Clinical hospital medicine fellowships: perspectives of employers, hospitalists, and medicine residents.

BACKGROUND

Clinical hospital medicine fellowships could accelerate the acquisition of increasingly demanding skills while enhancing esteem among subspecialty peers. We sought to determine whether medicine residents perceived such fellowships as relevant and would be willing to forgo substantial income during the training period, in the context of the perspectives of employers and practicing hospitalists.

DESIGN

A series of 3 tandem nationwide cross-sectional surveys conducted over the Internet during late 2005 and early 2006.

METHODS

Survey I was sent to 195 hospitalist employers identified through filtering classified advertisements. Survey II (containing Survey I results) was E-mailed by the Society of Hospital Medicine to its practicing hospitalists members. Survey III (containing results of the first 2 surveys) was E-mailed to U.S. internal medicine program directors for forwarding to their residents.

RESULTS

Two-thirds of 103 employers would offer either a signing bonus or a starting salary increase of at least $10,000 to fellowship graduates (more than 20% would pay at least $20,000 more in the salary). Based on a median experience of 8 years, 91% of 101 practicing hospitalists believed that clinical fellowship could at least possibly be a favorable career move, with 58% recommending it as being a probably or strongly favorable career move. Of 279 categorical medicine residents, 44% were considering a hospital medicine career, of whom 57% would consider doing a year of clinical fellowship training if available.

CONCLUSIONS

This study reveals a potentially unmet demand for clinical hospital medicine fellowship training. Further determination of need and related curricular development could be addressed under the leadership of national hospital medicine educational organizations.