Adolescent medicine training in pediatric residency programs.
OBJECTIVE
The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine.


METHODS
We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience.


RESULTS
Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training.


CONCLUSIONS
Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.
Fox
Harriette B
HB
National Alliance to Advance Adolescent Health, Washington, DC 20006, USA. hfox@thenationalalliance.org
McManus
Margaret A
MA
Klein
Jonathan D
JD
Diaz
Angela
A
Elster
Arthur B
AB
Felice
Marianne E
ME
Kaplan
David W
DW
Wibbelsman
Charles J
CJ
Wilson
Jane E
JE
D000293:Adolescent; D000295:Adolescent Medicine / Q000193:education*; D000328:Adult; D002983:Clinical Competence; D003479:Curriculum; D003625:Data Collection; D004503:Education, Medical, Graduate / Q000592:standards / Q000639:trends; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D010372:Pediatrics / Q000193:education*; D016730:Program Development; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult