Objective: To determine the careers of graduates of the General Pediatrics Academic Development Program (GPADP) and the pediatricians from the Clinical Scholars (CS) Program 8 to 16 years after completion of their fellowship to assess the current state of the academic general pediatrician and to determine the current activities of divisions of General Pediatrics in US medical schools.
Design: Analysis of questionnaire data from former fellows of the two programs, who trained during the years 1978 to 1988, as well as of data from questionnaires to all divisions of General Pediatrics (or their equivalent) in all medical schools in the United States.
Population: Surveys were conducted of the 111 graduates of the GPADP and the 39 pediatricians from the CS program and all 127 US medical schools.
Results: Of the 111 GPADP graduates, 101 were located, and 85 completed the questionnaire. Of 39 CS graduates, 36 were located, of whom 27 completed the questionnaire. Similarities were found between the two groups in percent being in academic positions (74%, GPADP vs 70.4%, CS), percent having achieved tenure (17.8%, GPADP vs 14.3%, CS), and percent of time spent in research (17%, GPADP vs 25%, CS). Considerable differences, however, were found in percent of time spent in direct patient care (35.7% time for GPADP and only 17. 8% time for CS) and in direct teaching (25.1% time for GPADP and only 17.6% time for CS). The mean number of articles published was greater among CS professionals (21.4 vs 14 for GPADP, but not statistically significant), as was the mean number of research grants (6.75 by CS vs 4.02 by GPADP). The GPADP fellows had obtained more education grants and more service grants. Both groups were concerned about the lack of time and support for research. Few General Pediatrics divisions had ongoing academic fellowship programs. The current number of new fellows by divisions of General Pediatrics who are educated to do research is small. Only 30 related programs exist in all the medical schools in the United States. However, large divisions of General Pediatrics, responsible for large teaching and clinical service programs, are now in place in the majority of medical schools. This represents progress since 1978, when few generalists were in full-time academia.
Conclusion: More than two thirds of both the GPADP graduates and CS professionals are now in academic departments. They have had modest success in obtaining grants, publishing articles, and achieving tenure, but large teaching and service demands and lack of research funds have made it difficult for both groups to be as productive in research as originally hoped. The field of Academic General Pediatrics now is established. It is the responsibility of graduates of these and similar programs to produce creative research and expand fellowship programs, as well as to do good clinical care, if a vigorous field of Academic General Pediatrics is to be achieved.