82
EDUCATION
GROVER F. PowFiis, M.D., Contributing Editor
PEDIATRICIANS’
REACTIONS
REGARDING
RESIDENCY
TRAINING
By ARILD E. HANSEN, M.D.#{176}
I
T IS the desire of every medical centerinterested in disorders of childhood to
improve their residency training program.
Although differences exist regarding the
ultimate objectives at various centers, it is
generally admitted that the main purpose
is to train specialized practitioners of
medi-cine for the childhood age group. In
at-tempting to find ways and means to
im-prove residency training, it seemed of value
to obtain opinions and reactions of
physi-cians practicing tile specialty in regard to
their own adequacy from past training and
experience in the practice of pediatrics. It
is the purpose of this communication to
report the results of a survey of pediatricians
by means of a brief questionnaire.
Two hundred and thirty-four
question-naires were sent to 220 members of the
Texas Pediatric Society and to 14
physi-cians who received part, or all, of their
resi-dency training at the University of Texas
Medical Branch but who are not practicing
in Texas. In the questionnaire, the
state-ment was made: “We are anxious to
im-prove the residency training program in
our institution and believe that you can be
of help to us. I am propounding the
state-ment, ‘If I had had more training in
_______
field, I would be a better
practitioner of pediatrics.’ The following
are some possibilities; please check those
you believe to be especially important or
add others.
“1. Clinical bacteriology and virology
2. Fundamentals of allergy
o From the Department of Pediatrics, Univer-sity of Texas Medical Branch, Galveston, Texas.
3. Developmental diagnosis
4. Psychiatric aspects of child behavior 5. Clinical roentgenology
6. Therapeutics
7. Electrocardiography
8.
____
_
_ - _
9.
_
- -
--_
-10.
-_
_
---- - --No attempt was made to define what was
meant by the categories listed, or to obtain
an expression of relative importance of the
subjects designated. It was believed,
how-ever, that subjects written in
(
8, 9, and 10)would have somewhat greater significance,
relatively, than those
(
1 to 7) indicatedby a check mark. A request was made to
denote the years in practice : 1-4 years,
5-14 years, 15 years or more.
The results arc summarized in table 1
regarding the chief topics of selection and
in table 2, the other subjects mentioned.
It was gratifying to receive 176 replies.
Two came back marked deceased or moved.
In other words, over 80% were returned. Re-plies came from 45 physicians in the 1-4
years group; 54 in the 5-14 years group;
and, 70 in the over 15 years group. The
number of years in practice was not
men-tioned by 7 physicians. The total number
of suggestions was 501 or 2.8 per physician.
Of these, 142 came from pediatricians in
practice 1-4 years; 156 from 5-14 years; 190
over 15 years; and, in 13 cases, the time
spent Practice was not stated.
There was no relationship between the
order in the original list and the order of
selection. Fundamentals of Allergy and
EDUCATION 83
TABLE 1
425 OF .501 SUGGESTIONS REGARDING FIELDS OF TRuNING MENTIONED BY
176 PEDIATRICIANS IN QUESTIONNAIRE
-
-Number Nutuher
- .
,‘ears in of of
Sug-. . . :%Ilergy
Practice Phvsi- gestions
..
cians Made
I I
1-4 45 109 28
5-14 .54 1Si S
Psvchi-. , .
atric 1)evelop- F1ectro-
Bacteri-. Roentgen-
fherapeu-tspeets or inentat carat- oiogy ana
. . . I ologv -. tics
niia viagnosis ograpnv iroiogy
. I
iienavior
18 21 16 15 6 .5
23 21 18 18 ‘iS 6
l5plus 70 171
Not stated 7 13
Total 176 425
34 43 ‘2 3 87 87 24 3 69
Z 23 14
1 1
.58 .57 44
11
1
23
being mentioned by about 50% of the pedia- was next (about 40% of the physicians) with
tricians (table 1). In the former, a somewhat a somewhat smaller percentage of the older
larger proportion (62%) came from the men men designating this field.
Electrocardiog-who have been in practice the shortest raphy and Roentgenology were indicated
period of time. In contrast, a somewhat by one-third of the physicians with similar
smaller proportion (62%) of the men in prac- distribution regarding the time in practice.
tice 1 to 4 years appeared to feel the need Sixth in the order of frequency (25%) was
for more work in Psychiatric Aspects of Bacteriology and Virology with relatively
Child Behavior. Developmental Diagnosis more (43%) being from physicians in the
TABLE
LESS FREQIJENTLY SUGGESTED FIELos OF TRAINING FROM QUESTIONNAIRE TO 176 PEmATuIcIANS
\‘ears . in Practice Number . Times Suggested © . -, :. a :; :-;; . :. % 1) E
.a
R -OZ . -;; I’-bo 0 1z
:#{149} I’;
-0 ‘ b 0 a “ r * ,1-4 ‘33 3 2 2 2 4 1 3 1 1 11- 1 7
- 2l 2
l5plus 19 5
4 ‘
- 11
‘
-84 REACTIONS REGARDING RESIDENCY TRAINING
5-14 year group. In spite of the great
ad-vances made ill chemotherapeutic and
anti-biotic agents, ollly 17% indicated a need for
greater knowledge in the field of
Therapeu-tics.
About 15% of the suggestions indicated
other fields of interest, Dermatology being
the highest (6.3% of the physicians) as shown
ill table 2. Only four physicians mentioned
Cardiology but it may be that most of those
who felt a need in this field had listed
Roent-genology and Electrocardiography
specifi-cally. The four who wrote in Management
of Parents were in the 1-4 year group.
Strict-ly speaking, this subject could be considered
as part of Psychiatric Aspects of Child
Be-havior, and the same may be said for How to
Live Together and The Exceptional Child.
The three who mentioned Communicable
Diseases were in the 1-4 year group. Infant
Feeding waswritten in twice-both being in
the over 15 year group.
It is encouraging to Ilote that the
prac-ticing pediatrician does not appear to feel
that he should have had more training in
such categories as Water and Electrolyte
Disturbances, Metabolic Disorders,
Con-tagious Diseases, Parasitology, Hematology,
and typically Pediatric Diagnostic
Prob-lems.
DIScuSSIoN
It would be impossible to attempt to
evaluate either the adequacy of a particular
physiciall OF the feeling of adequacy by the physician himself regarding his residency
training. It is felt, however, that the
sug-gestions indicated by these practitioners
warrant careful consideration. Inasmuch as
relatively few of the pediatricians in the
survey received their specialty training in
Texas, one perhaps is justified in assuming
that the findings are representative of the
country as a whole.
SUMMARY AND CONCLUSIONS
Q
uestionnaires sent to and returned from176 pediatricians practicing in the
South-west (mostly Texas) indicated that if their
residency training had emphasized certain
phases of medicine, they feel that they
would have been better practitioners of
pediatrics. There were 501 suggestions
made, 85% of which were in tile
follow-ing fields of interest: Allergy, Psychiatric
Aspects of Behavior Problems,
Develop-mental Diagnosis, Electrocardiography,
Roentgenology, Bacteriology-Virology and
Therapeutics. There was little difference
expressed in the listings in relation to the
