146 - Challenges in meeting pediatric training requirements: A CERA Study of Family Medicine Program Directors

Poster Number: 146
Publication Number: 146.218

Scott D. Krugman, Sinai Hospital of Baltimore, Baltimore, MD, United States; Aimee R. Eden, ABFM, Lexington, KY, United States; Zachary J. Morgan, American Board of Family Medicine, Lexington, KY, United States; Laura Hodo, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Background: The number of family physicians who care for children has decreased steadily over the past few decades. In response to this trend, in 2014 the ACGME implemented new requirements that changing the quantity of required pediatric patient encounters. It is not clear how residency programs adapted to meet these requirements.

Objective: To describe the current state of pediatric training in family medicine residencies and any challenges faced by program directors in meeting new program requirements.

Design/Methods: Questions about pediatric training in family medicine residencies were part a larger omnibus survey conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA) and emailed to 664 family medicine program directors. We analyzed the frequency of demographic variables and performed bivariate analyses of program-level variables and outcomes using SAS. The primary outcome measure was difficulty meeting pediatric required encounter numbers.  Comparator variables included demographic characteristics, curricular characteristics, and training setting. Chi-square tests of independence were used to test for bivariate statistical associations between the chosen variables.

Results: The demographic descriptions of the responding 312 family medicine residency programs (47% response rate) are shown in Table 1. Overall, 60% of the programs were community based but university affiliated. Programs averaged 5 months of pediatric specific block time with 46% (n=131) and only 22% (n=61) reported a pediatrician on core faculty (Table 2). The majority of programs reported the hospital as the primary location of training (Table 3) with 90 programs (32%) reporting a mixture of locations. Only 19% (Nf55) of program directors reported no challenges meeting the program requirements for the care of children (Table 4). We found statistically significant differences in challenges based on percentage Family Health Center Patients under 19 years of age (p = < .0001 ), percentage core family medicine faculty caring for sick children (p=0.0128), and primary location of pediatric training (p=.0006).Conclusion(s): Most family medicine programs have challenges meeting program requirements related to pediatric care. This may have implications for scope of family medicine practice and access to care for American children. More research is needed to elucidate the optimum training locations for family medicine residents to meet the ACGME requirements for the care of children.
Table 1. Demographic Characteristics of Programs
Table 2: Program director report of care of children in their program