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Training in Community Pediatrics: A National Survey of Program Directors

  • Barry S. Solomon
    Correspondence
    Address correspondence to Barry S. Solomon, MD, MPH, Johns Hopkins University School of Medicine, 600 North Wolfe St, Park 387, Baltimore, MD 21287
    Affiliations
    From the Dyson Initiative National Evaluation (DINE) Team: Department of Pediatrics (Drs Solomon and Minkovitz), Johns Hopkins University School of Medicine, Baltimore, Md; Department of Population and Family Health Sciences (Dr Minkovitz and Ms Mettrick), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; and Department of Pediatrics (Dr Carraccio), University of Maryland School of Medicine, Baltimore, Md
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  • Cynthia S. Minkovitz
    Affiliations
    From the Dyson Initiative National Evaluation (DINE) Team: Department of Pediatrics (Drs Solomon and Minkovitz), Johns Hopkins University School of Medicine, Baltimore, Md; Department of Population and Family Health Sciences (Dr Minkovitz and Ms Mettrick), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; and Department of Pediatrics (Dr Carraccio), University of Maryland School of Medicine, Baltimore, Md
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  • Jennifer E. Mettrick
    Affiliations
    From the Dyson Initiative National Evaluation (DINE) Team: Department of Pediatrics (Drs Solomon and Minkovitz), Johns Hopkins University School of Medicine, Baltimore, Md; Department of Population and Family Health Sciences (Dr Minkovitz and Ms Mettrick), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; and Department of Pediatrics (Dr Carraccio), University of Maryland School of Medicine, Baltimore, Md
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  • Carol Carraccio
    Affiliations
    From the Dyson Initiative National Evaluation (DINE) Team: Department of Pediatrics (Drs Solomon and Minkovitz), Johns Hopkins University School of Medicine, Baltimore, Md; Department of Population and Family Health Sciences (Dr Minkovitz and Ms Mettrick), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; and Department of Pediatrics (Dr Carraccio), University of Maryland School of Medicine, Baltimore, Md
    Search for articles by this author
      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 (≤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.

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