Pediatric training and workforce retention in remote regions: profiles and trajectories of residency graduates
TL;DR
A Pediatric Residency Program at a university hospital located in a remote area of Northeastern Brazil demonstrated a positive impact on graduate training, supporting the development of robust practical and socioemotional competencies and favoring regional retention in pediatrics and neonatology.
Abstract
ABSTRACT Introduction: Medical residency programs in remote regions play a strategic role in strengthening workforce retention and improving the quality of pediatric care. However, few studies have examined the professional trajectories of residency graduates, and their perceptions of the training received. Objective: To describe the sociodemographic profile, professional trajectory, and perceptions of training quality among graduates of a Pediatric Residency Program at a university hospital located in a remote area of Northeastern Brazil. Method: This was a cross-sectional, mixed-methods study involving graduates from 2005 to 2025. Data were collected through an electronic questionnaire addressing sociodemographic characteristics, professional trajectory, geographic retention, and evaluations of practical, theoretical, curricular, and soft-skill training. Descriptive analyses and predefined associations were conducted. Open-ended responses underwent thematic analysis. Results: A total of 39 graduates participated, predominantly women, aged 36-40 years and residing in the state of Rio Grande do Norte. Most participants work in pediatrics-especially neonatology-and maintain professional ties with the public health system. Practical training and preparation for the job market were widely rated as positive, whereas theoretical training more frequently received intermediate ratings. Structural aspects such as workload and supervision were well evaluated, while activities in remote settings and outpatient opportunities were identified as areas for improvement. Soft skills received high scores across all domains. Qualitative analysis reinforced positive perceptions of the training experience and highlighted suggestions for strengthening theoretical and outpatient components. Conclusion: The program demonstrated a positive impact on graduate training, supporting the development of robust practical and socioemotional competencies and favoring regional retention in pediatrics and neonatology. Although structural and theoretical challenges persist, the findings underscore the strategic role of residency programs located in remote areas in strengthening the pediatric workforce and consolidating healthcare delivery in underserved regions.