Medical Science Educator

, Volume 29, Issue 1, pp 29–33 | Cite as

Resident Experience and Education in Academic and Community Pediatric Primary Care Sites: Lessons for a Changing Healthcare Landscape

  • Benjamin N. FogelEmail author
  • Ronald C. Samuels
  • Jonathan Finkelstein
Short Communication



Efforts to improve pediatric primary care training in residency are important both for the residents and for the patients cared for in residency clinics. Pediatric residents typically get their primary care training at primary care centers affiliated with an academic center or at community-based locations. We aimed to compare residents’ experience of continuity clinic in academic centers and community settings, and to identify relative strengths and weaknesses of each.


Survey data was evaluated for residents at one large pediatric residency program.


Community sites had relative strengths in patient flow, population management, and perception of overall quality of care. Academic sites had relative strengths in continuity of care and ease of follow-up of results.


Community and academic pediatric primary care training sites have varied strengths that could inform efforts to improve residency training to better meet the needs of residents and patients.


Pediatrics Residency training Primary care Continuity clinic Resident experience 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no conflict of interest.


  1. 1.
    Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q 2005 [cited 2012 Jul 18];83:457–502. Available from:
  2. 2.
    Grumbach K, Bodenheimer T. Can health care teams improve primary care practice? JAMA. 2004;291:1246–51 Available from: Scholar
  3. 3.
    Friedberg MW, Hussey PS, Schneider EC. Primary care: a critical review of the evidence on quality and costs of health care. Health Aff. 2010;29:766–72 Available from: Scholar
  4. 4.
    Dougherty D, Schiff J, Mangione-Smith R. The Children’s Health Insurance Program Reauthorization Act quality measures initiatives: moving forward to improve measurement, care, and child and adolescent outcomes. Acad Pediatr. Elsevier Inc.; 2011 [cited 2012 May 1];11:S1–10. Available from:
  5. 5.
    Aysola J, Bitton A, Zaslavsky AM, Ayanian JZ. Quality and equity of primary care with patient-centered medical homes: results from a national survey. Med Care. 2013;51:68–77.CrossRefGoogle Scholar
  6. 6.
    Pan RJ, Cull WL, Brotherton SE. Pediatric residents’ career intentions: data from the leading edge of the pediatrician workforce. Pediatrics. 2002 [cited 2012 Jul 22];109:182–8. Available from:
  7. 7.
    Frintner MP, Cull WL. Pediatric training and career intentions, 2003-2009. Pediatrics. 2012 [cited 2012 Jul 22];129:522–8. Available from:
  8. 8.
    Collins J. Increasing interest in primary care. J Grad Med Educ. 2014;6:795.CrossRefGoogle Scholar
  9. 9.
    Laponis R, O’Sullivan PS, Hollander H, Cornett P, Julian K. Educating generalists: factors of resident continuity clinic associated with perceived impact on choosing a generalist career. J Grad Med Educ. 2011;3:469–74 Available from: Scholar
  10. 10.
    Wagner EH. Academia, chronic care, and the future of primary care. J Gen Intern Med. 2010;25:636–8.CrossRefGoogle Scholar
  11. 11.
    Walker J, Payne B, Clemans-Taylor B, Snyder E. Continuity of care in resident outpatient clinics: a scoping review of the literature. J Grad Med Educ. 2018;10:16–25.CrossRefGoogle Scholar
  12. 12.
    Stepczynski J, Holt SR, Ellman MS, Tobin D, Doolittle BR. Factors affecting resident satisfaction in continuity clinic—a systematic review. J Gen Intern Med. 2018:1–8.Google Scholar
  13. 13.
    Fogel BN, Warrick S, Finkelstein JA, Klein M. Change in residents’ experience in continuity clinic after patient-focused primary care redesign. Acad Pediatr. 2016;16:616–20. Elsevier Inc; Available from:. Scholar
  14. 14.
    Serwint JR. Multisite survey of pediatric residents’ continuity experiences: their perceptions of the clinical and educational opportunities. Pediatrics. 2001;107:E78 Available from: Scholar
  15. 15.
    Serwint JR, Feigelman S, Dumont-Driscoll M, Collins R, Zhan M, Kittredge D. Factors associated with resident satisfaction with their continuity experience. Ambul Pediatr. 2004;4:4–10 Available from: Scholar
  16. 16.
    Feigelman S, Olsson J, Drutz J, Dungy CI, Lopreiato J, Serwint JR. Changes in pediatric residents’ perceptions of their continuity experience during their training: a national study. Ambul Pediatr. 2005;5:221–7 Available from: Scholar
  17. 17.
    Roberts KB, Starr S, DeWitt TG. The University of Massachusetts Medical Center office-based continuity experience: are we preparing pediatrics residents for primary care practice? Pediatrics. 1997 [cited 2012 Jul 12];100:e2–e2. Available from:
  18. 18.
    Darden PM, Ector W, Moran C, Quattlebaum TG. Comparison of continuity in a resident versus private practice. Pediatrics. 2001 [cited 2012 Jul 12];108:1263–8. Available from:
  19. 19.
    Cohen GA, Nocton JJ. Comparison of medical knowledge between pediatric residents who attend continuity clinic at different sites. WMJ. 2009;108:349–51 Available from: Scholar
  20. 20.
    Osborn R, Bullis E, Fenick A, Powers E, Asnes A. Effect on continuity of care and trainee experience of immersion scheduling in pediatric residency. Acad Pediatr. 2018;18:e14.CrossRefGoogle Scholar
  21. 21.
    Drolet BC, Soh IY, Shultz PA, Fischer SA. A thematic review of resident commentary on duty hours and supervision regulations. J Grad Med Educ. 2012;4:454–9 Available from: Scholar
  22. 22.
    Burke AE, Rushton J, Guralnick S, Hicks P. Resident work duty hour requirements: medical educators’ perspectives. Acad Pediatr. 2010;10:369–71.CrossRefGoogle Scholar
  23. 23.
    Abramson EL, Naifeh MM, Stevenson MD, Mauer E, Hammad HT, Gerber LM, et al. Scholarly activity training during residency: are we hitting the mark? A national assessment of pediatric residents. Acad Pediatr. 2018;18:542–9.CrossRefGoogle Scholar
  24. 24.
    Abbott MB, First LR. Report of colloquium III: challenges for pediatric graduate medical education and how to meet them--a quality improvement approach to innovation in pediatric graduate medical education. Pediatrics. 2009 [cited 2012 Jul 30];123 Suppl:S22–5. Available from:

Copyright information

© International Association of Medical Science Educators 2018

Authors and Affiliations

  1. 1.Department of PediatricsPenn State College of MedicineHersheyUSA
  2. 2.Division of General PediatricsBoston Children’s Hospital, Harvard Medical SchoolBostonUSA

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