Career Development in Pediatric Emergency Medicine Fellowships: A Qualitative Study

ABSTRACT Objectives Effective career development guidance during fellowship is essential to prepare pediatric emergency medicine (PEM) fellows for diverse career paths. However, little is known about how PEM fellowships structure and deliver career development support. Our objectives were (1) To describe how PEM fellowship Program Directors (PDs) provide career development support to their fellows and (2) To explore how PEM junior faculty (JF) experienced career development during fellowship and how the process could be optimized. Methods In this qualitative study, we recruited PEM PDs and JF for semi‐structured 1:1 interviews, purposively sampling across United States geographic regions and program sizes. We developed an interview guide to explore perceptions of career development. Interviews were audio‐recorded, transcribed, coded, and analyzed thematically to identify key themes in PEM fellowship career development. Participants completed a survey collecting demographic data and information on fellowship career development curricula. Results We conducted 39 interviews (20 PDs and 19 JF) and identified 12 themes across four career development domains: exploration and niche development, academic versus non‐academic careers, mentorship, and transition to employment. PDs described individualized career development opportunities, whereas JF expressed a desire for more explicit structure and early scaffolding around niche exploration and mentorship assignment. Both groups noted a strong emphasis on academic careers, with limited exposure to non‐academic pathways. Job search preparation included guidance on applications and networking, but JF described less clarity around hiring timelines, negotiation, and contracts. Across domains, participants highlighted that fellow initiative is required to drive their career development. Conclusions By integrating both PD and JF perspectives on career development, this study identifies a dynamic interplay between program support and fellow initiative. Earlier scaffolding, specifically in niche exploration and mentorship, broader exposure to diverse career pathways, and greater transparency in job search preparation may strengthen how career development is provided during PEM fellowship.