Do pediatric fellows recognize the importance and contribution of training to mastery of the general competencies?

Six general competencies form the framework for accreditation of postgraduate fellowship programs and maintenance of certification for physician specialists. Fellows' perceptions of these competencies, however, remain unexplored.

To examine fellows' perceptions of the importance of the competencies to medical education and the contribution of fellowship training to mastery of the competencies, and to explore the alignment of the competencies with critical learning experiences.

Semi-structured interviews were conducted with 20 pediatric fellows in five divisions at one institution. Fellows recounted critical learning experiences, rated each competency for importance and contribution of training, and explained their ratings. Interviews were analyzed using standard qualitative methods.

Fellows assigned high ratings to medical knowledge and patient care for importance and contribution of training to mastery, referring to these competencies as 'staples of training'. They rated interpersonal and communication skills and professionalism higher for importance than contribution of training, viewing them as inherent traits or learned before fellowship. Fellows were unfamiliar with practice-based learning and improvement and systems-based practice and typically perceived them as secondary to training. Descriptions of critical learning experiences substantiated competency ratings for medical knowledge and patient care, but not practice-based learning and improvement.

Fellows perceive traditional knowledge and skills of medical practice as fundamental to postgraduate training, but other competencies as less central.