title: Reentry to Pediatric Residency After Global Health Experiences.
abstract: OBJECTIVE
  Although nonphysician reentry transitions have been characterized in literature, little is known about the reentry physicians in general, or residents in particular. We conducted a qualitative study to explore pediatric residents' reentry, using reverse culture shock as a conceptual framework.
  
  
  METHODS
  Eighteen pediatric residents who completed global health experiences in Africa (9 categorical residents with 1-month elective, 9 global child health residents with 12-month training) participated in interviews that included a card-sort to solicit emotional responses consistent with the conceptual framework. Data in the form of interview transcripts were coded and analyzed according to principles of grounded theory.
  
  
  RESULTS
  All pediatric residents, despite variable time abroad, reported a range of emotional responses on reentry to residency. Global child health residents felt disconnection and frustration more intensely than categorical residents, whereas categorical residents felt invigoration more intensely than global child health residents. Although residents met with program leadership after their return, no resident described these meetings as a formal debriefing, and few described a deliberate strategy for processing emotions on reentry.
  
  
  CONCLUSIONS
  Consistent with reverse culture shock, pediatric residents felt a range of emotions as they move toward a steady state of acculturating back into their residency program. Residency programs might consider creating safety nets to help cultivate support for residents when they reenter training.
authors.affiliation: Texas Children's Hospital, Houston, Texas; andBaylor College of Medicine, Houston, Texas dbalmer@temple.edu.
authors.forename: Dorene F
authors.initials: DF
authors.lastname: Balmer
authors.affiliation: Texas Children's Hospital, Houston, Texas; andBaylor College of Medicine, Houston, Texas.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Marton
authors.affiliation: Texas Children's Hospital, Houston, Texas; andBaylor College of Medicine, Houston, Texas.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Gillespie
authors.affiliation: Texas Children's Hospital, Houston, Texas; andBaylor College of Medicine, Houston, Texas.
authors.forename: Gordon E
authors.initials: GE
authors.lastname: Schutze
authors.affiliation: Texas Children's Hospital, Houston, Texas; andBaylor College of Medicine, Houston, Texas.
authors.forename: Anne
authors.initials: A
authors.lastname: Gill
mesh_terms: D000349:Africa; D003466:Cultural Characteristics; D004644:Emotions; D005260:Female; D014943:Global Health; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education*; D010820:Physicians / Q000523:psychology*