School health in pediatric residency training: 1994

To explore efforts of pediatric residency programs to provide future pediatricians with appropriate school health skills (given the growing recognition that school health programs have a positive effect on child health).

A survey was mailed to the directors of all 214 accredited pediatric residency programs in the United States.

Based on an overall response rate of 72%, a defined clinical experience in school health is required in only 34% of programs and offered by 43%. It usually consists of occasional half days during block rotations. Content included consultation on children with chronic illness, classroom observations, and participation in school-based clinics, health education classes, and multidisciplinary team meetings. Many residency programs viewed core topics in school health as appropriate for pediatric residency curriculum, and many of them included such instruction. In the programs that offered school health, dollars were generated only 16% of the time, and the funding level was seldom significant (>$50 000).

Tomorrow's pediatricians will need training in comprehensive school health (including education, service provision, and the assurance of a medical home for some children in the school), but school health is a minor part of the curricular experience for today's pediatric residents. Future investigations should target barriers to comprehensive school health training (including financial impediments) and look at alternative school and community experiences and their effect on trainees, schools, and school-aged children.