Palliative radiotherapy education in hospice and palliative medicine fellowship: A national needs assessment.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 87-87
Author(s):  
Emily Jean Martin ◽  
Joshua Adam Jones
Keyword(s):  
Medical Education ◽  
Radiation Oncology ◽  
Palliative Medicine ◽  
Palliative Radiotherapy ◽  
Program Directors ◽  
Fellowship Program ◽  
Electronic Survey ◽  
Fellowship Programs ◽  
Curricular Interventions ◽  
Fractionation Schedules

87 Background: Educational deficiencies among hospice and palliative medicine (HPM) physicians are thought to contribute to sub-optimal utilization of palliative radiotherapy (PRT) for patients with advanced cancer. We conducted a national survey of HPM fellowship program directors and fellows to assess the need for increased PRT education in HPM fellowship. Methods: A 17-item, anonymous, electronic survey was distributed via email in May 2018 to the directors of all US Accreditation Council for Graduate Medical Education-accredited HPM fellowship programs with at least one enrolled fellow. A similar 19-item survey was emailed to the coordinators of these programs for distribution to enrolled fellows. Three reminder emails were sent over a one-month period. Results: Eighty-one (68%) of 120 eligible program directors and 114 (34%) of 338 eligible fellows completed the surveys. Nearly all respondents (98% of program directors and 99% of fellows) agreed that HPM physicians should be familiar with the principles of PRT and 95% of both groups agreed that this topic should be taught in HPM fellowship. Thirty percent of programs, however, lacked any PRT curriculum and 57% of programs provided only 1 or 2 hours of didactic PRT education. The minority of fellows felt confident in their ability to identify radiation oncology emergencies (43%) or to manage symptoms associated with radiotherapy toxicities (42%) and only 56% felt confident in their ability to assess which patients should be referred to radiation oncology for possible PRT. Notably, the majority of fellows reported that if they were more knowledgeable about PRT they would be more likely to consider referral to radiation oncology (78%), to collaborate with the radiation oncologists involved in their patients’ care (76%), and to advocate for shorter fractionation schedules or possible omission of radiation therapy altogether based on a patient’s prognosis or goals of care (78%). Conclusions: HPM fellowship program directors and fellows agree that that there is a need for increased education in PRT in HPM fellowship. Curricular interventions that address this need may result in more appropriate utilization of PRT.

scholarly journals 2541. Impact of a Combined Infectious Disease-Critical Care Medicine (ID-CCM) Track on Fellowship Recruitment

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S883-S883
Author(s):  
Nitin Bhanot ◽  
Zaw Min ◽  
Matthew Moffa ◽  
Thomas L Walsh ◽  
James D Como
Keyword(s):  
Infectious Disease ◽  
Medical Education ◽  
Critical Care ◽  
Critical Care Medicine ◽  
Collaborative Effort ◽  
Fellowship Program ◽  
Fully Integrated ◽  
Increasing Trend ◽  
Fellowship Programs ◽  
Allegheny General Hospital

Abstract Background There has been a declining national trend in recent years of resident applications to Infectious Disease (ID) fellowship programs. This dearth of interested and available applicants has resulted in many programs failing to fill some or all of their fellowship slots. Our ID fellowship program, founded in 2013 at Allegheny General Hospital, had met with similar difficulty. Methods To increase the recruitment pool of candidates and combat the challenge to fill our positions, we incorporated a combined 3 year ID-Critical Care Medicine (CCM) track in 2016, initially with one of our two annual fellowship slots allotted to this track. This entailed a collaborative effort between the ID and CCM divisions, an internal application completion outlining the need and rationale for this combined program, and finally, approval from the institutional as well as the Accreditation Council for Graduate Medical Education (ACGME). Results The number of applicants interviewed from 2013 to 2016 for ID (pre-inception of the ID-CCM track), as well as those for ID, ID-CCM, or those interviewing for both tracks following 2016, were counted. We noted a consistent increasing trend in the numbers interviewed for both the ID (4, 8, and 12 total applicants) and ID-CCM (4, 10, and 12 total applicants) tracks over the three since the inception of our combined fellowship program; 3 additional applicants in years 2017 and 2018, and 5 in 2019, expressed interest in either ID or ID-CCM (Graph 1). This favorably amounted to filling our training positions. Conclusion Implementation of a combined ID-CCM fellowship program proved to be a viable strategy to increase the number of applicants at our institution. Given the success of having one dually-accredited slot, we have expanded the combined-track to both positions. As the first fully-integrated ID-CCM fellowship program in the country, we may be pioneering this novel training pathway for future physicians. Disclosures All authors: No reported disclosures.

scholarly journals Doing More With Less: A Centralized Model for Fellowship Program Coordination

2017 ◽  
Vol 9 (4) ◽  
pp. 523-526 ◽  
Author(s):  
Twinkle Patel ◽  
Katharina Schwan ◽  
Sara Hoover ◽  
Allison O'Hollaren ◽  
Suria Sadat ◽  
...  
Keyword(s):  
San Francisco ◽  
Administrative Support ◽  
Program Directors ◽  
Full Time ◽  
Fellowship Program ◽  
New Model ◽  
Program Coordinators ◽  
Fellowship Programs ◽  
Administrative Model ◽  
Centralized Model

ABSTRACT Background  Pediatrics fellowship programs typically are small, embedded in divisions, and vary in their approach to education. Program coordination usually falls to division administrators who operate in silos despite common requirements across programs, creating redundancy and inefficiency. Objective  We examined the feasibility, acceptability, and impact of a centralized administrative model for pediatrics fellowship support at a large university-based institution. Methods  In 2014, administrative support for the pediatrics fellowships at the University of California, San Francisco, was restructured from a model with division-level support to a centralized model. In the new model, a team of 6 full-time administrators supports 19 fellowship programs with a total of 80 fellows. The fellowship support team consists of 3 program coordinators, a data coordinator, a human resource coordinator, a team manager, and a faculty advisor. The team meets twice a month to discuss program issues and innovative ideas. Quarterly meetings are held with all coordinators and directors to discuss changes across fellowships and foster further collaboration. We surveyed program directors to examine the acceptability of the model and assessed its impact on finances and turnover. Results  Of 19 eligible fellowship program directors, 15 (79%) completed the survey. The majority indicated that the new administrative model was “better” or “much better” than the prior model. The new model resulted in decreased costs (an estimated $250,000 per year in salary support) and lower staff turnover. Conclusions  Centralization of fellowship administration is feasible and offers substantial benefits for all stakeholders involved.

scholarly journals Diversity, Equity, and Inclusion in Hematology and Oncology Fellowship Programs

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2977-2977
Author(s):  
Michael Mankbadi ◽  
Lidet Alemu ◽  
Afiya Bey ◽  
Nathan T. Connell ◽  
Lisa Fanning ◽  
...  
Keyword(s):  
Interim Analysis ◽  
Response Rate ◽  
Medical Oncology ◽  
Selection Process ◽  
Program Directors ◽  
Program Director ◽  
Fellowship Program ◽  
Medical Specialties ◽  
Fellowship Programs ◽  
Equity And Inclusion

Abstract Background The National Institutes of Health define African Americans or Blacks, American Indians, Alaska Natives, Hispanics or Latinos, Native Hawaiians, and other Pacific Islanders as being underrepresented in medicine. A number of studies have demonstrated that improving diversity of such underrepresented demographics within the medical profession improves patient outcomes, medical education and reduces health disparities in patients from vulnerable racial or socioeconomic groups. Despite this recognition, significant underrepresentation of various racial, ethnic, and sexual identities still exists within nearly all medical specialties. Aims The purpose of this study was to a gain a greater understanding of the current state of diversity, equity, and inclusion (DEI) efforts among U.S. hematology and medical oncology fellowship training programs. We explored the perspectives of adult and pediatric fellowship program directors regarding current recruitment strategies and suggestions for improvement to help mitigate the effects of implicit and explicit bias. Here, we present an interim analysis of the data using descriptive statistics. Methods: We convened a multi-institutional collaboration of fellowship program directors, teaching faculty, and staff members of the American Society of Hematology to develop a survey examining perceptions of DEI efforts among hematology and medical oncology fellowship program directors. The survey was pilot tested in a small group of program directors representing 6 different academic programs (5 adult, 1 pediatric). The final online survey was distributed via email to 224 fellowship program directors at U.S. adult and pediatric hematology and medical oncology fellowship programs. The survey included 29 questions regarding perspectives on bias within the fellowship selection process, current DEI initiatives, and current faculty and fellow demographics. Survey respondents were asked to rate the importance of numerous factors in determining which applicants to invite utilizing a scale of 0-10, with 0 and 10 representing lowest and highest importance, respectively. To measure program director perceptions of certain applicant groups, survey respondents were asked to rate applicant demographics as being advantaged/disadvantaged based on survey options ranging from 0-5, with 0 and 5 representing very disadvantaged and very advantaged, respectively. Results: At interim analysis, 41 of 224 program directors completed the survey for an interim response rate of 21%, including 25 adult program directors and 16 pediatric program directors, with representation from university and community programs. Of the program directors surveyed, 28 (68%) reported having access to a dedicated diversity committee or DEI policies in place to improve recruitment of underrepresented applicants. In determining which applicants to invite, respondents placed highest value on the applicant's program director letter (mean score ± standard deviation: 7.44±1.93), caliber of the applicant's residency program (7.28±2.06) and letters of recommendations (7.15±2.23). Survey respondents viewed white and male applicants as representing the most advantaged demographic group, while LGBTQI, age>40, and U.S. citizen and non-citizen international medical graduates were the most disadvantaged (Table 1). Suggestions regarding improving DEI in the fellowship selection process included implementing bias training, identifying potentially disadvantaged applicants in ERAS, increasing faculty diversity, and pairing underrepresented applicants with interviewers based on applicant preference. Conclusion: While the majority of hematology and medical oncology fellowship program directors report having DEI programs or policies to improve recruitment of underrepresented applicants, perceptions of advantaged/disadvantaged groups may extend beyond demographics traditionally viewed as being underrepresented in medicine. As our survey is ongoing, we plan to reanalyze our data when the survey has been finalized with a higher response rate utilizing multivariable regression to identify themes that may further improve DEI efforts within the fellowship selection process. Figure 1 Figure 1. Disclosures LaCasce: Bristol-Myers Squibb Company.: Other: Data Safetly and Monitoring. Murphy: North American Thrombosis Foundation: Honoraria. Naik: Rigel: Research Funding. Podoltsev: Pfizer: Honoraria; Blueprint Medicines: Honoraria; Incyte: Honoraria; Novartis: Honoraria; Celgene: Honoraria; PharmaEssentia: Honoraria; Bristol-Myers Squib: Honoraria; CTI BioPharma: Honoraria.

scholarly journals Dana-Farber Cancer Institute/Mass General Brigham Fellowship Response to the COVID-19 Pandemic

2021 ◽  
pp. OP.20.00894
Author(s):  
Robert M. Stern ◽  
M. Dror Michaelson ◽  
Erica L. Mayer ◽  
Aric D. Parnes ◽  
Annemarie E. Fogerty ◽  
...  
Keyword(s):  
Medical Education ◽  
Training Programs ◽  
Well Being ◽  
The United States ◽  
First Year ◽  
Fellowship Program ◽  
Dana Farber Cancer Institute ◽  
Fellowship Programs ◽  
Direct Feedback ◽  
Research Structure

The coronavirus disease (COVID)-19 pandemic has affected graduate medical education training programs, including hematology-oncology fellowship programs, both across the United States and abroad. Within the Dana-Farber Cancer Institute/Mass General Brigham hematology-oncology fellowship program, fellowship leadership had to quickly reorganize the program's clinical, educational, and research structure to minimize the risk of COVID-19 spread to our patients and staff, allow fellows to assist in the care of patients with COVID-19, maintain formal didactics despite physical distancing, and ensure the mental and physical well-being of fellows. Following the first wave of patients with COVID-19, we anonymously surveyed the Dana-Farber Cancer Institute/Mass General Brigham first-year fellows to explore their perceptions regarding what the program did well and what could have been improved in the COVID-19 response. In this article, we present the feedback from our fellows and the lessons we learned as a program from this feedback. To our knowledge, this represents the first effort in the hematology-oncology literature to directly assess a hematology-oncology program's overall response to COVID-19 through direct feedback from fellows.

scholarly journals Integrative Hematology Oncology Fellowship Program: A National Survey Based Analysis of Need

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1887-1887
Author(s):  
Krisstina L. Gowin ◽  
Betsy Wertheim ◽  
Ashley Larsen ◽  
John Camoriano
Keyword(s):  
Palliative Care ◽  
National Survey ◽  
Radiation Oncology ◽  
Formal Education ◽  
Training Programs ◽  
Care Program ◽  
Program Directors ◽  
The United States ◽  
Education Programs ◽  
Fellowship Programs

Abstract Introduction: Integrative hematology oncology (IHO), the combination of complementary medicine in conjunction with conventional cancer treatments, is emerging as an important supportive care modality. Formal education programs, such as IHO fellowship programs, are not currently available. We conducted a national survey to gauge interest and investigate barriers to the development of IHO training programs in the US. Methods: An 18-question survey was sent to hematology/oncology, radiation oncology, and palliative care program directors, physicians, and fellows, and internal medicine residents planning to enter into any of the above fellowship programs. Recruitment was national with use of public email list servs and social media. Program directors and fellowship programs were identified through the Accreditation Council for Graduate Medical Education (ACGME). Participant informed consent was completed online and, Qualtrics survey links were shared weekly via email in two 4-week sessions. Results: Participants (n=208) included physicians from: Hematology/Oncology 65.9% (n=137), Radiation Oncology 8.6%(n=18) and Palliative Care 25.4% (n=53). Hematology oncology respondents included physicians 47.4% (n=65), fellows 33.6% (n=46), and residents planning to enter into a hematology oncology fellowship 3.6% (n=5). Program directors (n=69) from each specialty included: 15.3% (n=21) from hematology/oncology, 61.1% (n=11) from radiation oncology, and 69.8% (n=37) from palliative care. Interestingly, palliative care had the highest response rate in this category. Survey respondents were mostly aged 31-40 y (38.4%), 41-50 y (23.8%), or 51-60 y (21.5%). Participant genders were male (45.7%), female (50.9%), or prefer not to identify (3.5%). There was diverse regional participation across the United States. Overall participant responses revealed significant interest for an IHO training program, despite little (36.0%) to no (49.4%) previous training in integrative medicine (Table 1). Curriculum topics of primary interest were physician/provider wellness, stress reduction techniques, off-label use of medication, exercise/physical activity, nutrition, and lifestyle counseling. The preferred education delivery was didactic lectures and clinical practice exposure. Barriers to implementation included lack of good curriculum and inadequate budget/time/faculty experience to implement the program. Need for IHO training was based on perceived benefit to patients in 39 participants (73.6%), and patient request for services in 37 participants (68.8%). Conclusion: In this national survey of 208 physicians, the majority (64%) expressed interest in IHO education programs. Barriers included lack of curriculum, expertise, budget, and time. Education preference for fellowship track and certificate programs were similar, suggesting interest of both available options. Most participants (87%) felt fellows should participate in IHO research. In conclusion, IHO training is perceived as valuable and desirable. Thus, the development and dissemination of IHO training programs is needed. Figure 1 Figure 1. Disclosures Gowin: Incyte: Speakers Bureau.

scholarly journals Gender Representation in Fellowship Program Director Positions in ACGME-Accredited Chronic Pain and Acute Pain Fellowship Programs

Pain Medicine ◽  
2021 ◽  
Author(s):  
Ryan S D’Souza ◽  
Brendan Langford ◽  
Susan Moeschler
Keyword(s):  
Chronic Pain ◽  
Medical Education ◽  
Acute Pain ◽  
Academic Medicine ◽  
Current Evidence ◽  
Academic Rank ◽  
Pain Medicine ◽  
Fellowship Program ◽  
H Index ◽  
Fellowship Programs

Abstract Objective We quantified the representation of female program directors (PDs) and assessed their respective demographics, academic metrics, and program-related characteristics in chronic pain and acute pain medicine fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Methods We identified chronic and acute pain PDs on the ACGME website on November 15, 2020. We abstracted data from public databases and performed comparisons of demographics, academic metrics, and program-related characteristics between female and male PDs. Results We identified 111 chronic pain programs and 35 acute pain programs. Overall, there were 35 (31.5%) chronic pain programs with a female PD and 76 (68.5%) chronic pain programs with a male PD. Female chronic pain PDs published fewer peer-reviewed articles (4.0 publications, interquartile range [IQR] = 2.0–12.0) compared with male chronic pain PDs (9.0 publications, IQR = 4.0–27.0; P = 0.050), although there was no difference in the H-index score (3.0 vs 4.0 publications, respectively; P = 0.062) or senior academic rank status (57.1% vs 50.0%, respectively; P = 0.543). There were 10 (28.6%) acute pain programs with a female PD and 25 (71.4%) acute pain programs with a male PD. Similar to the chronic pain cohort, there was no difference in senior academic rank status based on gender in acute pain PDs (50.0% vs 24.0%, respectively; P = 0.227). Conclusion Our study highlights gender differences in the PD role in ACGME-accredited chronic and acute pain fellowships. Female PDs remain underrepresented and have fewer peer-reviewed publications. Senior academic rank status was similar across genders, contradicting the current evidence in academic medicine.

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