Trial by Fire: Experiences of the 2020 Graduates of Pediatric Hospital Medicine Fellowships

Background and objective There is scarce data regarding the preparedness of pediatric hospital medicine (PHM) fellowship graduates for their first attending physician position. Hence, we sought to investigate how prepared PHM fellowship graduates felt in terms of attending-level skills and their satisfaction with their first job. Methods We conducted a national cross-sectional survey with open- and closed-ended questions to assess preparedness for topics taught in the PHM fellowship, and included questions to assess job satisfaction. In 2021, a survey was sent to PHM attendings who graduated from a PHM fellowship in 2020 (approximately one year into their first job). Participants were asked to rate their preparedness for 25 different topics on a 5-point Likert scale and to rate their satisfaction with their fellowship, fellowship director, and first job. We used descriptive statistics for the closed-ended questions. Answers to the open-ended questions were coded on the keywords of each answer. Results Twenty-one out of 42 attendings completed the survey, yielding a 50% response rate. Respondents felt most prepared to lead rounds (4.81/5, standard deviation [SD]: 0.60), teach residents (4.62/5, SD: 0.50), teach medical students (4.43/5, SD: 0.75), manage complex patients (4.19/5, SD: 0.87), and perform consults (4/5, SD: 1.26), and felt least prepared in neonatal resuscitation (2.24/5, SD: 1.41), sedation (1.86/5, SD: 1.01), and point-of-care ultrasound (1.57/5, SD: 0.98). On average, participants were moderately satisfied with their first job after the fellowship (average rating score: 4.33, range: 3-5). Respondents described areas of improvement for fellowship education, including preparation for their first attending job. Conclusions Our study reveals the areas in which respondents felt most and least prepared to perform as a new attending physician. Our findings can assist PHM fellowship program directors in preparing their trainees for entry into the workforce.