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Global health opportunities within pediatric subspecialty fellowship training programs: surveying the virtual landscape
Background There is growing interest in global health among medical trainees. Medical schools and residencies are responding to this trend by offering global health opportunities within their programs. Among United States (US) graduating pediatric residents, 40% choose to subspecialize after residency training. There is limited data, however, regarding global health opportunities within traditional post-residency, subspecialty fellowship training programs. The objectives of this study were to explore the availability and type of global health opportunities within Accreditation Council for Graduate Medical Education (ACGME)-accredited pediatric subspecialty fellowship training programs, as noted by their online report, and to document change in these opportunities over time. Methods The authors performed a systematic online review of ACGME-accredited fellowship training programs within a convenience sample of six US pediatric subspecialties. Utilizing two data sources, the American Medical Association-Fellowship and Residency Electronic Interactive Database Access (AMA-FREIDA) and individual program websites, all programs were coded for global health opportunities and opportunity types were stratified into predefined categories. Comparisons were made between 2008 and 2011 using Fisher exact test. All analyses were conducted using SAS Software v. 9.3 (SAS Institute Inc., Cary, NC). Results Of the 355 and 360 programs reviewed in 2008 and 2011 respectively, there was an increase in total number of programs listing global health opportunities on AMA-FREIDA (16% to 23%, p=0.02) and on individual program websites (8% to 16%, p=0.004). Nearly all subspecialties had an increased percentage of programs offering global health opportunities on both data sources; although only critical care experienced a significant increase (p=0.04, AMA-FREIDA). The types of opportunities differed across all subspecialties. Conclusions Global health opportunities among ACGME-accredited pediatric subspecialty fellowship programs are limited, but increasing as noted by their online report. The availability and types of these opportunities differ by pediatric subspecialty.
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机译：背景技术医学实习生对全球健康的兴趣日益浓厚。医学院和住院医师通过在其计划内提供全球健康机会来应对这一趋势。在美国（US）即将毕业的儿科住院医师中，有40％的人选择了居住培训后的专业化。但是，关于传统的在职后，专科研究金培训计划中的全球卫生机会的数据有限。这项研究的目的是探索由研究生医学教育认可委员会（ACGME）认可的小儿专科研究金培训计划所提供的全球健康机会和类型，并记录随着时间的推移这些机会的变化。方法作者在六个美国小儿科专业的便利样本中，对ACGME认可的研究金培训计划进行了系统的在线审查。利用两个数据源，即美国医学会奖学金和住院医生电子交互式数据库访问（AMA-FREIDA）以及各个计划的网站，所有计划均针对全球健康机会进行了编码，并且机会类型被划分为预定义的类别。使用Fisher精确检验对2008年和2011年进行了比较。所有分析都是使用SAS软件v.9.3版（SAS Institute Inc.，Cary，NC）进行的。结果分别在2008年和2011年审查的355个和360个程序中，在AMA-FREIDA（16％到23％，p = 0.02）和单个程序网站（8％）上列出全球卫生机会的程序总数有所增加至16％，p = 0.004）。几乎所有亚专业的计划在两个数据源上提供全球卫生机会的计划所占比例都在增加;尽管只有重症监护才有显着增加（p = 0.04，AMA-FREIDA）。所有子专业的机会类型都不尽相同。结论在ACGME认可的儿科专科研究金计划中，全球健康机会有限，但在线报告指出，这一机会正在增加。这些机会的可用性和类型因小儿专科而异。
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