Perceptions and Attitudes Toward Single-Board Hematology Training in the United States: A Program Director Survey

BACKGROUND: The American Board of Internal Medicine (ABIM) offers separate board examinations for adult hematology and medical oncology, yet the vast majority of fellowship training programs in the United States are structured as combined hematology/oncology programs. Single-board hematology tracks or programs may help increase recruitment and retention in non-malignant hematology; however, the barriers and attitudes toward hematology-only fellowship programs are unknown. We administered a survey to ACGME-accredited hematology/oncology program directors to explore their perceptions toward training in non-malignant hematology and their attitudes toward single-board hematology training. METHODS: In collaboration with the ASH Medical Educators Institute, we developed an anonymous online survey with 30 multiple-choice and open-ended questions to characterize attitudes toward specialization in non-malignant hematology and to assess program director interest and perceived barriers toward single-board hematology training. The survey was electronically administered to program directors of active hematology/oncology fellowship programs in the United States (n=139) in March/April 2019 using Qualtrics software. RESULTS: Of the 139 program directors who received the survey, 90 (65% response rate) completed the survey. The majority of program directors characterized their institutions as academic (87%), with only 9 (10%) describing their programs as community-based. Seventy-eight (87%) program directors believed that there is a shortage of exclusive non-malignant hematologists in the United States, and 59% felt that training more fellows to practice exclusive non-malignant hematology could help address the shortage (Table 1). Jobs for for exclusive non-malignant hematologists were perceived to exist only in academic settings by 47 (52%) respondents. In terms of fellowship training, program directors reported that an average of 5% of fellows per program pursued a career largely or exclusively focused on non-malignant hematology. In addition, 39 (43%) program directors felt that fellows were dissuaded from pursuing a career exclusively in non-malignant hematology. Regarding single-board hematology training, 73% of program directors believe that hematology-only training is both necessary and sufficient for fellows specializing in non-malignant hematology. The most commonly perceived barriers to single-board hematology fellowship programs were: 1) concerns for job availability for single-board hematology trainees, 2) concerns about limiting the training option to hematology only, and 3) lack of interested applicants to the program (Table 2). If barriers were addressed, 37% of programs directors reported that they would be interested in implementing a single-board hematology track at their institution. CONCLUSIONS: Combined hematology/oncology fellowship training is nearly exclusive to the United States. Our survey demonstrates that the percentage of fellows specializing in non-malignant hematology is significantly low (5%), a number that remains unchanged compared to a prior ASH program director survey in 2003. Our results also suggest that programs directors are interested in training fellows in non-malignant hematology and that single-board hematology training is generally acceptable among program directors. It will be important to address perceived barriers to hematology-only programs in order to promote implementation. Disclosures Naik: Elsevier: Other: Content Editor. Nagalla:Alnylam: Membership on an entity's Board of Directors or advisory committees.

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Education Research: Multiple sclerosis and neuroimmunology fellowship training status in the United States

Neurology ◽

10.1212/wnl.0000000000009096 ◽

2020 ◽

Vol 94 (11) ◽

pp. 495-500 ◽

Cited By ~ 1

Author(s):

Ahmed Z. Obeidat ◽

Yasir N. Jassam ◽

Le H. Hua ◽

Gary Cutter ◽

Corey C. Ford ◽

...

Keyword(s):

United States ◽

Multiple Sclerosis ◽

Program Directors ◽

The United States ◽

Fellowship Training ◽

Current Status ◽

Application Process ◽

Shared Resources ◽

Fellowship Programs ◽

Internal Funding

ObjectiveTo investigate the current status of postgraduate training in neuroimmunology and multiple sclerosis (NI/MS) in the United States.MethodsWe developed a questionnaire to collect information on fellowship training focus, duration of training, number of fellows, funding application process, rotations, visa sponsorship, and an open-ended question about challenges facing training in NI/MS. We identified target programs and sent the questionnaires electronically to fellowship program directors.ResultsWe identified and sent the questionnaire to 69 NI/MS fellowship programs. We successfully obtained data from 64 programs. Most programs were small, matriculating 1–2 fellows per year, and incorporated both NI and MS training into the curriculum. Most programs were flexible in their duration, typically lasting 1–2 years, and offered opportunities for research during training. Only 56% reported the ability to sponsor nonimmigrant visas. Most institutions reported having some internal funding, although the availability of these funds varied from year to year. Several program directors identified funding availability and the current absence of national subspecialty certification as major challenges facing NI/MS training.ConclusionOur study is the first to describe the current status of NI/MS training in the United States. We found many similarities across programs. We anticipate that these data will serve as a first step towards developing a standard NI/MS curriculum and help identify areas where shared resources could enhance trainee education despite differences in training environments. We identified funding availability, certification status, and nonimmigrant visa sponsorship as potential barriers to future growth in the field.

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Resident Involvement in Tactical Medicine: 12 Years Later

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19000013 ◽

2019 ◽

Vol 34 (02) ◽

pp. 217-219

Author(s):

Nicholas P. Petit ◽

Jason P. Stopyra ◽

Ricardo A. Padilla ◽

William P. Bozeman

Keyword(s):

Law Enforcement ◽

Online Survey ◽

The United States ◽

Fellowship Training ◽

Federal Law ◽

Law Enforcement Agencies ◽

Special Operations ◽

Resident Involvement ◽

Fellowship Programs ◽

Tactical Medicine

Introduction:Interest in tactical medicine, the provision of medical support to law enforcement and military special operations teams, continues to grow. The majority of tactical physicians are emergency physicians with additional training and experience in tactical operations. A 2005 survey found that 18% of responding Emergency Medicine (EM) residencies offered their resident physicians structured exposure to tactical medicine at that time.Methods:This study sought to assess interval changes in tactical medicine exposure during EM residency and Emergency Medical Services (EMS) fellowship training. A secure online survey was distributed electronically to all 212 EM residency programs and 44 EMS fellowship programs in the United States.Results:Responses were received from 99 (46%) EM residency and 40 (91%) EMS fellowship programs. Results showed that 52 (53%) of the responding residencies offered physician trainees formal exposure to tactical medicine as part of their training (P < .0001 compared to 18% in 2005). In addition, 32 (72%) of the 40 responding EMS fellowships (newly established since the initial survey) offered this opportunity. Experiences ranged from observation to active participation during tactical training and call-outs. The EM residents and EMS fellows provide support to local, state, and federal law enforcement agencies. A small number of programs (six residencies and four fellowships) allowed a subset of qualified trainees to be armed during tactical operations.Conclusion:Overall, training opportunities in tactical medicine have grown significantly over the last decade from 18% to 53% of responding EM residencies. In addition, 72% of responding EMS fellowships incorporate tactical medicine in their training program.Petit NP, Stopyra JP, Padilla RA, Bozeman WP. Resident involvement in tactical medicine: 12 years later. Prehosp Disaster Med. 2019;34(2):217–219

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Status of global health fellowship training in the United States and Canada

Canadian Medical Education Journal ◽

10.36834/cmej.56953 ◽

2019 ◽

Vol 10 (4) ◽

pp. e80-e95

Author(s):

Ann Evensen ◽

Sean Duffy ◽

Russell Dawe ◽

Andrea Pike ◽

Brett Nelson

Keyword(s):

Global Health ◽

Program Directors ◽

The United States ◽

Fellowship Training ◽

Web Based ◽

Training Requirements ◽

Median Size ◽

Fellowship Programs ◽

Program Characteristics ◽

Clear Objective

Background: Increasing numbers of residency graduates desire global health (GH) fellowship training. However, the full extent of training options is not clear. Objective: To identify clinical GH fellowships in all specialties in the U.S. and Canada and to describe their demographics, innovative features, and challenges. Methods: The authors surveyed program directors or designees from GH fellowships with a web-based tool in 2017. Program directors reported demographics and program characteristics. Results: The authors identified 85 potential programs. Fifty-four programs (63.5%) responded confirming 50 fellowships. The number of U.S. GH fellowship programs increased by 89.7% since 2010. One-third of fellowships accepted graduates from more than one specialty. The most common single-specialty programs were Emergency Medicine or Family Medicine. Fellowship duration was most commonly 24 months. Median size was one fellow per year. Funding and lack of qualified applicants were significant challenges. Most programs were funded through fellow billing for patient care or other means of self-support. Conclusions: The number of U.S. and Canadian GH fellowship programs has nearly doubled since 2010. Programs reported lack of funding and qualified applicants as their most significant challenges. Consensus amongst stakeholders regarding training requirements may improve outcomes for future fellows, their employers, and the patients they serve.

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Glomerular Disease Education Experience across Nephrology Fellowship Programs: An International Survey

Glomerular Diseases ◽

10.1159/000521598 ◽

2021 ◽

Author(s):

Harish Seethapathy ◽

Sayna Norouzi ◽

Kate J. Robson ◽

Lida Gharibvand ◽

Ali Poyan Mehr

Keyword(s):

Online Survey ◽

The United States ◽

Fellowship Training ◽

Glomerular Disease ◽

Comfort Level ◽

Diagnosis And Treatment ◽

Multiple Choice Questions ◽

Glomerular Diseases ◽

Fellowship Programs ◽

Disease Study

Introduction: Glomerular disease (GN) education is an important, albeit a challenging component of nephrology fellowship training. We hypothesized that trainee experience varies widely across programs, leading to differences in self-reported comfort levels in the diagnosis and management of glomerular diseases. Methods: The Glomerular Disease Study & Trial Consortium (GlomCon) conducted an anonymous online survey to determine the educational experience of nephrology trainees. We used multiple-choice questions to obtain data about a) curriculum-based education, b) dedicated specialty clinic, and c) exposure to pathology. We leveraged a visual analogue scale of 1-100 (with a higher number indicating a higher comfort level) to assess self-reported levels of clinical comfort. The survey was disseminated via email to the subscribing members of GlomCon, and through Twitter. Results: In total, there were 109 respondents to our survey, and 56% were from training programs in the United States. Exposure to a specialized GN clinic was reported by 45%, while 77% reported the presence of an onsite nephropathologist at their training program. Self-reported comfort scores were 59±25 and 52±25 for diagnosis and treatment of glomerular diseases respectively. Days spent in GN clinic per year, years of fellowship and dedicated nephropathology didactics were associated with higher diagnosis and treatment comfort scores. Conclusion: Trainees report a wide variation in glomerular disease education across fellowship programs. A lack of nephropathology exposure and a dedicated GN curriculum were associated with lower scores in self-reported clinical comfort in caring for patients with glomerular disease.

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Impact of COVID-19 on gastroenterology fellowship training: a multicenter analysis of endoscopy volumes

Endoscopy International Open ◽

10.1055/a-1526-1419 ◽

2021 ◽

Vol 09 (10) ◽

pp. E1572-E1578

Author(s):

Swathi Paleti ◽

Zain A. Sobani ◽

Thomas R. McCarty ◽

Aditya Gutta ◽

Anas Gremida ◽

...

Keyword(s):

United States ◽

The United States ◽

Fellowship Training ◽

Volume Data ◽

Historic Period ◽

Endoscopy Training ◽

Period 2 ◽

Fellowship Programs ◽

Procedure Volume ◽

Lower Endoscopy

Abstract Background and study aims The COVID-19 pandemic has had a profound impact on gastroenterology training programs. We aimed to objectively evaluate procedural training volume and impact of COVID-19 on gastroenterology fellowship programs in the United States. Methods This was a retrospective, multicenter study. Procedure volume data on upper and lower endoscopies performed by gastroenterology fellows was abstracted directly from the electronic medical record. The study period was stratified into 2 time periods: Study Period 1, SP1 (03/15/2020 to 06/30/2020) and Study Period 2, SP2 (07/01/2020 to 12/15/2020). Procedure volumes during SP1 and SP2 were compared to Historic Period 1 (HP1) (03/15/2019 to 06/30/2019) and Historic Period 2 (HP2) (07/01/2019 to 12/15/2019) as historical reference. Results Data from 23 gastroenterology fellowship programs (total procedures = 127,958) with a median of 284 fellows (range 273–289; representing 17.8 % of all trainees in the United States) were collected. Compared to HP1, fellows performed 53.6 % less procedures in SP1 (total volume: 28,808 vs 13,378; mean 105.52 ± 71.94 vs 47.61 ± 41.43 per fellow; P < 0.0001). This reduction was significant across all three training years and for both lower and upper endoscopies (P < 0.0001). However, the reduction in volume was more pronounced for lower endoscopy compared to upper endoscopy [59.03 % (95 % CI: 58.2–59.86) vs 48.75 % (95 % CI: 47.96–49.54); P < 0.0001]. The procedure volume in SP2 returned to near baseline of HP2 (total volume: 42,497 vs 43,275; mean 147.05 ± 96.36 vs 150.78 ± 99.67; P = 0.65). Conclusions Although there was a significant reduction in fellows’ endoscopy volume in the initial stages of the pandemic, adaptive mechanisms have resulted in a return of procedure volume to near baseline without ongoing impact on endoscopy training.

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Contemporary Challenges for Fellowship Training in Adult Cardiothoracic Anesthesiology: Perspectives From Program Directors Around the United States

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2020.02.011 ◽

2020 ◽

Vol 34 (8) ◽

pp. 2047-2059 ◽

Cited By ~ 4

Author(s):

Michelle Capdeville ◽

Jennifer Hargrave ◽

Prakash A. Patel ◽

Kinjal M. Patel ◽

Ronak G. Desai ◽

...

Keyword(s):

United States ◽

Program Directors ◽

The United States ◽

Fellowship Training

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Practice Patterns of Sleep Otolaryngologists at Training Institutions in the United States

Otolaryngology ◽

10.1177/0194599816671699 ◽

2016 ◽

Vol 156 (6) ◽

pp. 1025-1031 ◽

Cited By ~ 3

Author(s):

Austin S. Lam ◽

Sarah K. Wise ◽

Raj C. Dedhia

Keyword(s):

United States ◽

Residency Training ◽

Online Survey ◽

Practice Patterns ◽

Training Programs ◽

Program Directors ◽

The United States ◽

Sleep Medicine ◽

Board Certification ◽

Obstructive Sleep

Objective To assess the practice characteristics of adult sleep otolaryngologists within US otolaryngology residency training programs. Study Design Cross-sectional online survey. Setting Otolaryngology residency training programs. Subjects and Methods Program directors from 106 otolaryngology training programs in the United States were contacted. Program directors were instructed to forward a survey to otolaryngologists within the institution who provided Accreditation Council for Graduate Medical Education (ACGME) Otolaryngology Milestone Project feedback in “sleep-disordered breathing.” The survey assessed demographics, nonsurgical practices, and surgical/procedural practices of adult sleep otolaryngologists. Data were collected and analyzed. Results Forty-six surveys met inclusion criteria, representing 40 of 106 (38%) programs. Ninety-three percent of respondents reported that residents gained a significant portion of their sleep medicine training from themselves (ie, the respondents), yet only 36% of respondents spent ≥50% of their time on sleep medicine/surgery. Forty-one percent reported being board certified in sleep, with 18% having completed an ACGME fellowship in sleep medicine. Respondents with board certification were more likely to spend greater portions of their practice on sleep medicine/surgery, χ2(3, n = 44) = 23.161 ( P < .001), treat non–obstructive sleep apnea sleep disorders (13 of 18 vs 1 of 26, P < .001), interpret polysomnograms (13 of 17 vs 1 of 15, P < .001), and perform drug-induced sleep endoscopy, χ2(1, n = 43) = 5.43, ( P = .02). A similar pattern was seen with stratification by ACGME sleep medicine fellowship. Conclusion This study highlights the variance in practice patterns among sleep otolaryngologists who instruct residents. Board certification and fellowship training in sleep medicine significantly influence breadth of trainee exposure to this field. The highly disparate trainee experiences to sleep otolaryngology across US programs require attention.

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The Educational Evolution of Fellowship Training in Cardiothoracic Anesthesiology – Perspectives From Program Directors Around the United States

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2017.11.026 ◽

2018 ◽

Vol 32 (2) ◽

pp. 607-620 ◽

Cited By ~ 14

Author(s):

Michelle Capdeville ◽

Kelly G. Ural ◽

Prakash A. Patel ◽

David M. Broussard ◽

Jordan E. Goldhammer ◽

...

Keyword(s):

United States ◽

Program Directors ◽

The United States ◽

Fellowship Training

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Mind the Gap: Representation of Medical Education in Cardiology-Related Articles and Journals

Journal of Graduate Medical Education ◽

10.4300/jgme-d-15-00285.1 ◽

2016 ◽

Vol 8 (3) ◽

pp. 341-345 ◽

Cited By ~ 6

Author(s):

Clint Allred ◽

Kathryn Berlacher ◽

Saurabh Aggarwal ◽

Alex J. Auseon

Keyword(s):

United States ◽

Medical Education ◽

Mission Statement ◽

Medical Training ◽

Mission Statements ◽

The United States ◽

Fellowship Training ◽

Apparent Lack ◽

Fellowship Programs ◽

Number Of Publications

ABSTRACT Cardiology fellowship programs are at the interface of medical education and the care of patients suffering from the leading cause of mortality in the United States, yet there is an apparent lack of research guiding the effective education of fellows.Background We sought to quantify the number of publications in cardiology journals that pertained to the education of cardiology trainees and the number of cardiologists participating in education research.Objective For the period between January and December 2012, we cataloged cardiology-specific and general medical/medical education journals and sorted them by impact factor. Tables of content were reviewed for articles with an educational focus, a cardiology focus, or both. We recorded the authors' areas of medical training, and keywords from each cardiology journal's mission statement were reviewed for emphasis on education.Methods Twenty-six cardiology journals, containing 6645 articles, were reviewed. Only 4 articles had education themes. Ten general medical and 15 medical education journals contained 6810 articles. Of these, only 7 focused on medical education in cardiology, and none focused on cardiology fellowship training. Among the 4887 authors of publications in medical education journals, 25 were cardiologists (less than 1%), and among the 1036 total words in the mission statements of all cardiology journals, the term “education” appeared once.Results Published educational research is lacking in cardiology training, and few cardiologists appear to be active members of the education scholarship community. Cardiology organizations and academic journals should support efforts to identify target areas of study and publish scholarship in educational innovation.Conclusions

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Fellowship program directors and trainees across the United States find parental leave policies to be inconsistent, inaccessible, and inadequate

PLoS ONE ◽

10.1371/journal.pone.0260057 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0260057

Author(s):

Daniel Sabido Jamorabo ◽

Amrin Khander ◽

Vasilios Koulouris ◽

Jeremy Eli Feith ◽

William Matthew Briggs ◽

...

Keyword(s):

United States ◽

Parental Leave ◽

Well Being ◽

Program Directors ◽

The United States ◽

Time Constraints ◽

Categorical Variables ◽

Continuous Variables ◽

Fellowship Program ◽

Fellowship Programs

Introduction Determine the consistency, accessibility, and adequacy of parental leave policies for adult and pediatric medicine fellowship programs. Methods We administered a 40-question survey to fellowship program directors (PDs) and trainees in adult and pediatric cardiology, hematology/oncology, gastroenterology, and pulmonology/critical care fellowship programs in the United States. We used Chi-square tests to compare proportions for categorical variables and t-tests to compare means for continuous variables. Results A total of 190 PDs from 500 programs (38.0%) and 236 trainees from 142 programs (28.4%) responded. Most respondents did not believe that parental leave policies were accessible publicly (322/426; 75.6%), on password-protected intranet (343/426; 80.5%), or upon request (240/426; 56.3%). The PDs and trainees broadly felt that parental leave for fellows should be 5–10 weeks (156/426; 36.6%) or 11–15 weeks (165/426; 38.7%). A majority of PDs felt that there was no increased burden upon other fellows (122/190; 64.2%) or change in overall well-being (110/190; 57.9%). When asked about the biggest barrier to parental leave support, most PDs noted time constrains of fellowship (101/190; 53.1%) and the limited number of fellows (43/190; 22.6%). Trainees similarly selected the time constraints of training (88/236; 37.3%), but nearly one-fifth chose the culture in medicine (44/236; 18.6%). There were no statistically significant differences in answers based on the respondents’ sex, specialty, or subspecialty. Discussion Parental leave policies are broadly in place, but did not feel these were readily accessible, standardized, or of optimum length. PDs and trainees noted several barriers that undermine support for better parental leave policies, including time constraints of fellowship, the limited number of fellows for coverage, and workplace culture. Standardization of parental leave policies is advisable to allow trainees to pursue fellowship training and care for their newborns without undermining their educational experiences.

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