Is it worth it? A qualitative analysis of the impact of medical education fellowships on careers

Abstract

Objectives: Medical education fellowships provide training in teaching, assessment, educational program administration, and scholarship. The longitudinal impact of this training is unknown. The objective of this study was to explore the impact of medical education fellowships on the careers of graduates. Methods:The authors performed a qualitative study with a constructivistinterpretivist paradigm using semistructured interviews in 2021. The authors used a purposeful randomized stratified sampling strategy of graduates to ensure diversity of representation (gender, region, fellowship duration, and career stage). Two researchers independently analyzed interview transcriptions using a modified grounded theory approach. Results:The authors interviewed 10 graduates and identified three overarching concepts: motivations for pursuing fellowship, benefits of training, and drivers of career development. Graduates sought training because of their desire for growth and career preparation and at the advice of mentors. Fellowships provided knowledge and skills in a structured learning environment, supported by mentors and a collaborative community. Fellowship training shaped the careers of graduates by increasing their self-efficacy, enhancing their outcome expectations, refining their goals, and influencing their professional identity formation. They acquired expertise that prepared them for jobs, developed credibility, felt competitive in the job market, anticipated successful promotion, reached for greater goals, broadened their educational worldview, and evolved their professional identity as a result of fellowship training. Conclusions: Fellowship training in medical education provides knowledge and skills, a structured learning environment, and important relationships that shape the careers of graduates by impacting their self-efficacy, outcome expectations, goal creation, and professional identity formation. INTRODUC TI ON The availability of formal postgraduate training in medical education grew significantly over the past few decades, resulting in the creation of more than 40 medical education fellowships in the field of emergency medicine (EM) alone. 1,2 Medical education fellowships offer many advantages, including professional development, protected time, dedicated mentorship, and continued clinical practice, all of which are important to early career success in academic medicine. 3-5 However, the impact fellowships have on graduates' careers is unclear. Prior research attempted to assess the outcomes of medical education fellowships in a number of ways, including studies of the curricular structure of these fellowships and cataloging the publications and other academic achievements of fellowship graduates and by soliciting the opinions of academic chairs. 2,4-10 Missing from this research are the perspectives of fellowship graduates on their own careers. They can also provide important insights to residents considering such training, inform departmental leaders contemplating a greater investment in medical educa...

RaT race: A standardized open‐access education resource provides a structured resident‐as‐teacher experience

“…While the proportion of sessions taught by residents varied between residency programs, most programs favored senior resident instructors, which is aligned with FoEM's implementation guidelines 44 . The fact that residents appear to be motivated by their interest in teaching and a desire to give back to their residency programs and FoEM is not surprising as personal interest has been identified previously as a motivator for participation in specialized activities 64,65 . Faculty identified multiple benefits of FoEM, including the opportunity for a structured RaT experience, reducing the need for faculty teachers, and having available materials requiring minimal preparatory time.…”

“…44 The fact that residents appear to be motivated by their interest in teaching and a desire to give back to their residency programs and FoEM is not surprising as personal interest has been identified previously as a motivator for participation in specialized activities. 64,65 Faculty identified multiple benefits of FoEM, including the opportunity for a structured RaT experience, reducing the need for faculty teachers, and having available materials requiring minimal preparatory time. Given the broad use of FoEM in EM, incorporation of FoEM as a RAT experience could augment these benefits on a large scale, assisting programs in meeting regulatory requirements, structuring RaT training nationally, and offsetting the workload of faculty educators who often have multiple leadership roles and competing demands on their time.…”

Development of entrustable professional activities for emergency medicine medical education fellowships: A modified Delphi study

“…By applying this outcomes‐based framework, the EPAs developed in this study will be better able to meet the current needs of MedEd systems 12,39–40 . Additionally, as many MedEd fellowship graduates go on to serve in leadership positions in MedEd, the application of this framework can have macro level influence, impacting patients served by physicians these fellows train 1,10,12,39–41 …”

“…12,[39][40] Additionally, as many MedEd fellowship graduates go on to serve in leadership positions in MedEd, the application of this framework can have macro level influence, impacting patients served by physicians these fellows train. 1,10,12,[39][40][41] This list of core EPAs has multiple applications. This is the first step in implementing competency-based education in EM MedEd fellowships as the EPAs created in this study, once comprehensively described, can be adopted by all EM MedEd fellowships as a competency-based outcomes framework.…”

“…Components and outcomes of both 1‐year teaching and 2‐year education scholarship fellowships are variable and site‐dependent 5,6 . Limited studies have assessed outcomes of MedEd fellowships, but objective outcome data for fellows and what they pursue after fellowship continues to be a challenge 9–11 . Department chairs, fellowship directors, and other major stakeholders continue to perceive a need for further training in many areas 11 .…”