Graduating Pediatric Residents Entering the Hospital Medicine Workforce, 2006–2015

Leyenaar, JoAnna K.; Frintner, Mary Pat

doi:10.1016/j.acap.2017.05.001

Cited by 26 publications

(26 citation statements)

References 20 publications

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“…Researchers demonstrated that new pediatric residency graduates who took positions at community sites were influenced by control over working hours and acceptable income in one study. 6 In a different study, researchers found that community PHM physicians prioritized resource availability, work schedules, and clinical responsibilities over nonclinical responsibilities and career development. 10 Although the physicians in our study were also motivated by work-life integration and various clinical responsibilities as seen in the themes of personal and professional satisfaction and scope of practice, income was not mentioned as a motivating factor.…”

Section: Discussionmentioning

confidence: 99%

“…Authors of previous studies have shown that graduating residents and PHM fellows more frequently choose to work at universitybased sites. 5,6 A study of PHM fellowship graduates revealed that 72% worked in freestanding children' s hospitals and 96% worked in an environment where trainees provide a significant portion of patient care. 5 Similarly, in a study of residency graduates from 2006 to 2015, 60.7% chose to work in a tertiary care setting.…”

mentioning

confidence: 99%

“…5 Similarly, in a study of residency graduates from 2006 to 2015, 60.7% chose to work in a tertiary care setting. 6 This suggests that fellowship and residency graduates prefer university-based positions over community-based jobs. However, only ∼30% of pediatric hospitalizations occur in freestanding children' s hospitals.…”

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confidence: 99%

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Career Motivators for Community Pediatric Hospitalists

Jackson

Marek

Fromme

2019

Hospital Pediatrics

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BACKGROUND AND OBJECTIVES: Within the field of pediatric hospital medicine, physicians can choose to work at community-based or university-based centers. The factors that motivate pediatric hospitalists to work specifically at community sites have not yet been fully explored. Our objective with this study was to elucidate the motivators for pediatric hospitalists to begin and continue work at community sites. METHODS: A qualitative study was performed via phone-based focus groups. Physicians were included if they were able to attend 1 of the offered group sessions and they self-identified as spending the majority of their time working as community-based pediatric hospitalists. Data were analyzed through a constant comparative analysis. RESULTS: Five themes emerged regarding factors that motivate pediatricians to begin and continue their careers as hospitalists in the community. The themes were (1) professional impact, (2) scope of practice, (3) personal and professional satisfaction, (4) community involvement, and (5) job availability.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Career Motivators for Community Pediatric Hospitalists

Jackson

Marek

Fromme

2019

Hospital Pediatrics

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“…Although the number of PHM fellowship positions is expected to grow in the coming years, there is currently a shortage relative to the anticipated demand. With approximately 2,800 US pediatric residents graduating annually and data indicating that 7% of graduating residents enter and remain in PHM for at least fi ve years, 10,11 almost 200 fellowship spots may be needed each year. As of November 2019, 77 fellowship positions were available for residents graduating in 2020, 12 which is less than half of the potential demand.…”

Section: Fellowship Training and The Phm Pipelinementioning

confidence: 99%

The Future of Pediatric Hospital Medicine: Challenges and Opportunities

Wang

Shaughnessy

Leyenaar

2020

Journal of Hospital Medicine

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P ediatric hospital medicine (PHM) is in the midst of an exciting period of growth. In 2016, the American Board of Medical Specialties approved the petition for PHM to become the newest pediatric subspecialty, taking PHM on a divergent path from the Focused Practice in Hospital Medicine designation established for adult hospitalists. Establishment as a subspecialty has allowed PHM to defi ne the unique skills and qualifi cations that hospitalists bring to patients and the healthcare system. These skills and qualifi cations are delineated in the PHM core competencies and national fellowship curriculum. 1,2 In order to realize the vision of PHM to improve care for hospitalized children described by Roberts et al., 3 concerted efforts are needed to train and retain a workforce that is equipped with the skills to catalyze improvements in inpatient pediatric care. We discuss challenges and opportunities facing PHM in workforce development, sustainability of clinical work models, and interhospital collaboration. FELLOWSHIP TRAINING AND THE PHM PIPELINEThe development of PHM as a subspecialty was driven by a number of factors. 4 The acuity of hospitalized children has increased signifi cantly, with a population comprised of more children with complex chronic conditions and/or technology dependence, serious complications of acute conditions, and acute mental health problems. At the same time, the medical and behavioral conditions seen by outpatient general pediatricians have become more complex and time intensive, with these practitioners less likely to work in inpatient settings. Hospitalist care has positive impacts on healthcare effi ciency and value, and both parents and primary care pediatricians report high levels of satisfaction with the healthcare delivered by PHM services. 4 A national count of the number of pediatric hospitalists is currently lacking. Conservative estimates suggest that at least 3,000 pediatric hospitalists currently practice in the United States. 5 These hospitalists have highly varied scopes of practice and work across diverse settings-more diverse, perhaps, than any other pediatric subspecialty. Although diffi cult to quantify, we estimate that approximately one-third of pediatric hospitalists in the US work in community hospitals and the remainder practice at children's hospitals. 6 Many of the needs of hospitalized children differ across these settings, and the roles and challenges faced by hospitalists in these settings correspondingly differ. Community hospitalists frequently take active roles in newborn care and emergency department consultation, often without the support of other pediatric subspecialties. 7 In contrast, hospitalists working at children's hospitals more frequently care for highly complex patients, often collaborate across multiple specialties and assume nonclinical roles in quality improvement (QI), research, and medical education.

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“…10 The ABMS approved the ABIM/ABFM FPHM as its first approved designation in March 2017 after more than 2,500 physicians earned this designation. 11 Of the >2,800 pediatric residency graduates (not including combined programs) each year, 10% report planning on becoming pediatric hospitalists, 12 and currently only 72-74 fellows graduate from PHM fellowships yearly. 13 FPHM for pediatric hospital medicine would provide focused maintenance of certification and hospitalist designation for those who cannot match to fellowship programs.…”

Section: Future Directions For Pediatric Hospitalistsmentioning

confidence: 99%