Training in community pediatrics: a national survey of program directors.
OBJECTIVE
To describe the spectrum of residency training in community-based settings, assess the extent of resident education on community pediatrics topics, and determine whether educational activities vary by program size or availability of primary care tracks.


METHODS
Survey of US pediatric residency program directors from May-September 2002. A 10-item self-administered questionnaire assessed the programs' extent of resident involvement in 15 selected community-based settings and inclusion of didactic or practical education regarding 13 community health topics.


RESULTS
Of 168 programs surveyed (81% response rate), 40% were small (< or =30 residents), 35% were medium (31-50 residents), 25% were large (>50 residents), and 15% had primary care tracks. Frequently required community-based settings included schools (69%), child protection teams (62%), day care centers (57%), and home visiting (48%). Of 15 community-based settings, 28% required involvement in fewer than 4, 41% required involvement in 4-6, and 31% required involvement in 7 or more. More than two-thirds offered didactic teaching and practical experience on issues related to managed care, cultural competency, and the mental health and social service systems. There were no differences in the number of required community-based settings by program size or presence of primary care tracks.


CONCLUSIONS
Most pediatric residency programs require exposure to community-based settings and provide education on various community health topics. Ongoing challenges include continued implementation amid work duty hour limitations, best practice models for practical implementation of community-based experience into residency training, and the impact of such training on future involvement in the community and physician practice.
Solomon
Barry S
BS
Dyson Initiative National Evaluation (DINE) Team, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. bsolomon@jhmi.edu
Minkovitz
Cynthia S
CS
Mettrick
Jennifer E
JE
Carraccio
Carol
C
D003153:Community Health Services; D003479:Curriculum; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D010344:Patient Advocacy; D010372:Pediatrics / Q000193:education*; D012106:Research; D014481:United States