Crecelius, TeelaLinker, Anne S.Gottenborg, EmilyKwan, BrianKeniston, AngelaMcBeth, LaurenMartin, Shannon K.2024-09-192024-09-192024Crecelius T, Linker AS, Gottenborg E, et al. A Qualitative Study of Internal Medicine Subspecialty Fellowship Program Directors' Perspectives on Short-Term Hospitalist Employment Prior to Fellowship. J Grad Med Educ. 2024;16(2):210-220. doi:10.4300/JGME-D-23-00550.1https://hdl.handle.net/1805/43421Background: Some internal medicine (IM) residents pursuing subspecialty training choose short-term hospitalist employment prior to fellowship, or “pre-fellowship hospitalist years.” Residency and fellowship program directors (PDs) advise residents on this decision, but PD experience with fellows pursuing pre-fellowship hospitalist years and the impact on fellowship applications is unknown. Objective: We aimed to explore perceptions of fellowship PDs regarding experience with fellows who pursued pre-fellowship hospitalist years, including perceived effects on how such years affect fellowship application candidacy. Methods: A purposive sample of 20 fellowship PDs in the most highly competitive and commonly selected IM fellowships (cardiology, pulmonology/critical care medicine, hematology/oncology, gastroenterology) from 5 academic institutions were approached for participation in fall 2021. Interviews included semi-structured questions about pre-fellowship hospitalist employment. Utilizing rapid qualitative analysis, interview transcripts were summarized and reviewed to identify themes and subthemes describing fellowship PDs’ perspectives of pre-fellowship hospitalist years. Results: Sixteen fellowship PDs (80%) participated. PDs identified 4 major themes as important for trainees considering pre-fellowship hospitalist years: (1) Explain the “Why”—why the year was pursued; (2) Characteristics of the Hospitalist Position—what type of employment; (3) The Challenges—potential concerns faced with pre-fellowship hospitalist years; and (4) Describe the “What”—the experience’s contribution to resident professional development. Conclusions: Fellowship PDs in 4 competitive IM subspecialities placed a strong emphasis on explaining a clear, logical reason for seeking short-term hospitalist employment prior to fellowship, describing how it fits into the overall career trajectory, and selecting activities that demonstrate continued commitment to the subspecialty.en-USPublisher PolicyGraduate medical educationEmploymentHospitalistsInternal medicineArticle