easy to understand why adolescents would need their own subspecialty, or narrow area of study or concentration, in medicine.  However, this need wasn’t always so obvious.  It took some time, historical change and scientific advancements for this subspecialty to emerge.



According to,The History of Adolescent Medicine, the predecessors to formalized adolescent medicine as early back as the late 19th century in England.  Physicians in England treating adolescent boys at boarding schools established an association.  During the post-World War I era, universities began offering medical services for college students.  Then, came the post-World War II era, the period in which the adolescent masses grabbed the much needed attention of society and the medical community.

According to the journal, Pediatric Research, by the early 1960s, America saw its teenage population increase dramatically from 30 million to 40 million.  The change in the values and numbers of the youth of America led to what the authors described as: "rejection of traditional religious, work, and interpersonal values by an increasingly independent and growing youth population in the 1960s led to more sexual experimentation, inconsistent contraceptive practices, wide use of illicit drugs, cigarettes and alcohol and secondary as well as postsecondary school failure."

Advances in various fields of medicine fortunately followed these changes and increases in high risk behaviors.  Psychiatry recognized that mental health problems show up in adolescence.  Gynecology had technological advancements including, but not limited to, the Papanicolau or “Pap” smear.  Named after Dr. Papanicolau, the Pap smear revolutionized preventative medicine for sexually active teens.  Chronic disease management saw improvements as well.  Children once at risk for dying during childhood began living into adolescence because of advancements in surgery, organ transplantation, chemotherapy and others.

These fields of medicine had been working independently and without focus on the adolescent patient, but came together to address the needs of the nation’s masses of adolescents.  A formalized field of adolescent medicine was established in the late 20th century.  By 1994, the first exam for certification in adolescent medicine was given by The American Board of Pediatrics.  Training programs in adolescent medicine quickly followed.  According to the Society for Adolescent Health and Medicine,there are presently 26 adolescent medicine training programs, 2-3 years in duration, available to medical doctors who first specialized in pediatrics or internal medicine.

Adolescence is a difficult and trying time for many teens.  More than ever, the medical community is prepared to address the needs of adolescents.  I hope readers have gained awareness, an appreciation for and a better understanding of the subspecialty of adolescent medicine.  Yet, how does a parent or friend, know if the teenager in their life is navigating through adolescence without cause for concern?  Find out in Adolescent Medicine Part 2 of 3:  “When is erratic behavior cause for concern?”

For More Information About this topic:

Pediatric Research <>.

Visit your doctor regularly and listen to your body.

Keep moving, eat healthy foods, exercise regularly, and live long and well!

Read Dr. Mackarey’s Health & Exercise Forum in the Scranton Times-Tribune every Monday. Next week: Adolescent Medicine Part 2 of 3.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at The Commonwealth Medical College.