A Qualitative Study of Internal Medicine Subspecialty Fellowship Program Directors' Perspectives on Short-Term Hospitalist Employment Prior to Fellowship.

Publisher: Accreditation Council for Graduate Medical Education Country of Publication: United States NLM ID: 101521733 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1949-8357 (Electronic) Linking ISSN: 19498357 NLM ISO Abbreviation: J Grad Med Educ Subsets: MEDLINE

Original Publication: Chicago, ILL : Accreditation Council for Graduate Medical Education

Hospitalists* ; Fellowships and Scholarships* ; Internship and Residency* ; Internal Medicine*/education ; Qualitative Research* ; Employment*; Humans ; Education, Medical, Graduate ; Female ; Male ; Interviews as Topic

Background Some internal medicine (IM) residents pursuing subspecialty training choose short-term hospitalist employment prior to fellowship, or "pre-fellowship hospitalist years." Residency and fellowship program directors (PDs) advise residents on this decision, but PD experience with fellows pursuing pre-fellowship hospitalist years and the impact on fellowship applications is unknown. Objective We aimed to explore perceptions of fellowship PDs regarding experience with fellows who pursued pre-fellowship hospitalist years, including perceived effects on how such years affect fellowship application candidacy. Methods A purposive sample of 20 fellowship PDs in the most highly competitive and commonly selected IM fellowships (cardiology, pulmonology/critical care medicine, hematology/oncology, gastroenterology) from 5 academic institutions were approached for participation in fall 2021. Interviews included semi-structured questions about pre-fellowship hospitalist employment. Utilizing rapid qualitative analysis, interview transcripts were summarized and reviewed to identify themes and subthemes describing fellowship PDs' perspectives of pre-fellowship hospitalist years. Results Sixteen fellowship PDs (80%) participated. PDs identified 4 major themes as important for trainees considering pre-fellowship hospitalist years: (1) Explain the "Why"-why the year was pursued; (2) Characteristics of the Hospitalist Position-what type of employment; (3) The Challenges-potential concerns faced with pre-fellowship hospitalist years; and (4) Describe the "What"-the experience's contribution to resident professional development. Conclusions Fellowship PDs in 4 competitive IM subspecialities placed a strong emphasis on explaining a clear, logical reason for seeking short-term hospitalist employment prior to fellowship, describing how it fits into the overall career trajectory, and selecting activities that demonstrate continued commitment to the subspecialty.

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Date Created: 20240712 Date Completed: 20240712 Latest Revision: 20240714

20240714

PMC11234311

10.4300/JGME-D-23-00550.1

38993320