National Survey of Combined Pediatrics-Anesthesiology Residents and Graduates: Factors Contributing to Changing Career Aspirations Over Time.
Journal
Anesthesia and analgesia
ISSN: 1526-7598
Titre abrégé: Anesth Analg
Pays: United States
ID NLM: 1310650
Informations de publication
Date de publication:
01 12 2023
01 12 2023
Historique:
medline:
20
11
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
The Dual Pathway for Certification in Pediatrics and Anesthesiology was created in 2011 to develop leaders in caring for children with complex medical and surgical conditions. While existing dual-trained practitioners report continued practice in both pediatric anesthesiology (PA) and pediatric critical care medicine (PCCM), recent surveys of dual pathway trainees have shown that only one-quarter still currently plan to pursue training in PCCM, a change from their initial plans to complete training in both PA and PCCM. The aim of this study was to further characterize the motivations driving shifts in career trajectory during training as well as factors affecting the combined training experience. We conducted an online mixed-methods survey of all individuals who had matriculated at 1 of the 7 Accreditation Council for Graduate Medical Education-accredited combined pediatrics-anesthesiology residencies from 2011 to 2018. The survey consisted of a 30-item questionnaire addressing training experience, anticipated career trajectory, and respondent demographics. Descriptive statistics were used for closed-format questions. Responses to open-ended questions were systematically analyzed through inductive iterative review by 2 of the authors to elicit a set of overarching themes. We achieved a response rate of 85% (n = 53/62) with respondents from 7 of 7 combined residency programs. When asked about career goals, the majority of respondents planned to pursue both PA and PCCM (60%, n = 32) at the start of residency. However, at the time of survey completion, the percentage of respondents who were still planning to (or had already completed) train in both PA and PCCM had decreased to 23% (n = 12). Factors such as lifestyle and length of training contributed more to career choices during/after training compared to before residency. Thematic analysis of open-ended questions regarding transition between specialties, impact of dual training, and general comments revealed 3 major themes: (1) challenges of transitioning between specialties, (2) dual training is mutually beneficial, and (3) the need for an established fellowship training pathway. While there is continued interest in dual training in PA/PCCM for residents who enter the combined pediatrics-anesthesiology residency, factors such as duration of training and lifestyle become more important during residency and alter their career trajectories, often away from PCCM. Optimization of dual-subspecialty fellowship training will be critical to sustaining interest in dual-subspecialty training in PA/PCCM.
Sections du résumé
BACKGROUND
The Dual Pathway for Certification in Pediatrics and Anesthesiology was created in 2011 to develop leaders in caring for children with complex medical and surgical conditions. While existing dual-trained practitioners report continued practice in both pediatric anesthesiology (PA) and pediatric critical care medicine (PCCM), recent surveys of dual pathway trainees have shown that only one-quarter still currently plan to pursue training in PCCM, a change from their initial plans to complete training in both PA and PCCM. The aim of this study was to further characterize the motivations driving shifts in career trajectory during training as well as factors affecting the combined training experience.
METHODS
We conducted an online mixed-methods survey of all individuals who had matriculated at 1 of the 7 Accreditation Council for Graduate Medical Education-accredited combined pediatrics-anesthesiology residencies from 2011 to 2018. The survey consisted of a 30-item questionnaire addressing training experience, anticipated career trajectory, and respondent demographics. Descriptive statistics were used for closed-format questions. Responses to open-ended questions were systematically analyzed through inductive iterative review by 2 of the authors to elicit a set of overarching themes.
RESULTS
We achieved a response rate of 85% (n = 53/62) with respondents from 7 of 7 combined residency programs. When asked about career goals, the majority of respondents planned to pursue both PA and PCCM (60%, n = 32) at the start of residency. However, at the time of survey completion, the percentage of respondents who were still planning to (or had already completed) train in both PA and PCCM had decreased to 23% (n = 12). Factors such as lifestyle and length of training contributed more to career choices during/after training compared to before residency. Thematic analysis of open-ended questions regarding transition between specialties, impact of dual training, and general comments revealed 3 major themes: (1) challenges of transitioning between specialties, (2) dual training is mutually beneficial, and (3) the need for an established fellowship training pathway.
CONCLUSIONS
While there is continued interest in dual training in PA/PCCM for residents who enter the combined pediatrics-anesthesiology residency, factors such as duration of training and lifestyle become more important during residency and alter their career trajectories, often away from PCCM. Optimization of dual-subspecialty fellowship training will be critical to sustaining interest in dual-subspecialty training in PA/PCCM.
Identifiants
pubmed: 36729970
doi: 10.1213/ANE.0000000000006308
pii: 00000539-990000000-00468
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1250-1256Informations de copyright
Copyright © 2022 International Anesthesia Research Society.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Levin DL, Downes JJ, David Todres I. History of pediatric critical care medicine. J Pediatr Intensive Care. 2013;2:147–167.
Epstein D, Brill JE. A history of pediatric critical care medicine. Pediatr Res. 2005;58:987–996.
Parker MM, Thompson AE, Lumb P, Lacroix J, St Andre A. Co-evolutions of pediatric and adult critical care. Crit Care Med. 2021;49:188–200.
American Board of Pediatrics. Pediatrics-anesthesiology program. 2009. Accessed January 21, 2022. https://www.abp.org/content/pediatrics-anesthesiology-program .
Sheehan J, Wagner J, Agarwal R. Survey highlights barriers to post-residency training for combined pediatrics, anesthesia residents. AAP News. https://publications.aap.org/aapnews/news/14136
Brandford E, Wang T, Nguyen C, Rassbach CE. Sense of belonging and professional identity among combined pediatrics-anesthesiology residents. Acad Pediatr. 2022;22:1246–1253.
Welch TP, Kilbaugh TJ, McCloskey JJ, Juriga LL, Abdallah AB, Fehr JJ. The current state of combined pediatric anesthesiology-critical care practice: a survey of dual-trained practitioners in the United States. Anesth Analg. 2021;132:194–201.
Sanford EL. Pediatrics-anesthesia combined residency training: an applicant’s perspective. Anesth Analg. 2013;116:1386–1388.
Shenoi AN, Kalyanaraman M, Pillai A, Raghava PS, Day S. Burnout and psychological distress among pediatric critical care physicians in the United States. Crit Care Med. 2018;46:116–122.
Sanford EL. Pediatrics and anesthesiology combined residency: a graduate’s perspective and opinion on combined pediatric anesthesiology and critical care fellowship. Anesth Analg. 2019;129:634–635.
Yaster M, Davis PJ, Greeley WJ. The American pediatric critical care anesthesiologist: an endangered species worth saving. Anesth Analg. 2019;128:204–206.
Longacre MM, Cummings BM, Bader AM. Building a bridge between pediatric anesthesiologists and pediatric intensive care. Anesth Analg. 2019;128:328–334.