The Accreditation Council for Graduate Medical Education (ACGME) delineates requirements for pediatric residency programs. Compliance is stringently monitored through a very comprehensive system. The ACGME requirements for pediatric residency programs clearly state that:

"There must be a structured educational experience that prepares residents for the role of advocate for the health of children within the community. These experiences should utilize settings within the community such as home health services, Head Start, Early Childhood Education and community resource settings."1

Specific attention is paid to preparation of the pediatrician in training for their role as consultant to schools, early childhood education and childcare settings. Additionally, the role of the pediatrician in disease and injury prevention and their role in the legislative process are recognized as core curricular components in pediatric residency education. The American Academy of Pediatrics (AAP) recognizes in a policy statement that:

"…with sweeping changes occurring in the world of medicine and other human services, it is especially important now for pediatricians now to reexamine and reaffirm their role as professionals in the community-as community pediatricians – and prepare themselves for it just as diligently as they prepare for traditional clinical roles."2

This represents a significant opportunity for multiple community settings, including many early childhood programs, to form effective collaborations with pediatric residency programs. It is a truly symbiotic relationship (Diagram 1). The following is a description of many roles that pediatric residents have taken on within this framework:

• HEALTH CONSULTANT
  
  • Effectively deliver successful talks directed at providers or parents on topics including: Nutrition, ADHD, Child Development, Violence Prevention, Asthma, Media Literacy, Environmental Toxins and Dental Health.
  • Administer specific screening tools such as the Denver Developmental Screen and obesity screening with referral to appropriate services
  • Reviewing and developing health forms
    Training staff in medication administration
    
• POLICY ADVISOR/CREATOR
  
  • Core residency faculty in conjunction with residents can sit on health advisory boards, policy advisory committees
    
• PROGRAM DEVELOPER
  
  • Collaborate in organizing specific campaigns such as Influenza Vaccine Programs, Reach Out and Read Campaigns, Helmet Use education and distribution programs
    
• COMMUNITY LIAISON
  
  • Residents have unique access to largely underserved populations including young infants of low socio-economic status and immigrant populations and can serve as effective communicators of your programs message to hard to reach populations. Information on free meals and immigrant access to health care have been shared through collaborations.
    
• FUND RAISER/IN KIND CONTRIBUTOR
  
  • Residents have access to alternative grants (Pediatric Societies, Medical Education Grants)
  • Time investments from pediatric residents as well as supportive faculty and administrative time can amount to significant in kind contributions
    
• PARTNER IN LEGISLATIVE ADVOCACY EFFORTS
  
  • The combined force of early childhood programs and the medical expertise and clinical experiences of pediatric residents and their supporting medical centers have achieved effective lobbying efforts in pursuit of the well being of children

SUMMARY:

A changing philosophy in pediatric graduate medical education presents opportunities for successful partnerships between pediatric residency programs and early childhood programs. A growing requirement for resident curriculum and experience in early childhood programs, advocacy efforts and public health will create a free and uniquely trained "workforce" for early childhood programs to tap into. Residents, early childhood programs and ultimately child health and well being are the co-beneficiaries of these collaborations. Docs For Tots will provide technical assistance for early childhood programs wishing to collaborate with pediatric residency programs.

1. 2004 ACGME Pediatric Residency Program Requirements.
2. "The Pediatrician's Role in Community Pediatrics", 1999 Policy Statement of The American Academy of Pediatrics.

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