Changes, Challenges, and Variations in Neonatal-Perinatal Medicine Fellowship: A View from the Program Directors.

Autor:	Gray MM; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington., Bruno C; Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut., French H; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania., Myers P; Department of Pediatrics, Northwestern School of Medicine, Chicago, Illinois., Carbajal MM; Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas., Reber KM; Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas., Christou H; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Karpen H; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia., Johnston LC; Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
Jazyk:	angličtina
Zdroj:	American journal of perinatology [Am J Perinatol] 2024 May; Vol. 41 (S 01), pp. e163-e173. Date of Electronic Publication: 2022 May 12.
DOI:	10.1055/a-1850-3929
Abstrakt:	Objectives: Neonatal-perinatal medicine (NPM) fellowship programs in the United States support >800 learners annually. Understanding variations in the programmatic structure, challenges, and needs is essential to optimize the educational environment and ensure the specialty's future. Study Design: NPM fellowship program directors (PDs) and associate program directors (APDs) were invited to complete an electronic survey on their program administration, recruitment, clinical training, assessment methods, scholarly program, and career pathways. Each participant identified individual programmatic strengths, challenges, opportunities, and threats to the field. Results: Representatives from 59 NPM fellowships provided data (response rate 59/96 = 61%). In total, 30% of PDs received less than the Accreditation Council for Graduate Medical Education -recommended protected time for administrative duties, and 44% of APDs received no protected time. Fellow clinical service assignments varied widely from 13 to 18 months and 90 to 175 call nights over 3 years. Recruitment practices varied across programs; 59% of respondents raised concerns over the pipeline of applicants. Conflicts between fellows and advanced practice providers were identified by 61% of responders. Programs varied in their scholarly offerings, with 44% of NPM fellowships interested in adding broader research opportunities. Conclusion: NPM fellowship leaders identified a need for improved programmatic support, enhanced measures to assess competency, opportunities to strengthen scholarly programs, shared curricular resources, and strategies to balance education with clinical demands. PDs and APDs identified threats to the future of NPM training programs including the diminishing pipeline of applicants into neonatology, challenges with clinical exposure and competence, inadequate support for the educational mission, issues supporting high-quality scholarship, and fewer graduates pursuing physician-investigator pathways. National organizations and academic institutions should take action to address these challenges so that fellowships can optimally prepare graduates to meet their patients' needs. Key Points: · Numerous challenges exist for current program directors in NPM including balancing clinical work with scholarly activities, accurately assessing competency, optimizing the culture of the learning environment, and ensuring that fellows are adequately prepared for a range of postgraduate positions.. · Significant variation exists across NPM fellowship programs in clinical service/calls assigned over 3 years of fellowship training, as well as opportunities to pursue scholarly activities across a variety of areas.. · Challenges exist related to ensuring an adequate number of future applicants into the specialty, including those from backgrounds traditionally underrepresented in medicine, as well as those seeking to pursue careers as physician-investigators.. Competing Interests: M.M.C. is a member of Executive Council for the Organization of Neonatal-Perinatal Training Program Directors (ONTPD). H.E.K. is on the advisory board of Progeny Health and associated as a member of Organization of Neontatal Training Program Directors Executive Committee. L.C.J. is a member of the Organization of Neonatal Training Program Directors (ONTPD) Executive Committee 2017-2021. The other authors reported no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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