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Are Final Residency Milestones Correlated With Early Fellowship Performance in Pediatrics?
Suzanne Reed1, Richard Mink2, Joseph Stanek3
1S. Reed is associate professor and pediatric residency associate program director, Department of Pediatrics, The Ohio State University College of Medicine/Nationwide Children's Hospital, Columbus, Ohio.
Summary
Residency milestones show weak correlation with early fellowship performance in pediatrics. Fellowship programs should use residency scores cautiously for individualized training, as milestones are context-dependent.
Area of Science:
- Medical Education Research
- Graduate Medical Education
- Pediatric Subspecialty Training
Background:
- Milestones assess trainee development from novice to expert in graduate medical education.
- Assessing the correlation between residency and fellowship performance is crucial for program evaluation.
Purpose of the Study:
- To examine the correlation between residency milestones and initial fellowship milestone performance in pediatrics.
- To determine if residency milestone scores predict early fellowship success.
Main Methods:
- Retrospective cohort study of 3,592 pediatric fellows (2017-2020).
- Analysis of milestone scores at end of residency (R), mid-first fellowship year (F1), and end of first fellowship year (F2).
- Descriptive statistics and Spearman correlation used to assess milestone associations.
Main Results:
- High composite residency (R) scores contrasted with lower early fellowship (F1, F2) scores.
- Positive but weak correlations found between R and F1 (ρ = 0.12) and R and F2 (ρ = 0.15) scores.
- Trainees from the same institution for residency and fellowship had higher F1 and F2 scores.
- Professionalism and communication milestones showed the strongest, yet still weak, associations between R and F2 scores (rs = 0.13-0.20).
Conclusions:
- Milestone performance is context-dependent, with weak associations across competencies.
- Residency milestones may inform early fellowship individualized education but should not be over-relied upon.
- Fellowship programs need to consider the limitations of residency milestone scores for predicting performance.
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