Training in pediatric critical care medicine: A survey of pediatric residency training programs

BACKGROUNDAfter completing their critical care rotations, pediatric residents are expected to have acquired skills in the resuscitation of critically ill newborns and children. Recent Accreditation Council on Graduate Medical Education (ACGME) guidelines have limited the time devoted to critical care training during pediatric residency. We sought to determine how individual programs have structured their critical care training experience in light of these changes. MATERIALS AND METHODSA questionnaire was mailed to each pediatric residency program listed in the 1996–1997 Graduate Medical Education Directory. Information was obtained regarding the structure of critical care training. Data were analyzed using descriptive techniques, one-way analysis of variance with Scheffé post hoc test, and Fisher exact test as appropriate. RESULTSData were received from 149 programs (71% response rate). Most programs were in compliance with ACGME standards regarding the number of months devoted to neonatal intensive care, pediatric intensive care, and emergency medicine. There were no significant differences in the total number of rotations in either the neonatal intensive care unit (NICU) or the pediatric intensive care unit (PICU) when the programs were stratified by size. There were no significant differences in the percentage of programs requiring night call in either the NICU or the PICU during off-service months. However, small programs (< 25 residents) required significantly fewer rotations in emergency medicine (P < 0.001). Most programs complemented the critical care experience by offering additional rotations and advanced life support training. CONCLUSIONSPediatric residency programs have structured their critical care rotations in a similar fashion in accordance with ACGME guidelines. The success in meeting the stated objectives, as measured by the ability of graduating residents to stabilize critically ill children, is not known and will require further study.