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Pediatric Subspecialty Fellowship Clinical Training Project: Recent Graduates and Midcareer Survey Comparison

Gary L. Freed, Kelly M. Dunham, Lauren M. Moran, Laura Spera, Gail A. McGuinness, David K. Stevenson on behalf of the Research Advisory Committee of the American Board of Pediatrics

The American Board of Pediatrics charged a task force to examine fellowship training. As part of that process, a study was conducted to assess the perceptions of fellowship training by those who had recently completed training and those who were in the middle of their careers.

The American Board of Pediatrics provided a random sample of subspecialists stratified across all 14 subspecialties (N = 5072). Subspecialists were identified either as recent graduates (N = 2702), those who had completed fellowship within the last 5 years or as midcareer subspecialists (N = 2370), and those who completed fellowship 15 to 20 years ago. Two distinct 20-item structured questionnaires were administered by mail, 1 for each group, in January through March 2012. χ2 Statistics were used to assess differences between groups.

Response rates were 77.8% for recent graduates and 73.8% for midcareer subspecialists. Overall, most subspecialists described their work primarily as a clinician (36%) or as a clinician-educator (48%). Fewer (12%) reported primarily research. The majority of subspecialists (55%) have full-time academic appointments, but recent graduates are more likely to do so than midcareer subspecialists (62% vs 48%; P < .0001). The majority (60%) believe that the overall length of training in their subspecialty should remain at 3 years. However, almost one-third (29%) believe there should be 2 different tracks in their subspecialty, shorter for clinicians and/or clinician-educators and longer for those pursuing an academic career.

We found a significant range of opinion regarding subspecialty training. Some of this variation is undoubtedly due to differences between the individual subspecialties.