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OBJECTIVE:To characterize current practices of US pediatric residency programs around use of community-based continuity clinics for residency training. METHODS:A national, anonymous survey was sent electronically to all US pediatric program directors (PDs) through the Association of Pediatric Program Directors (APPD). The survey assessed preceptor recruitment, faculty development, teaching methods, and PDs' satisfaction with the experience and teaching at community sites. Data were analyzed using descriptive statistics and Chi 2 Test of Independence. RESULTS:A total of 99 of 200 (50%) programs responded.Fifty-six percent (55/99) did not sent any residents into the community. Of the remaining 44 programs, 48% had difficulty recruiting preceptors. Only 34% require preceptors to engage in faculty development around teaching and less than half require community preceptors to work through a formal curriculum. Almost all PDs that sent residents to communitybased practices were very to extremely satisfied with resident experiences (84%), but 37% were not satisfied with residents having their own patient panel. CONCLUSIONS:While the majority of PD's were satisfied with resident experiences in community-based sites, recruitment was challenging, and teaching and faculty development methods varied. Determining incentives to help recruitment, ensuring use of a formal primary care curriculum and providing faculty development around teaching, will be critical for training.

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Our study assessed how primary care providers in a large outpatient network follow ECR guidelines with regards to laboratory screening for comorbidities of obese patients in the 9 to 11 year age group. This retrospective cohort study included 706 patients seen in an outpatient network with a 10 year well child check from 7/1/17 to 7/1/18 and a BMI greater than or equal to the 95th percentile. Our study found 42% of patients, who met ECR guidelines, had no lipid screening or obesity co-morbidity screening obtained. The most frequently abnormal test was the lipid panel, at 23%, and notably 16 % of Hemoglobin A1C screening resulted pre-diabetic range. Our study serves as an updated review of ECR compliance in a large primary care network and suggests an opportunity to enhance education on screening recommendations.