Published online December 16, 2008
PEDIATRICS Vol. 123 Supplement January 2009, pp. S31-S37 (doi:10.1542/peds.2008-1578I)

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Freed, G. L. Search for Related Content PubMed PubMed Citation Articles by Freed, G. L. Related Collections Office Practice Social Bookmarking                         What's this?

SUPPLEMENT ARTICLE

Pediatric Fellows: Perspectives on Training and Future Scope of Practice

Gary L. Freed, MD, MPH^a,b, Kelly M. Dunham, MPP^a,b, Kara E. Switalski, MPH^a,b, M. Douglas Jones, Jr, MD^c, Gail A. McGuinness, MD^d and the Research Advisory Committee of the American Board of Pediatrics

^a Child Health Evaluation and Research Unit, Ann Arbor, Michigan
^b Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan
^c Department of Pediatrics, University of Colorado Denver, School of Medicine, Aurora, Colorado
^d Executive Vice-president, American Board of Pediatrics, Chapel Hill, North Carolina

OBJECTIVE. Training for pediatric residents who intend to pursue fellowship differs little from training for residents who intend to practice general pediatrics. It is unknown how well residents who intend to pursue subspecialty training believe that residency prepares them for subspecialty fellowships or future careers. To characterize the strengths and weaknesses of residency training and the factors influencing subspecialty choice from the perspective of subspecialty fellows, we conducted a survey of current fellows on these issues.

METHODS. A random sample of 1000 physicians who were entering their second or third year of fellowship in the United States in 2007 received a structured questionnaire by mail. The survey focused on decision-making in selection of residency and fellowship programs, strength of residency training in preparation for fellowship, and plans for future practice.

RESULTS. The overall response rate was 81%. A majority of the fellows would not have shortened their general pediatrics residency before fellowship if given the option (64% [n = 482]). However, more than half (52% [n = 390]) of the fellows would have chosen a 2-year fellowship without research or scholarly activity over the current 3-year structure. Few current fellows believed they could have used any additional training in the areas of patient safety, coordination of care for children with complex illnesses, or patient communication.

CONCLUSIONS. The finding that a large proportion of fellows would opt for shortened subspecialty training should prompt discussion and debate within the profession regarding the skills necessary for a pediatric subspecialist. Patient safety, physician-parent communication, and care coordination are emphasized primarily through informal training during residency. Although most clinicians believe themselves to be adequately prepared, research has identified gaps in clinician skills and understanding of these issues of great importance to patients and their families.

---

Key Words: fellows • subspecialists • training • career choice • residency

---

Accepted Sep 22, 2008.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. D. Jones Jr, G. A. McGuinness, L. R. First, L. K. Leslie, and and the Residency Review and Redesign in Pediatric Linking Process to Outcome: Are We Training Pediatricians to Meet Evolving Health Care Needs? Pediatrics, January 1, 2009; 123(Supplement_1): S1 - S7. [Abstract] [Full Text] [PDF]

				G. L. Freed, K. M. Dunham, K. E. Switalski, M. D. Jones Jr, G. A. McGuinness, and and the Research Advisory Committee of the America Recently Trained General Pediatricians: Perspectives on Residency Training and Scope of Practice Pediatrics, January 1, 2009; 123(Supplement_1): S38 - S43. [Abstract] [Full Text] [PDF]

				L. K. Leslie What Can Data Tell Us About the Quality and Relevance of Current Pediatric Residency Education? Pediatrics, January 1, 2009; 123(Supplement_1): S50 - S55. [Abstract] [Full Text] [PDF]