Early Career Experiences of Pediatricians Pursuing or Not Pursuing Fellowship Training

BACKGROUND AND OBJECTIVES: Choosing career paths can be difficult decisions for residents contemplating fellowship training. This study compares the experiences of early career pediatricians who did and did not pursue fellowships. METHODS: We analyzed national, weighted data from pediatricians 8 to 10 years after residency (n = 842). Work environment, work–life balance, and satisfaction were compared for pediatricians who had pursued fellowship training (fellowship trained) and those who did not pursue fellowship training (generalist trained). Logistic and linear regression examined the independent effects of fellowship training while controlling for demographic differences. RESULTS: A total of 39% of the pediatricians (328/842) pursued fellowship training. The fellowship-trained group was less likely than the generalist-trained group to spend time in direct patient care and more likely to report learning opportunities in their work environment. This group was also more likely to report an income of ≥$150 000, although no difference was found when only full-time pediatricians were examined. Generalist-trained pediatricians were more likely to work <50 hours per week, have flexibility with their schedules, and be satisfied with time spent with their own children. Pediatricians in both the fellowship-trained and generalist-trained groups generally found their work to be rewarding and were satisfied with their lives. CONCLUSIONS: Although residents need to consider important life and career differences when contemplating fellowship training and general care, pediatricians in both groups can achieve overall life and career satisfaction

A Longitudinal Study of Pediatricians Early in their Careers: PLACES

The American Academy of Pediatrics (AAP) launched the Pediatrician Life and Career Experience Study (PLACES), a longitudinal study that tracks the personal and professional experiences of early career pediatricians, in 2012. We used a multipronged approach to develop the study methodology and survey domains and items, including review of existing literature and qualitative research with the target population. We chose to include 2 cohorts of US pediatricians on the basis of residency graduation dates, including 1 group who were several years out of residency (2002–2004 Residency Graduates Cohort) and a second group who recently graduated from residency at study launch (2009–2011 Residency Graduates Cohort). Recruitment into PLACES was a 2-stage process: (1) random sample recruitment from the target population and completion of an initial intake survey and (2) completion of the first Annual Survey by pediatricians who responded positively to stage 1. Overall, 41.2% of pediatricians randomly selected to participate in PLACES indicated positive interest in the study by completing intake surveys; of this group, 1804 (93.7%) completed the first Annual Survey and were considered enrolled in PLACES. Participants were more likely to be female, AAP members, and graduates of US medical schools compared with the target sample; weights were calculated to adjust for these differences. We will survey PLACES pediatricians 2 times per year. PLACES data will allow the AAP to examine career and life choices and transitions experienced by early-career pediatricians

Cross-Cultural Patterns in College Student Drinking and its Consequences—A Comparison between the USA and Sweden

Aims: The aim of the study was to compare alcohol use, consequences and common risk factors between American and Swedish college students. Methods: A secondary comparative analysis from one American and two Swedish studies in college settings. Results: Swedish freshmen report higher alcohol use than US freshmen students. Swedish residence hall students report higher alcohol use than US residence hall students, but lower than American fraternity/sorority members. US students were less likely to be drinkers. Controlling for age, country moderated the relationship between family history and harmful drinking scores for women (stronger in the USA), and between expectancies and harmful drinking scores for men (stronger in Sweden), though in both cases this represented a small effect and patterns were similar overall. Conclusions: Swedish students are at higher risk for alcohol use than US students, but similar patterns between aetiological predictors and outcomes in both countries suggest that research from the USA is generalizable to Swedish students and vice versa. More research is needed to better understand unique relationships associated with age and family history

A Theory of Mindful Decision-Making: How Self-Compassion and Mindfulness May Counteract Negative Outcomes of Maximizing

The field of positive psychology aims to understand and enhance those aspects of life that contribute to human flourishing. One area of research within positive psychology focuses on people’s choices and how they impact well-being outcomes such as optimism, life satisfaction, happiness, and depression. Maximizing, an approach to making choices that involves seeking the best objective outcome, has been associated with a number of negative subjective outcomes in these areas. Meanwhile, satisficing, or seeking an option that is good enough to meet one’s needs, relates to more positive subjective outcomes but sometimes does not yield as objectively good results. This paper examines the current literature on maximizing and satisficing, including outcomes associated with the two decision-making styles and potential mechanisms underlying them. It then makes a theoretical argument that mindful decision-making, defined as approaching decisions with mindfulness and self-compassion, might enable individuals to overcome the negative subjective outcomes associated with maximizing. Empirical research to test this theory is recommended, and practical implications for enhancing individuals’ well-being through interventions that engender mindful decision-making are discussed

Gender imbalance of fields despite equal opportunity : gender and higher education decision-making processes at Carleton College

Despite the fact that women and men have similar educational access in the United States, different fields of study remain extremely numerically imbalanced by gender. Although some researchers have considered why this is so, research methods have typically depended on statistical or survey data instead of asking participants to describe their own experiences (Jacobs 1996). In order to address that gap in research, I have combined quantitative survey data with interviews of fourteen Carleton College students to get an idea of how individuals at this unique liberal arts school describe their educational decision-making. Using Devaluation Theory and Socialization Theory in conjunction with previously-identified decision-making models emphasizing influences of people, perceived rewards and stigmatization on decision-making, I investigate why gender imbalances remain in so many fields at Carleton despite its high numbers of women in predominantly male fields (Dryler 1998, Eccles 1987, England et al. 2007, Mastekaasa and Smeby 2008). Findings reveal a complex tug-of-war between factors that influence individuals before, during and considering what will happen after their time at college

Perceived Cultural Competency Skills and Deficiencies Among Pediatric Residents and Faculty at a Large Teaching Hospital

To identify demographic, educational, and experiential factors associated with perceived self-efficacy in cultural competency (PSECC) for pediatric residents and faculty at a large, tertiary-care children's hospital and to identify key barriers to the delivery of culturally competent pediatric care. We conducted a cross-sectional assessment of cultural competency (CC) education, training, and skills using an online survey of residents and faculty at a large children's hospital. With our data analysis, we sought associations between PSECC skills, cross-cultural training or work experience, and demographic background. Participants were asked to identify and rank barriers to CC care and additional training they would like to see implemented. A total of 114 residents (55%) and 143 faculty (65%) who responded to the survey assessing PSECC. Residents were more likely to have had CC training than faculty. More than half of the residents and faculty had participated in an underserved-group clinical experience domestically or abroad. Those residents with underserved-group experience were more likely to be comfortable with interpreter use ( = .03) and culturally sensitive issues ( = .06). Faculty who participated in underserved-group care in the United States were more likely to believe that cultural bias affects care ( = .005). Both identified time constraints, language barriers, and lack of knowledge as chief barriers to acquiring CC, and both desired more training. Residents and faculty at a large children's hospital believe that they lack adequate CC training. Underserved-group clinical experiences both domestically and abroad are associated with perceived improved cross-cultural care skills. Increasing the extent and quality of CC education in both resident training and faculty development is needed