Improving community based pediatric residencies by local affiliation.

Community hospital graduate medical education programs have been judged deficient in several areas when compared with university programs. Generally community programs are smaller, they have a greater percentage of foreign house officers and unfilled house staff positions, and their graduates do less well on specialty board examinations. Difficulties may exist in offering a balanced and broad-based educational exposure. Four separate pediatric residencies in Phoenix became affiliated in 1972. The traditional deficiencies have been overcome, and a very popular and well-balanced program has ensued. Additionally, wasteful duplication has been avoided. Disadvantages have included complex scheduling and loss of continual close contact with house officers. Assigning patients to residents for continuity of care has been difficult. Experiences gained in this amalgamation may well apply to other hospitals facing similar problems. Local consortiums, such as this, fit well into university affiliated programs or statewide organizations.