Pediatric Residency…Here Comes More Changes!

Pediatric Blog

Pediatricians who are not practicing in the academic realm may be interested to know that more changes are coming for residents during their training. One new requirement that I look forward to helping create at my institution is career tracks. I think this is a great idea, which will hopefully enhance pediatric residency and pediatric skills.

In the early 2000s, duty hour restrictions were enforced, and even more restrictions were applied to interns’ work hours in 2011. Today, an intern cannot work more than a 16-hour shift! Imagine that. As a residency program director, I’m planning to attend both a national and a regional meeting this fall to prepare for the newest requirements that are set to begin in July 2013.

The 2 big changes to programs in all fields of medicine are: the implementation of the next accreditation system by the Accreditation Council for Graduate Medical Education (ACGME), and the use of Milestones for resident evaluations. Just like the milestones we use in the developmental evaluation of children, the residency milestones will assess performance along a continuum. However, the “milestones” for which the resident will be evaluated will not be whether he or she has a good pincer grasp or is able to ride a tricycle, but rather whether he or she has the ability to perform “entrustable professional activities,” or the daily duties and skills required of a pediatrician.

The requirement of career tracks in pediatric training has great potential. Residents will likely have more job satisfaction and have some specialization included in their training to help them toward their ultimate career goals—whether they aspire to be a general pediatrician who works mainly in the outpatient setting or whether they hope to work as a pediatric hospitalist or subspecialist, and so on. Residents will work with their faculty mentor who will assist this process. Exactly how career tracks will work is one of the topics that will be discussed at the pediatric meetings this fall.

What rotations helped you? General pediatricians and subspecialists can reflect on which particular residency experiences or rotations enhanced their performance in their current positions and which were not so beneficial. I know I felt like I was in the neonatal ICU way too much when I was a resident. However, a few general pediatricians who practice in rural areas have told me that they wish they had more neonatal ICU training because they have to attend high-risk deliveries. These pediatricians are also thankful for the resuscitation skills they honed during their months in the neonatal ICU. I encourage readers to write on their own residency experiences and the effect they have had—or not had—on their current practice.