Current Roles and Perceived Needs of Pediatric Hospital Medicine Fellowship Graduates

Abstract

OBJECTIVES: Pediatric hospitalists report the need for additional training in clinical and nonclinical domains. Pediatric hospital medicine (PHM) fellowships seek to provide this training and produce leaders in the field. Our objective is to describe current roles and perceived training needs of PHM fellowship graduates. METHODS: In 2014, all PHM fellowship graduates were asked to complete a Web-based survey. Survey questions addressed demographics, past training, current roles, and training needs in clinical care, research, education, and administration. Associations between fellowship experiences and outcomes were examined. RESULTS: Fifty-one of 61 eligible individuals completed the survey. Average duration as a pediatric hospitalist was 5 years. Ninety percent completed pediatric categorical residency, whereas 10% completed an Internal Medicine-Pediatrics Residency. Most respondents completed a 1- (38%) or 2-year (46%) fellowship program. Ninety-six percent of respondents currently work in academic environments. The perceived need for additional clinical training was low, except procedures (44%). Nearly all teach medical students and pediatric residents, reporting adequate training in variety of teaching strategies. The majority of respondents conduct research, most commonly quality improvement (QI; 67%) and education (52%). Two-thirds are first authors on at least 1 peer-reviewed article. Research training needs include QI methodology (44%), biostatistics (43%), and obtaining funding (54%). A considerable number of respondents have academic leadership positions. CONCLUSIONS: PHM fellowship graduates are academic hospitalists with diverse responsibilities. Despite a short average career span, many have achieved leadership roles and been academically productive. Future curriculum development should focus on procedures, QI, and research training.

Development of a Curricular Framework for Pediatric Hospital Medicine Fellowships

“…Furthermore, they report significant amounts of effort spent in research, QI, development of practice guidelines, medical education, and hospital leadership. 15,17 When comparing perceived competencies between fellowshiptrained and nonfellowship-trained pediatric hospitalists, it is noted that fellowship-trained physicians report feeling more competent in managing patients with medical complexity, undertaking research projects, participating in and leading QI programs, and educating trainees. 14 This curricular framework includes specific training in each of these areas to ensure continued competence for fellows in training.…”

“…Most needs identified were in nonclinical areas, such as hospital program management, practice guideline design, development of educational curricula, and research skills. 15 Our curricular framework is built to include and bolster these areas. Furthermore, 40% of recent fellowship graduates noted deficiencies in their procedural skills.…”

“…Furthermore, 40% of recent fellowship graduates noted deficiencies in their procedural skills. 15 We anticipate that the required clinical EUs and additional individualized study will allow programs to address this gap.…”

“…The group also reviewed current literature regarding reported needs of PHM fellowship graduates and practicing pediatric hospitalists to ensure alignment of the framework with needs of those in the field. 14,15 The framework was then finalized at the annual PDs' meeting in July 2016. Key components addressed included minimum required EUs for core clinical activities and site characteristics, such as community versus tertiary/quaternary hospital.…”

Learning by Doing: Design and Evaluation of a Quality Improvement Curriculum for Pediatric Hospitalists

“… 6 Another survey of recent Pediatric Hospital Medicine (PHM) fellowship graduates identified a similar perceived need for further QI training, despite the additional QI exposure during most fellowships. 7 Need for faculty training in QI is magnified at academic medical centers, where a lack of faculty mentors is a frequently cited barrier to teaching QI to residents and medical students. 3 , 4 , 8 – 10 …”