Perelman School of Medicine at the University of Pennsylvania
Philadelphia, PA

Abstract Authors: Joshua M. Diamond, MD; Michael G. Shashaty, MD; Meeta P. Kerlin, MD; Nilam S. Mangalmurti, MD; Michael F. Beers, MD; and Maryl Kreider, MD

Program Director: Maryl Kreider, MD

Type of Program: Pulmonary/Critical Care Fellowship Training Program

BACKGROUND

The goal of academic pulmonary-critical care fellowship programs is to produce highly qualified, well trained, well rounded academic clinicians and physician-scientists. Unfortunately, the process of transitioning from fellowship to attending is often one of the most stressful and unsettling transitions of a trainee’s career. Attempts at exposing fellows to attending physicians in a wide variety of clinical roles can be overwhelming, especially to trainees early in the fellowship process. In order to improve fellows comfort with planning for future careers in pulmonary-critical care medicine and better prepare them for life after fellowship, we have developed a longitudinal career development experience that begins in the first fellowship year.

METHODS

Prior to July 2015, our program utilized monthly small group sessions with rotating faculty members to expose all fellows to the following career paths: basic science or clinical research, industry, private practice, and university-based clinical roles. Both formal evaluations and informal feedback highlighted that lack of practical, “how to” information made this program inadequate for supporting the fellow to-faculty transition. In July 2015, we implemented a longitudinal educational program providing fellows with focused guidance, targeted to their year of training, in how to use the fellowship years to transition successfully at the end of training. In the summer of their first fellowship year, we help fellows to identify their interests in pursuing one of three training pathways: basic science research, clinical translational research (including epidemiology and health-services research), or clinical education, with a focus on education, safety, and quality improvement. During a 2-day scholarship retreat, during which they are freed from clinical responsibilities, fellows participate in structured workshops regarding training pathways and one-on-one meetings with potential content and/or career mentors. Follow-up meetings are then set up based on individualized need. During the subsequent fellowship years, focused half-day workshops are organized around two themes: 1) Developing a research career, and 2) Getting a job. Each workshop includes faculty panels for fellows to learn about how career pathways match up with their own interests. Additionally, structured training is provided on practical aspects. For the research workshop, topics include how to be a good mentee, timing grant submissions to best enable the faculty transition, preparing fellowship and career development grants, and understanding the NIH study section review process. For the job workshop, topics include developing a national reputation, starting a job search, writing a cover letter, interviewing techniques, and achieving work-life balance.

RESULTS

Qualitative evaluations of our pre-2015 career development series revealed that sessions were “anxiety provoking”, “overwhelming for first year fellows”, and insufficiently focused enough on topics of interest. Fellows desired sessions in which “faculty should get across key points, or set a framework and then allow for questions.” While we have just begun to collect information on the impact of the longitudinal program, preliminary feedback has been overwhelmingly positive. Fellows rated the Getting a Job Workshop very highly, with the majority of responders agreeing or strongly agreeing that the small group sessions were helpful. Fellows felt that the format and content was “very insightful and practical”. Fellows described a need for separate basic science oriented sessions for trainees given the specific needs inherent in such a job.

DISCUSSION

We have developed a longitudinal career development mentoring curriculum for fellows beginning in the first year of fellowship that targets the individualized needs of fellows throughout their training. In the later fellowship years, this curriculum is specifically tailored to choosing a career track and taking practical steps to transition to such a career. More fellow derived feedback is needed to assess the impact of our efforts on facilitating the transition from fellow to attending.