Resident Experiences with the Individualized Curriculum: Current State and Future Opportunities

Daniel J. Schumacher, MD, MEd;¹ Mary Pat Frintner, MSPH;² William L. Cull, PhD².

¹Cincinnati Children's Hospital Medical Center, Cincinnati, United States and ²American Academy of Pediatrics, Elk Grove Village, IL, United States.

Presented at the 2017 Pediatric Academic Societies Annual Meeting.

Background: 2016 residency graduates are the first cohort to complete training since establishment of the Accreditation Council for Graduate Medical Education (ACGME) requirement for an individualized curriculum (IC). Little is known about residents' experiences across programs for these six months.

Objective: Determine graduating pediatric resident experiences with the IC.

Methods: National, random sample of US graduating pediatric residents surveyed in 2015 (n=1,000; response=56%) about IC. Residents were asked who defined their IC experiences (resident-defined, chosen from program options, assigned by program) and how important the IC was in preparing them for the next steps in their career (extremely important, important, moderately important, somewhat important, not very important). They were also asked to provide the focus of the IC they found most valuable (free text). Chi-square tests examined for differences in IC experiences across career goals (primary, hospital, or subspecialty care) and relationships for IC experiences and importance of IC in next steps in their career.

Results: Approximately half (50.5%) reported they defined at least part of their IC. Almost all (96.5%) reported choosing IC options from a list provided by the program. Finally, a majority of residents (60.9%) reported they were assigned at least part of their IC experiences by the program. Residents with subspecialty career goals were more likely (compared to those with hospitalist or primary care) to have IC experiences defined by themselves, (56.3%, 45.5%, and 44.6%, respectively, p<0.05). Most residents (60.7%) found their IC experiences to be extremely important/important to next steps in their careers. Residents who themselves chose at least part of their IC experiences (both self-defined and from a program list) were more likely to report their IC experiences were extremely important or important to the next steps in their career, p<0.01 for both. Valuable IC experiences most commonly reported by residents who answered the open-ended question (n=387) were: specialty experiences, something related to future career, and primary care experiences.

Conclusion: Residents report that it is more common for their program to assign their IC experience than for them to define their own experience. With residents considering self-chosen IC experiences to be an important component of their IC experiences, future efforts should focus on maximizing these beneficial opportunities.