Peu d’études explorent comment les futurs pédiatres se représentent la médecine de l’adolescent (MA) alors qu’ils y seront confrontés. Ce travail avait pour objectif principal de recueillir les représentations de la MA auprès de futurs pédiatres et pour objectif secondaire de préciser leurs besoins en termes de formation. Un questionnaire déclaratif électronique a été diffusé via l’Association des juniors de pédiatrie (AJP) aux internes de pédiatrie ayant validé 6 semestres. Ce questionnaire, composé de 51 questions, explorait leur caractéristiques démographiques et leur formation pratique en MA ; leur représentations de la MA ; et les besoins ressentis en termes de formation. Cent vingt et un internes ont répondu à l’enquête (taux de réponse 43 %). Les adolescents étaient perçus comme intéressants (75 %) et chronophages (84 %). Quatre cinquième des répondants considéraient qu’une formation spécifique à la MA était nécessaire. Les internes jugeant cette formation inutile étaient ceux qui n’avaient pas pratiqué de stage hospitalier en MA. Un enseignement dédié à la MA avait été proposé à moins de la moitié des internes (45 %). Un tiers des répondants avait effectué un stage d’au moins 2 mois dans une unité de MA. Former les futurs pédiatres à la MA est une priorité en matière de santé publique. Le référentiel de compétences dans ce champ de la pédiatrie doit être articulé avec l’identification de terrains de stages hospitaliers et extra-hospitaliers. À l’heure de la réforme du troisième cycle une mobilisation de la pédiatrie s’impose.

The perception of adolescent medicine (AM) among future pediatricians in France has scarcely been explored although adolescent health care is an integral part of the pediatrician's job. Moreover, pediatric residents seem to have a lack of enthusiasm for this field. The aim of this study was to assess the beliefs and perceptions of fourth-year French pediatric residents regarding adolescents and AM.

We conducted a national electronic survey among French pediatric residents in their last year of residency. An original 51-item, open-ended declarative questionnaire was sent out including questions on demographics, career expectations, AM block rotation experiences, and perceptions and beliefs regarding adolescents and AM. Difficulties and barriers experienced in this field were investigated. Queries about residents’ specific AM courses and about their educational needs were also explored.

The survey was conducted online between January and March 2015. There were 121 respondents, achieving a 43% response rate. The majority of respondents perceived teens as interesting (75%), vulnerable (83%), and time-consuming (84%). Up to four fifths of respondents (81%) considered AM to be a skill that all pediatricians should acquire. A subgroup analysis showed that the residents who had not experienced an AM block rotation did not seem to be convinced of the need for training in this field (P=0.09). The following issues were reported as major difficulties by residents: providing care for teens reluctant to seek health care (65%), managing violent behavior among adolescents in the emergency ward (98%), and managing adolescents who attempt suicide (80%). Less than half (45%) of the residents reported their residency program had a specific AM course. Among them, 73% attended the lectures and 57% found them useful. One third (32%) of the respondents had experienced a 2-month block rotation in the field of AM during their residency.

This is the first nationwide study in France in this field. Although the response rate is below 50%, it exceeded our expectations. Our results are in line with previous studies showing that pediatric residents report a high interest in working with adolescents and yet their educational needs in AM are unmet. The limitations of this study include the self-selection bias and implicit limitations carried by the phrasing of the survey questions.

There is a need to devise a better educational approach combining a broader proposal of AM block rotations together with a specific competency framework in adolescent health, since we know it improves the quality of health care delivered to adolescents. Moreover, training pediatricians in AM is a public health priority so as to comply with medical schools’ principles of social accountability and address the priority health needs for an efficient, equitable, and sustainable health system. At a time when postgraduate reform is being made, the inclusion of an AM curriculum in the general pediatrician course is necessary.