124 - Surveying Primary Care Alumni to Inform Current Training

Publication Number: 4122.124

Jane Nathanson, CHOP, Perelman School of Medicine, Philadelphia, PA, United States; George Dalembert, Children's Hospital of Philadelphia, Philadelphia, PA, United States; John Flibotte, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Jeanine Ronan, Children's Hospital of Philadelphia, Philadelphia, PA, United States

Background: The 2025 ACGME changes aim to increase ambulatory exposure based on concerns about resident under-preparedness. Residency programs vary in how they prepare trainees for primary care, with tertiary hospitals often presumed to provide less relevant training.

Objective: To guide program adjustments, we sought insights from alumni of a large, tertiary, urban hospital-based program on preparing residents for primary care careers.

Design/Methods: Using REDCap, we surveyed alumni on perceived strengths and gaps in residency training for primary care. In consultation with program leaders, we developed open-ended questions to collect demographic data, feedback on residency experiences, and rotations deemed required, ideal, or supplemental for optimal preparation. Surveys were sent to 70 alumni (2014–2024 graduates) who pursued primary care careers. We used inductive content analysis to categorize responses and simple statistics to quantify themes.

Results: 43 alumni (61%) responded, practicing across 15 U.S. states and two countries. 11 (26%) pursued additional training, most often the NCSP/RWJ Clinical Scholars Program; others completed degrees in business, education, or global health policy, or an Academic General Pediatrics Fellowship. 78% (n=33) remained in their first post-residency job. 65% (n=28) practice in academic settings, with others in community/non-profit, FQHC, private, or public health/government roles.

Most respondents held all-clinical positions (n=23); many also engaged in education, research, quality improvement, or community work. The most frequently recommended supplemental electives were sports medicine (n=39) and lactation (n=38). Alumni encouraged additional education in billing and coding; learning from social work, child psychiatry, and developmental pediatrics; and more exposure to acute care visits.

Conclusion(s): New ACGME flexibility may allow individualized training and targeted experiences to better support transitions to primary care. Consistent with research on the difficulty of graduates all seeing “simple” diagnoses, e.g., otitis, alumni highlighted more acute care exposure. The range of career settings, focus areas, and geographies reflects the goal of academic institutions producing primary care doctors who broadly serve their communities. The strong response rate enhances confidence in these insights from those well positioned to advise on resident preparation.

Integrating alumni feedback into implementation of ACGME changes may improve primary care training. Future work should explore factors influencing job satisfaction, professionalism, and physician well-being.

Alumni and job characteristics, feedback on training for primary care careers
Primary care alumni residency training survey table.pdf