Changing Trends in US Pediatric Residency Training and Interest in Global Health

Frintner M, Anspacher M, O'Callahan C, Spector J, St Clair N, Howard C, Pak-Gorstein S.

Presented at the 2017 Pediatric Academic Societies Annual Meeting.

Background: US pediatric residency programs increasingly offer global health (GH) training opportunities. However, it is unclear if the demand for GH training, exposure to GH training, and influence of GH training on career choices have also changed.

Objectives: We examined trends among graduating pediatric residents in GH participation and exposure, importance of GH training in program selection, and future plans to work abroad by comparing survey responses from 2008 and 2016.

Methods: Questions on GH were nested in the 2016 AAP Annual Survey of Graduating Residents, a randomly sampled national survey of 1,000 residents from US programs (response=56%) and 2008 (response=59%). Multivariable logistic regression examined responses across years, controlling for gender, age, race, marital and parental status, medical school location, program size, career goal, and educational debt adjusted to 2016 dollars.

Results: Compared with responses in 2008, more residents reported that their programs offered GH training in 2016 (59% vs 73%, respectively; aOR=1.71, 95% CI=1.27-2.29). More residents in 2016 reported receiving training in health care of immigrant/refugee children (66% in 2016, 54% in 2008; aOR=1.60, CI=1.22-2.11), epidemiology of child mortality in developing countries (55% in 2016, 44% in 2008; aOR=1.45, CI=1.11-1.90), and ethical issues in working/volunteering in developing countries (44% in 2016, 27% in 2008; aOR=2.11, CI=1.59-2.81). Fewer residents in 2016 reported GH training as being essential or very important in selecting a residency program compared to 2008 (17% in 2016, 22% in 2008; aOR=.64, CI=.46 to .90). Fewer residents in 2016 reported definite or very likely plans to work or volunteer in a developing country after residency (27% in 2016 and 34% in 2008; aOR=.69, CI=.52-.92).

Conclusions: More residents are exposed to GH training opportunities during pediatric residency programs in 2016 compared with 2008. While a proportion of residents selected their residency programs based on GH training availability, slightly less reported this as an important factor in program choice in 2016 compared to 2008, possibly due to the large increase in the number of programs offering GH training. While interest to work in a developing country after residency declined in 2016, a quarter of residents still reported plans to do so.