PEDIATRICS Vol. 74 No. 2 August 1984, pp. 191-197
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Adolescent Medicine: Attitudes and Skills of Pediatric and Medical Residents

Gail B. Slap MD, MS1

1 From the Section of General Medicine, Department of Medicine, Hospital of the University of Pennsylvania; and Section of Adolescent Medicine, Division of General Pediatrics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia

Adolescents receive care from different specialists whose training may affect the quality of care. To measure possible effects, all 80 level 1 and level 3 pediatric and medical residents at one institution completed a questionnaire that asked if they planned to care for adolescents and determined their attitudes and skills for 30 relevant tasks. The mean age chosen for transfer of care from a pediatrician to an internist was 18.7 years by the pediatric residents and 16.6 years by the medical residents (P = .00001). Skill in obtaining histories; staging puberty; screening for scoliosis; performing pelvic examinations; diagnosing delayed puberty, psychiatric disorders, or learning disabilities; immunizing; and treating knee and hip pain more often were thought to be important by pediatric residents (88% to 100%) than by medical residents (40% to 75%) (P < .02). More than 70% of PL-3 but fewer than 50% of ML-3 residents rated themselves skilled for these tasks (P < .05). Fewer than 60% of each resident group rated themselves skilled in contraception. Both groups rated themselves underskilled in adolescent history-taking; counseling; evaluation of psychopathology; and treatment of dysmenorrhea and hypertension. In both groups, the decision to care for an adolescent was negatively influenced by the presence of a psychosocial disorder. In conclusion, both pediatric and medical residents plan to care for adolescents, and both recognize deficiencies in their training. Pediatric residents, however, are more confident of their skills in adolescent care than are medical residents.

Key Words: adolescent medicine • internship • residency • internal medicine • pediatrics

Submitted on July 20, 1983
Accepted on October 4, 1983




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