OBJECTIVES: To examine pediatric residents' research experiences during residency and to explore whether residents' attitudes toward research are related to their decision to pursue subspecialty fellowships. STUDY DESIGN: A national random sample of 500 PL-3 pediatric residents completing training in 2001 was surveyed. Responses were obtained from 318 residents (64%). Resident research experiences and perceived competence were compared for residents planning to pursue subspecialty training (34%) and residents who were not (66%). RESULTS: Residents interested in a subspecialty were more likely to have had formal research training (39% vs 27%) and to have assisted on a research project (26% vs 14%) during residency. Upon residency completion, residents in both groups rated their knowledge of most research skills as being fair or poor. A favorable rating toward research was the strongest predictor of whether residents have subspecialty rather than general pediatrics as their future clinical goal (OR=3.7). CONCLUSIONS: Given residents' limited research exposure and the strong association found between residents' research attitudes and their plans to pursue subspecialty training, serious consideration should be given to the possible benefits of research promotion programs, which may lead to increased resident interest in pediatric fellowships and pediatric research.

Career Mobility↗

PubMed2003

Developmental and behavioral pediatric practice patterns and implications for the workforce: results of the Future of Pediatric Education II Survey of Sections Project.

A survey of developmental-behavioral pediatricians was conducted to obtain data and insights on their current practice. As part of the Future of Pediatric Education (FOPE) II Survey of Sections Project, questionnaires were sent to individuals who were most likely to represent those pediatricians engaged in the subspecialty of developmental-behavioral pediatrics. Four groups of physicians were compared within the survey: developmental-behavioral fellowship group (n = 272), developmental disabilities fellowship group (n = 139), general academic pediatrics or other fellowship group (n = 57), and a nonfellowship group (n = 224). A majority of respondents indicated a need for an increased number of subspecialists in developmental-behavioral pediatrics in their community during the next 3 to 5 years. There were significant differences in the survey results of a variety of practice issues between those who had and had not received formal fellowship training. The survey data illustrate a developmental-behavioral pediatrician workforce that is becoming increasingly fellowship trained, receiving more referrals, and encountering constraints to seeing more patients in an era of declining reimbursement for services. To overcome these obstacles, stakeholders in child health, including health care payers, will need to be educated about the unique skills and clinical expertise of physicians in developmental-behavioral pediatrics and neurodevelopmental disabilities.

Child↗

PubMed2002

A hair tourniquet resulting in strangulation and amputation of the clitoris.

BACKGROUND: Hair tourniquet syndrome involves fibers of hair or thread wrapped around an appendage producing tissue necrosis. Appendages commonly involved include the toe, finger, and penis. We report a hair tourniquet resulting in amputation of the clitoris. CASE: An adolescent presented with a 4-year history of intermittent genital pain that increased in severity over the preceding 5 days. Physical examination revealed a necrotic clitoris surrounded by a black hair. During the examination, the tissue fell off resulting in immediate improvement in the patient's pain. CONCLUSION: We report a case of a clitoral hair tourniquet syndrome leading to autoamputation of the clitoris. A high index of suspicion for this condition is important because of the potential consequences of delayed treatment.

Adolescent↗

PubMed2002

Pediatricians working part-time: past, present, and future.

BACKGROUND: Pediatrics has consistently attracted a large number of women. Although the majority of practicing pediatricians are male, female pediatricians will soon constitute the majority. The challenge to balance personal and professional life is of particular concern to women, and part-time positions may provide a potential solution. OBJECTIVE: To examine how many pediatricians currently work part-time, to examine trends in part-time employment from 1993 to present, to determine pediatric residents' interest in part-time employment, and to identify perceived barriers to part-time work. DESIGN/METHODS: Two data sources were used for these analyses. The first was an American Academy of Pediatrics Periodic Survey from 1993 and 2000 asking a combined national sample of 3218 American Academy of Pediatrics members about their employment status. Multiple mailings were conducted for each survey producing an overall response rate of 62%. The second data source was a survey asking a national random sample of 500 pediatric residents completing training in 2000 about their job search experiences and attitudes toward part-time employment. Four mailings of this survey were completed, and responses were obtained from 71% of residents. RESULTS: The percentage of pediatricians working part-time increased from 11% in 1993 to 15% in 2000. This increase did not exceed what would be expected based on the rise in the percentage of pediatricians who are female from 36% in 1993 to 45% in 2000. On average, pediatricians working part-time provided 36% fewer direct patient care hours than full-time pediatricians (42 hours vs 27 hours). No statistically significant difference in direct patient care hours was apparent between male and female pediatricians working full-time. Female residents were more likely than male residents to consider part-time or reduced-hours positions (42% vs 14%) and to accept part-time or reduced-hours positions (14% vs 3%). Also, considerably more female residents (58%) than male residents (15%) indicated that they would be interested in arranging a part-time position within the next 5 years. The most commonly perceived barriers to working part-time by both male and female residents included loss of income (70%), reduction in job benefits such as health insurance (47%), and loan repayment (46%). When those who reported some interest in part-time employment were asked how they would spend their extra time, most reported that they would address family needs related to children (females: 92%; males: 63%). Finally, residents interested in working part-time were more likely to be without a position when surveyed than residents not interested in part-time work (15% vs 2%). CONCLUSIONS: The relative percentages of female pediatricians and pediatricians working part-time will likely continue to grow. As a result, the total direct patient care hours available for children may be reduced. Pediatric practices will benefit by better accommodating the needs of pediatricians to balance work and family goals, and future workforce projections and training decisions must begin taking part-time employment rates into account.

Appointments and Schedules↗

PubMedDate not supplied

The need for a developmental approach to adolescent decision-making.

Explore the source record for details and available documents.

Adolescent↗