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

Presented at the 2017 Pediatric Academic Societies Annual Meeting.

Background: Pediatric residency programs increasingly offer global health (GH) training. The quality of preparation in GH work and association with plans for future GH careers have not been nationally surveyed.

Objectives: Describe exposure to GH training in pediatric residency programs, perceived quality of preparation, and interest in GH careers.

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%). McNemar tests compared perceived quality of GH training with that in 8 non-GH clinical activities. Chi-square tests compared a) GH training and preparation in GH and b) preparation in GH and interest in GH careers.

Results: Of 550 respondents, 402 (73%) reported that their program offered GH training. A range of 44% to 66% of all respondents received training in 6 key GH topics. Of all respondents, 13% completed an international GH elective and 7% completed a domestic (refugee/immigrant health) GH elective. Of those who completed an elective abroad, 64% reported receiving formal preparation and 76% participated in debriefing upon return.

Overall, 27% reported excellent or very good preparation for future work in GH, which was the lowest rating compared with 8 non-GH clinical activities assessed in the survey (p<.01). Residents whose programs offered GH training were more likely to report excellent/very good preparation compared with programs that did not offer training (33% vs 10%, p<.001).

Forty-two percent of all respondents and 83% of those who completed a GH elective planned to incorporate GH into their careers. Most commonly reported were plans to carry out international clinical work, but many were in interested in GH education and advocacy, as well as GH domestic work (table). Residents who reported excellent/very good preparation were more likely to incorporate GH into their careers (p<.001).

Conclusions: Opportunities for GH training exist in most US pediatric residency programs and include exposure to both domestic and international populations. Four in 10 residents plan to incorporate GH into their careers, however only one-fourth feel well prepared in GH, which highlights the need to further integrate GH training into residency programs. Also, while most residents who completed an elective abroad receive formal preparation and debriefing, about one-third did not, indicating a continued need to strengthen program support for GH electives. 

Proportion of residents who plan to incorporate GH into their career.png

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