DIFFERENCES IN PEDIATRIC SUBSPECIALITY TRAINING REQUIREMENTS

Abstract

The special requirements of the Accreditation Council for Graduate Medical Education state that the subspecialty rotations in pediatric training programs should not consume more than 11 months. No guidelines are offered concerning which subspecialties should be required or offered as electives. To examine current residency training practices we polled all pediatric residencies with at least 20 residents. Of 109 programs, 37 (34%) responded. Responses showed that the number of required subspecialty months ranged from 0 (22%) to 10 (3%) with a mean of 2.9 months. Subspecialty rotations most frequently required by pediatric training programs are: development 15 (41%), cardiology 13 (35%), hematology/oncology 13 (35%) and neurology 11 (30%). Pediatric surgery is required by 7 programs (19%), while only 6 (16%) require infectious disease and only 4 programs (11%) require experience in a practitioner's office. In addition to required rotations, elective time available for subspecialty training ranged from 4 to 10 months. Required subspecialty experiences vary widely among graduates of United States training programs. Potential explanations include differences in the perception of what knowledge and expertise are required for entry into practice as well as factors other than educational considerations, such as patient service commitment and faculty influence. Whether these differences in required subspecialty training are beneficial or detrimental requires further investigation.