Training in general paediatrics: is it time for change?

Abstract

Objective: To determine current Australian general paediatrician's perceptions regarding the adequacy of their training particularly in the new morbidity (NM) area (developmental, behavioural and psychosocial). To ascertain if there is a perceived need to change training in this area, the level of support for change and to canvass opinion on how to achieve change.

Methods: Australian general paediatricians were surveyed by mail in April 2002. The data obtained from those trained before and after the 1992 changes to training were compared by chi(2) analysis.

Results: The response rate was 76%. More than one in five new referrals were for NM problems according to 62% of the respondents. The majority (67%) of respondents reported that they were poorly or very poorly trained for NM work in contrast to a majority (82%) who rated that they were well or very well trained for general paediatric work (P < 0.001). Respondents believed that they were poorly or very poorly trained in the use of stimulants (74%), selective serotonin reuptake inhibitors (SSRIs) (93%), tricyclic antidepressants (TCAs) (79%) and clonidine (86%), despite a third of scripts being for one of these medications. The majority of all general paediatricians (90%) want changes to advanced training. Seminars/tutorials, organized visits to general paediatricians' rooms and a mandatory 12 month NM term were the most highly supported options for change.

Conclusions: In view of the prevalence of the NM problems, the perception of inadequate training and the overwhelming support for change it is time for new models of training to be developed and tested.