Sir.—Regarding the recent article by Burg,1 today's pediatric residents in teaching hospitals are being trained almost exclusively by pediatric subspecialists, practically all of whom are full-time academicians with little or no experience in general pediatrics. As a consequence, the residents are both adept at ordering batteries of sophisticated (and expensive) laboratory tests in the workup of patients and skilled in the management of rare and/or complicated diseases. However, their training in general pediatrics is, for the most part, inadequate. Their history-taking is often poor, their physical examinations cursory or incomplete, and their skill in differential diagnosis minimal.
At a time when there is a real need for practicing pediatric generalists, a majority of residents are choosing pediatric subspecialties and academic careers, in large part because their role models are the full-time academic subspecialists. Greater involvement of the practicing pediatric generalist in the teaching of pediatric residents, especially in