ABSTRACT
OBJECTIVE: To describe the role and perspectives of pediatrics clerkship directors (CDs) who provide advice to students who apply to Pediatrics residency training programs. METHODS: We developed a survey based on previous studies and data from the 2012 National Residency Matching Program- Program Director (NRMP-PD) survey. Topics included CDs roles and confidence in advising, perspectives on applicants' competitiveness, and resources used to inform advising practice. This survey was disseminated as part of the 2013 Council on Medical Student Education in Pediatrics annual survey. RESULTS: CDs from 63 (45%) Liaison Committee for Medical Education-accredited medical schools in the United States responded. All CDs had some advising role, and most (68%) served in a formal advising capacity. Most (58%) also participated in the intern selection process at their institution. Those with formal advising roles were not significantly more confident in their advising than those without formal roles. CDs relied heavily on subjective resources and most did not use the NRMP-PD survey data. Despite this, the perspectives of CDs were similar to those of program directors based on the most recent NRMP-PD survey. CONCLUSIONS: Pediatrics CDs uniformly serve in advising capacities and have perspectives that compare favorably with those of program directors. Despite this concordance, the high reliance on subjective resources and the frequency in which CDs participate in intern selection raises concern. The results of this study have several implications for key stakeholders in the residency selection process.
Subject(s)
Clinical Clerkship , Internship and Residency , Pediatrics/education , Physician Executives/psychology , Professional Role , Adult , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Professional Competence , Self Concept , Surveys and Questionnaires , United StatesSubject(s)
Communication , Electronic Mail , Internet , Professional Competence , Behavior , Education, Medical, Graduate , Humans , Pediatrics/educationABSTRACT
OBJECTIVE: To test the hypothesis that discharge disposition for adolescents admitted to medical hospitals after attempting suicide varies as a function of hospital type and geographic region. DESIGN: Retrospective cohort analysis. SETTING: The nationally representative Kids' Inpatient Database for 2000. PARTICIPANTS: Patients aged 10 to 19 years with a diagnosis of suicide attempt or self-inflicted injury.Main Outcome Measure Likelihood of transfer to another facility vs discharge to home. RESULTS: Care for 32 655 adolescents who attempted suicide was provided in adult hospitals (83% of hospitalizations), children's units in general hospitals (10%), and children's hospitals (4%). More than half (66%) of medical hospitalizations ended with discharge to home, 21% with transfer to a psychiatric, rehabilitation, or chronic care (P/R/C) facility, 10% with transfer to a skilled nursing facility, intermediate care facility, or short-term acute care hospital facility, and 2% with death or departure against medical advice. After adjustment for individual patient characteristics, children's units were 44% more likely than adult hospitals to transfer adolescent patients to a P/R/C facility (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.07-1.94). Patients cared for outside the Northeast were significantly less likely to be transferred to a P/R/C facility (South: OR, 0.79; 95% CI, 0.65-0.97; Midwest: OR, 0.63; 95% CI, 0.49-0.80; West: OR, 0.29; 95% CI, 0.22-0.38). CONCLUSIONS: Most adolescents admitted to a medical hospital after a suicide attempt are discharged to home, and the likelihood of transfer to another facility appears to be influenced by the geographic location of the admitting hospital and whether it caters to children.
