Sir.—I write to laud the articles by Hoekelman1 and Cohen and colleagues2 in the February 1989 issue of AJDC. In looking at the balance between the financial needs of young people in pediatric training and the financial distress that institutions increasingly are incurring and are going to incur to an even greater degree, one wonders whether, in addition to some of the solutions suggested by the above authors, pediatric residency training should be changed, both at the training program level and at the American board level.
Of the total 3 years in pediatric residency at our institution, 3 months are spent on vacation and 6 months are spent in "electives." Of these electives, one is psychosocial and of definitive value in future practice. On the other electives, the resident acts as a junior fellow, by and large, doing the initial consultation on the patient for the fellow