Association of Pediatric Program Directors (APPD): About Us

About The APPD

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A Brief History of The Association of Pediatric Program Directors

In the early 1980s the American Board of Pediatrics had been active in sponsoring programs for pediatric program directors during which concerns pertinent to graduate medical education were discussed. At those meetings program directors expressed a need for an ongoing forum for communication among program directors from both medical school and non-medical school training programs. In the spring of 1984 the American Board of Pediatrics (ABP) approached the American Academy of Pediatrics (AAP) and the Association of Medical School Pediatric Department Chairman (AMSPDC) to ask them to consider the formation of an association of pediatric program directors. An ad hoc committee consisting of Edmund C. Burke, M.D., Robert J. Haggerty, M.D., Donal M. Dunphy, M.D., Melvin E. Jenkins, M.D., Thomas K. Oliver, Jr., M.D., Joseph W. St. Geme, Jr., M.D., Evan Charney, M.D., Henry R. Shinefield, M.D., and Harold Meyer, M.D. was formed. The committee met in San Francisco on May 2, 1984 and was unanimous in favor of the formation of an association of pediatric program directors. The key strategic decision was made at that meeting that the Association should be independent of AMSPDC so that non-medical school programs could fully participate. Bylaws were drafted which apportioned the offices by class of program: medical school, non-medical school, military, etc. Membership was initially limited to the "designated director of the residency training program as listed with the Residency Review Committee for Pediatrics" or "the chairman of the department of pediatrics responsible for the training program where there is a separately designated program director" and "the director of a pediatric program that is an affiliate of a component of a program listed with the Residency Review Committee." A steering committee consisting of Evan Charney, M.D., Robert S. Holm, M.D., Melvin E. Jenkins, Jr., M.D., Thomas K. Oliver, Jr., M.D., Henry R. Shinefield, M.D., and Joseph W. St. Geme, Jr., M.D. was formed.

The first meeting of the Association of Pediatric Program Directors occurred at the Washington Sheraton Hotel in Washington, D.C. the evening of Thursday, May 9, 1985 from 7:00 p.m. to 10:00 p.m. in association with the APS/SPR/APA meeting. The steering committee presented and the attendees approved the following slate of candidates; Henry R. Shinefield, M.D., President, Thomas K. Oliver, Jr., M.D., President-Elect, Robert S. Holm, M.D., Secretary/Treasurer, and Gerald B. Merenstein, M.D., Evan Charney, M.D., and Melvin E. Jenkins, Jr., M.D. as Councilors. The bylaws were approved. The agenda for that first meeting is attached. The Articles of Incorporation of The Association of Pediatric Program Directors were filed in the Office of the Michigan Department of Commerce, Corporations and Securities on February 12, 1986.

The annual meeting of the APPD has been held in conjunction with the APS/SPR/APA (now designated Pediatric Academic Societies (PAS)) each spring. Over the first several years the meeting expanded from three hours in the evening to a morning meeting with presentations by various organizations including the ABP, AAP, and NRMP. In 1988 the meeting expanded to a full day meeting with invited workshops in the afternoon.

The early meetings appear to have been dominated by discussions of medical manpower issues, particularly the perception that too many subspecialists were being trained and that primary care should be emphasized, the proposal of the American Board of Pediatrics to initiate time limited certification, and issues related to the Residency Review Committee. These early meetings also produced a number of resolutions including the following from the spring 1986 meeting "Be it resolved that the American Academy of Pediatrics, American Board of Pediatrics, and The American Medical Association be petitioned to allow the Association of Pediatric Program Directors to provide them with a list of recommendations for possible appointments to the Residency Review Committee and be it further resolved that the Accreditation Council for Graduate Medical Education be petitioned to create a position on the Pediatric Residency Review Committee for an appointment from The Association of Pediatric Program Directors."

In 1990 the annual spring meeting unofficially expanded to a two day format with a one day "pre-meeting" consisting of an introductory leadership training seminar for program directors led by Robert Doughty, M.D., Harold Seashore, Ph.D., and Edith Seashore, M.S.W. In 1991 the pre-meeting was expanded to include parallel seminars for introductory leadership training and advanced leadership training. In 1991 the growing need for some orientation of new program directors was first met by a three-hour dinner meeting for new program directors the evening before the main spring meeting. The year 1991 was also notable for contact by an ad hoc group of medicine/pediatrics program directors with the APPD suggesting an ongoing liaison and contact from Larry Wolk, M. D., the chair of the AAP Resident Section, suggesting a liaison between AAP Residency Section and the APPD.

For the first several years of the Association the board met once a year on the evening following the annual meeting. In 1989 or 1990 the board began to hold an additional one-day meeting each September in the Washington, D.C. area. The fall board meeting dealt with issues that had come to the attention of the APPD leadership since the previous spring meeting and served as a planning session for the following spring meeting. In 1991 an amendment to the by-laws expanded the number of councilors from three to four.

The spring 1992 meeting was notable for an expanded pre-meeting with an "open forum on the special needs of small pediatric residencies" listed in the program as lasting from "2:00 p.m. to 10:00 p.m. (or whatever)". The 1992 spring meeting also contained a serious dialogue between the ABP and the APPD regarding the ABP's proposed new resident tracking system. That dialogue appears to be the first instance of APPD input having a significant impact on the policies and procedures of one of the established regulatory pediatric entities. Another major topic at the spring 1992 meeting was the issue of ethics in recruitment through the Match. A process was begun in 1992 that extended over a two-year period to draft guidelines for ethics in recruitment. That effort came to an end when the Department of Justice issued a restraining order against the Association of Family Practice Residency Program Directors stating that the AFPDs proposed ethics in recruitment statement was in violation of various restraint of trade provisions of labor statue. In May 1992, Julia A. McMillian, M.D. succeeded Robert S. Holm, M.D. as Secretary/Treasurer. Bob Holm assumed the position of Executive Secretary.

By the early 1990s the APPD had established on-going liaison relationships with a number of organizations including COPE (Council on Pediatric Education), PCOC (Primary Care Organization Consortium), FOPO (Federation of Pediatric Organizations), MPPDA (Medicine/Pediatrics Program Directors Association), NRMP (National Residency Matching Program) and the RRC. Intermittent liaison has been maintained with the AAMC (American Association of Medical Colleges), and COMSEP (Council on Medical School Education in Pediatrics). As liaisons with other organizations grew, the need for continuity in leadership became more apparent. The terms of the president, president-elect, and past-president were extended by amendment to the by-laws from one year to two years. The first president to serve a two-year term was Kenneth Roberts, M.D., from May 1994 through May 1996.

Dr. Roberts was responsible for initiating the accelerating growth of the APPD that began in the mid-1990s. He retained the Degnon Associates as the APPD's professional management in the later part of his tenure with George Degnon becoming the Executive Secretary in 1996 replacing Bob Holm. A key board meeting occurred the evening of the spring meeting of 1996. At that meeting the president and executive director of the Association of Program Directors of Internal Medicine (APDIM) presented an overview of their organization's structure and activities. Their organization included program directors, chief residents, and residency coordinators as well as program directors. APDIM held two annual meetings, had an ongoing professional staff, and an ongoing committee structure. The board at that meeting decided to consider expansion of APPD activities along the line of APDIM. Membership dues were increased from $60 to $150. A new enhanced newsletter was published for the first time in the summer of 1996. A significant board meeting followed in October 1996 during which a number of topics were discussed: an annual fall meeting with an emphasis on orientation of new program directors, a committee structure, the inclusion of residency coordinators and chief residents in the organization, expanded liaisons with other pediatric organizations, the exploration of potential outside funding for APPD activities and initiatives, a revision of the by-laws to support these activities, and a "ramping up" of membership dues to support the professional management of the association and its increased activities with George and Laura Degnon of Degnon Associates providing administrative support.

Between 1996 and 1998 many of these strategic goals were met. The first fall meeting of the Association of Pediatric Program Directors took place at the Ritz Carlton Hotel in Tyson's Corner, Virginia in September 1997. This meeting, which provided orientation for new program directors and coordinators, had 116 registrants. Significant external funding was obtained for the first time by the association for the production of a pediatric procedure logbook for residents that was produced in 1998. A competitive process of workshop proposals for the spring meeting was initiated in place of invited workshops. A committee structure was created. The first logo for the association, the now familiar letter blocks, was adopted. A program director's handbook was created. The APPD ListServ came on line 1997, thanks to Drs. Glenda Lindsay and Bob Kamei. The residency coordinators were fully integrated into the spring meeting for the first time in April 1998. And, last but not least, the by-laws revision process that had begun under Ken Roberts was completed. Laura Degnon succeeded George Degnon as the Executive Director of the APPD. Carol Berkowitz became the first president of the APPD to address a plenary session of AMSPDC.

From 1998 through 2001 the Association has continued to flourish. The fall meeting has become an entrenched feature of the Association; the fifth annual fall meeting in 2001 being cancelled because of the World Trade Center tragedy. The promising early liaison with the Medicine/Pediatrics Program Association has grown with the significant presence of the MPPDA at the 1999 and 2001 spring meetings. The Association has become a respected advocate for graduate medical education. The RRC has solicited input from the Association for the past two revisions of its program requirements for pediatrics. Dr. Carol Carraccio, the current president of the association, has been a vital link between the association and the ACGME's outcomes project. Significant funding was obtained from Pfizer to initiate the Association of Pediatric Program Directors' Consultation Awards, three day consultation visits to programs to furnish advice on curriculum development, implementation of residency review committee requirements, or preparation for accreditation site visits and program evaluation. Awards of up to $5,000 were to begin to selected programs to fund the consultations in 2001. The consultation program was developed under the guidance of Dr. Edward L. Zalneratis, the president-elect of the association. The APPD web page, www.APPD.org came on line in the spring of 1999. Elections for the various Association offices are now fully competitive. Between 1998 and 2001 the association was significantly involved with the Federation of Pediatric Organizations as that federation began to consider implementation of the FOPE II report. The association also provided valuable input to the National Residency Matching Program as it changed over from a "hospital selecting" to "student selecting" algorithm and as it considered a two phased match. The recent establishment of the task forces creates the potential for broad ongoing membership participation.