Adolescent Medicine Training in Pediatric Residency Programs
ABSTRACT The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine.
We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience.
Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training.
Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.
Article: Health Reform and Adolescents[Show abstract] [Hide abstract]
ABSTRACT: he promise of health reform is not only that it will provide much needed health insurance for the 46 million Americans without coverage, but that it will also focus more resources on prevention and strengthen the delivery system to make it more effi cient and effective. Adolescents are an ideal target for health reform. They have signifi cant unmet physical, reproductive, and behavioral health needs associated with long-term personal and societal costs. Many low and moderate income adolescents are uninsured and have limited options for purchasing affordable, comprehensive coverage. Historic community-based provider arrangements, outmoded payment policies, and inadequate provider training and supply have resulted in health care delivery systems poorly structured to meet adolescents' health needs. Health reform offers an important opportunity to provide adolescents with appropriate and affordable coverage and to support a comprehensive primary care system that can respond earlier and more effectively to their needs. The National Alliance recommends that all low income children up to age 21 be considered a mandatory child eligibility group under Medicaid and CHIP and that all children up to age 21 have access to a benefi t package that places greater emphasis on prevention and offers comprehensive physical, mental, and oral health services to enable them to achieve and maintain optimal health and functioning. Reforming the delivery system for adolescents will require a variety of payment reforms for all primary care providers and new funding mechanisms for those interested in offering enhanced models of comprehensive, interdisciplinary care. In addition, federal support is needed to improve the training and supply of medical and mental health professionals with expertise in caring for adolescents.
Article: Preventing Adolescent Pregnancy.[Show abstract] [Hide abstract]
ABSTRACT: The problem of high rates of unintended adolescent pregnancy in the United States continues unchecked. The author discusses efforts to prevent adolescent pregnancy and to ameliorate its effects, including sex education, community outreach and clinical services, and the development of innovative local programs. Other approaches include counseling, use of social learning theory, use of developmental theory, skills building, and self-concept development.Adolescent medicine (Philadelphia, Pa.) 03/1990; 1(1):113-126.
- PEDIATRICS 01/2010; 125(1):191-2. DOI:10.1542/peds.2009-2904 · 5.30 Impact Factor