The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project

Background and Objectives: The proportion of family physicians caring for children is decreasing. At the same time, US family medicine residency training requirements have increased flexibility in how to train future family physicians in caring for this population. Our objective was to evaluate the correlation between residency program structures and curriculum with graduates caring for children. Methods: We conducted a prospective cohort study of family medicine graduates using the 2018 Council of Academic Family Medicine Education Research Alliance program director study to measure program characteristics and pediatric curricular elements, and the 2021 family medicine National Graduate Survey (NGS) of residents who graduated in 2018 to measure outcomes. We used logistic regression to determine associations between residency elements and graduate practice of outpatient pediatrics, inpatients pediatrics, or newborn hospital care. Results: After data from the two sources were merged, our final sample was 779 family medicine graduates (48% of the NGS sample), where 74.7% reported practicing outpatient pediatrics, 16.8% inpatient pediatrics, and 25.9% newborn care. In multivariate analyses, residency processes associated with the care of children in one or more settings included having more than 10% of continuity clinic patients under the age of 10 and having two or more family medicine faculty supervising inpatient pediatrics or newborn care. Conclusions: In a large national cohort study, we found that residency processes—especially faculty role modeling care of children and the inclusion of children in continuity clinic—are positively associated with residency graduates providing care for children. With residency training requirements changing, these results offer evidence-based interventions for programs to produce graduates who will care for children.