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Pediatric residents' continuity clinics: how are we really doing?
M C Dumont-Driscoll1, L T Barbian, B H Pollock
1Department of Pediatrics, University of Florida College of Medicine, Gainesville 32610, USA.
Pediatrics
|October 1, 1995
Summary
Pediatric residency programs often lack resources and protected time for continuity clinics (CCs), impacting resident education and patient care despite Accreditation Council for Graduate Medical Education (ACGME) guidelines. Enhancements are needed for effective ambulatory medicine training.
Area of Science:
- Medical Education
- Pediatrics
- Health Services Research
Background:
- The Accreditation Council for Graduate Medical Education (ACGME) mandated continuity clinics (CCs) for pediatric residents in 1989.
- These clinics are intended to provide longitudinal patient care experience and training in ambulatory medicine.
Purpose of the Study:
- To evaluate the current state of pediatric continuity clinics.
- To identify factors influencing resident education and patient care within these clinics.
Main Methods:
- A survey was distributed to directors of continuity clinics across US pediatric residency programs.
- The questionnaire assessed educational, administrative, and clinical aspects of the CCs.
Main Results:
- 164 programs (74.9%) responded, representing over 90% of US pediatric residents.
- 55% of programs had non-ACGME-approved attendance exemptions, and 64% altered schedules based on inpatient rotations.
- Many clinics lacked core curricula, adequate resources, faculty, and support staff, limiting patient continuity and resident experience.
Conclusions:
- Many pediatric residency programs fail to provide adequate priority, protected time, or resources for continuity clinics, despite ACGME requirements.
- Continuity clinics are crucial for teaching longitudinal and ambulatory medicine, especially with current healthcare reform and primary care education focus.
- Enhanced departmental support and dedicated resources are essential to improve the educational value and effectiveness of continuity clinics.