title: How well do paediatric residency programmes prepare residents for clinical practice and their future careers?
abstract: BACKGROUND
  Educators across Canada are presently discussing whether the current 4-year residency programmes adequately prepare paediatricians for their future careers. Studies carried out in the USA have repeatedly shown areas of weakness in residency training, but there are no studies looking at the overall adequacy of training across Canada.
  
  
  OBJECTIVE
  To assess practising paediatricians' perceptions of the adequacy of their residency training as preparation for clinical practice and to assess practising paediatricians' opinions about the required mandatory length of training.
  
  
  METHODS
  A questionnaire based on previous studies was sent to 434 paediatricians certified between 1999 and 2003, asking for their opinions of their preparedness for practice in the broad areas of paediatrics and in the professional roles of the doctor-specialist.
  
  
  RESULTS
  Overall, 239 (55%) paediatricians replied, 96% of whom indicated they were 'adequately' or 'very well' trained. Areas in which opinions on training were positive included emergency medicine, neonatology, endocrinology, haematology/oncology, neurology, infectious diseases and respirology. Areas where preparation was considered to have been less adequate included gynaecology, child psychiatry, behavioural psychology, surgical specialties, orthopaedics and adolescents. With respect to the roles of the doctor-specialist, strengths of training included the areas of medical expert, collaborator, ethics and professionalism, and communicator. Respondents felt they were less adequately prepared for the role of a medical expert dealing with palliative care, for dealing with bereaved parents and as manager of an office practice. Despite these weaknesses, 80% felt that 4 years of training was sufficient.
  
  
  CONCLUSIONS
  The results of the study are comparable with those of previous studies carried out in the USA and reinforce the need for regular programme assessment. This study will hopefully lead to the improvement of current paediatric residency programmes and enhanced education and training of future paediatricians. Although overall satisfaction with training was high, paediatric programmes need to make some changes by providing more appropriate training with less tertiary care, hospital-based training and more community and ambulatory-based experiences.
authors.affiliation: Division of Pediatric Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Lani
authors.initials: L
authors.lastname: Lieberman
authors.forename: Robert I
authors.initials: RI
authors.lastname: Hilliard
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education*; D010465:Perception; D011795:Surveys and Questionnaires