Virtual Interviews: Challenges and Opportunities for Pulmonary Disease and Critical Care Medicine Fellowship Programs.
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SUBMITTER: Strumpf Z
PROVIDER: S-EPMC8787732 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Rationale: Clinical and research training opportunities in global health are of increasing interest to medical trainees, but little is known about such opportunities in U.S.-based pulmonary and pulmonary/critical care medicine (PCCM) fellowship programs.Objectives: Summarize currently available global health-related training opportunities and identify potential barriers to implementing global health curricula among U.S.-based PCCM fellowship programs.Methods: We sent a confidential, online, targeted needs assessment to PCCM fellowship program directors and associate program directors. Data collected included program demographics, currently available global health-related clinical and research training opportunities, potential barriers to the implementation of global health-related programmatic content, and perceived interest in global health-related training opportunities by current and/or prospective trainees. To evaluate for nonresponse bias, we performed an online search to identify global health-related training opportunities offered by nonresponding programs.Results: Out of 171 surveyed programs, 63 PCCM fellowship programs (37%) provided survey responses. Most responses (n = 56, 89%) were from combined PCCM training programs; 66% (n = 40) of programs offered at least one component of global health-related clinical or research training. Overall, 27% (n = 17) had a Ruth L. Kirschstein National Research Service Award Institutional Research Training Grant (National Institutes of Health T32), 73% (n = 46) had fewer than 35 faculty members, and 51% (n = 32) had at least one faculty member conducting global health-focused research. Most responding programs (66%, n = 40) offered at least one global health-related educational component. Among programs that would like to offer global health-related training components, the most common barriers included competing priorities for lecture content and a lack of in-division mentors with global health experience, a champion for global health-related activities, and established partnerships outside the United States.Conclusions: PCCM program leaders are interested in offering global health-related training opportunities, but important barriers include lack of mentorship, dedicated fellowship time, and established global partnerships. Future research is needed to better understand global health-related interests and training needs of incoming fellows and to design creative solutions for providing global health-related training across academic institutions with variable global health-related training capacities.
| S-EPMC6850800 | biostudies-literature
Project description:BackgroundPulmonary medicine specialists find themselves responsible for the diagnosis and management of patients with sleep disorders. Despite the increasing prevalence of many of these conditions, many sleep medicine fellowship training slots go unfilled, leading to a growing gap between the volume of patients seeking care for sleep abnormalities and the number of physicians formally trained to manage them. To address this need, we convened a multisociety panel to develop a list of curricular recommendations related to sleep medicine for pulmonary fellowship training programs.MethodsSurveys of pulmonary and pulmonary/critical care fellowship program directors and recent graduates of these programs were performed to assess the current state of sleep medicine education in pulmonary training, as well as the current scope of practice of pulmonary specialists. These data were used to inform a modified Delphi process focused on developing curricular recommendations relevant to sleep medicine.ResultsSurveys confirmed that pulmonary medicine specialists are often responsible for the diagnosis and treatment of a number of sleep conditions, including several that are not traditionally considered related to respiratory medicine. Through five rounds of voting, the panel crafted a list of 52 curricular competencies relevant to sleep medicine for recommended inclusion in pulmonary training programs.ConclusionsPracticing pulmonary specialists require a broad knowledge of sleep medicine to provide appropriate care to patients they will be expected to manage. Training program directors may use the list of competencies as a framework to ensure adequate mastery of important content by graduating fellows.
| S-EPMC6435938 | biostudies-literature
Project description:Due to the COVID-19 pandemic, most graduate medical education (GME) training programs conducted virtual interviews for prospective trainees during the 2020-2021 application cycle. Many internal medicine (IM) subspecialty fellowship programs hosted virtual interviews for the first time with little published data to guide best practices.To evaluate how IM subspecialty fellowship applicants perceived the virtual interview day experience.We designed a 38-item questionnaire that was sent via email to applicants in eight IM subspecialty programs at a single tertiary academic medical center (University of California, San Francisco) from September-November, 2020.Seventy-five applicants completed the survey (75/244, 30.7%), including applicants from all eight fellowship programs. Most survey respondents agreed that the length of the virtual interview day (mean = 6.4 hours) was long enough to gather the information they needed (n = 65, 86.7%) and short enough to prevent fatigue (n = 55, 73.3%). Almost all survey respondents agreed that they could adequately assess the clinical experience (n = 71, 97.3%), research opportunities (n = 72, 98.6%), and program culture (n = 68, 93.2%). Of the respondents who attended a virtual educational conference, most agreed it helped to provide a sense of the program's educational culture (n = 20, 66.7%). Areas for improvement were identified, with some survey respondents reporting that the virtual interview day was too long (n = 11) or that they would have preferred to meet more fellows (n = 10).Survey respondents indicated that the virtual interview was an adequate format to learn about fellowship programs. These findings can inform future virtual interviews for GME training programs.
| S-EPMC8253192 | biostudies-literature
Project description:BackgroundEndotracheal intubation in the intensive care unit (ICU) is a high-risk procedure. Competence in endotracheal intubation is a requirement for Pulmonary and Critical Care Medicine (PCCM) training programs, but fellow experience as the primary operator in intubating ICU patients has not been described on a large scale.ObjectiveWe hypothesized that significant variation surrounding endotracheal intubation practices in medical ICUs exists in United States (US) PCCM training programs.MethodsWe administered a survey to a convenience sample of US PCCM fellows to elicit typical intubation practices in the medical ICU.Results89 discrete US PCCM and Internal Medicine CCM training programs (77% response rate) were represented. At 43% of programs, the PCCM fellow was "always or almost always" designated the primary operator for intubation of a medical ICU patient, whereas at 21% of programs, the PCCM fellow was "rarely or never" the primary operator responsible for intubating in the ICU. Factors influencing this variation included time of day, hospital policies, attending skill or preference, ICU census and acuity, and patient factors. There was an association between location of the training program, but not program size, and whether the PCCM fellow was the primary operator.ConclusionThere is significant variation in whether PCCM fellows are the primary operators to intubate medical ICU patients during training. Further work should explore how this variation affects fellow career development and competence in intubation.
| S-EPMC7959255 | biostudies-literature
Project description:BACKGROUND: There is growing interest in global health among medical trainees. Medical schools and residencies are responding to this trend by offering global health opportunities within their programs. Among United States (US) graduating pediatric residents, 40% choose to subspecialize after residency training. There is limited data, however, regarding global health opportunities within traditional post-residency, subspecialty fellowship training programs. The objectives of this study were to explore the availability and type of global health opportunities within Accreditation Council for Graduate Medical Education (ACGME)-accredited pediatric subspecialty fellowship training programs, as noted by their online report, and to document change in these opportunities over time. METHODS: The authors performed a systematic online review of ACGME-accredited fellowship training programs within a convenience sample of six US pediatric subspecialties. Utilizing two data sources, the American Medical Association-Fellowship and Residency Electronic Interactive Database Access (AMA-FREIDA) and individual program websites, all programs were coded for global health opportunities and opportunity types were stratified into predefined categories. Comparisons were made between 2008 and 2011 using Fisher exact test. All analyses were conducted using SAS Software v. 9.3 (SAS Institute Inc., Cary, NC). RESULTS: Of the 355 and 360 programs reviewed in 2008 and 2011 respectively, there was an increase in total number of programs listing global health opportunities on AMA-FREIDA (16% to 23%, p=0.02) and on individual program websites (8% to 16%, p=0.004). Nearly all subspecialties had an increased percentage of programs offering global health opportunities on both data sources; although only critical care experienced a significant increase (p=0.04, AMA-FREIDA). The types of opportunities differed across all subspecialties. CONCLUSIONS: Global health opportunities among ACGME-accredited pediatric subspecialty fellowship programs are limited, but increasing as noted by their online report. The availability and types of these opportunities differ by pediatric subspecialty.
| S-EPMC3691626 | biostudies-literature
Project description:PurposeTo understand the opinions of both orthopaedic sports medicine fellowship program directors (PDs) and applicants regarding the utility of virtual interviews in comparison to in-person interviews following the 2022-2023 application cycle.MethodsAn anonymous online survey was distributed through the American Orthopaedic Society for Sports Medicine to applicants and PDs of orthopaedic sports medicine fellowship programs. Questions in the survey included how the virtual format affected the applicants' personal connection to the program, the interview day structure, and costs associated with the interview process.ResultsResponses were received from 69 of 93 PDs (74%) and 97 of 266 applicants (36%). Ninety-five percent of PDs (59 of 62) preferred in-person interviews, compared to 79% of applicants (70 of 89). Ninety-eight percent of PDs (60 of 61) and 82% of applicants (72 of 88) thought it was important/very important to interview in-person. Sixty-one percent of PDs (35 of 57) and 49% of applicants agreed/strongly agreed that conducting virtual interviews negatively affected their personal connection with the fellowship interviewee/program. The presence of virtual interviews allowed 50% (43 of 86) of applicants to go on more interviews. Thirty-two percent (18 of 57) of fellowship programs saved up to $5,000 conducting virtual interviews, and 85% (69 of 81) of applicants saved up to $5,000 on travel expenses by attending virtual interviews.ConclusionsVirtual interviews allow fellowship applicants to complete more interviews and presented financial savings for both programs and applicants. However, both PDs and applicants stated that interviewing in-person is essential for applicants to meet faculty and tour the facilities.Clinical relevanceThis study may be valuable to fellowship programs considering continued use of virtual interviews.
| S-EPMC10753054 | biostudies-literature
Project description:BackgroundAlthough it is well known that the coronavirus disease (COVID-19) pandemic has had a profound effect on health care, its impact on fellowship training in Pulmonary and Critical Care Medicine (PCCM) has not been well described.ObjectiveWe conducted an anonymous survey of PCCM program directors (PDs) to assess the impact of the COVID-19 pandemic on PCCM fellowship training across the United States.MethodsWe developed a 30-question web-based survey that was distributed to U.S. PCCM PDs through the Association of Pulmonary and Critical Care Medicine Program Directors.ResultsThe survey was sent to 242 PDs, of whom 28.5% responded. Most of the responses (76.8%) came from university-based programs. Almost universally, PDs reported a decrease in the number of pulmonary function tests (100%), outpatient visits (94.1%), and elective bronchoscopies (96%). Three-quarters (77.6%) of the PDs reported that their PCCM fellows spent more time in the intensive care unit than originally scheduled.ConclusionThe COVID-19 pandemic has had a variable impact on different aspects of fellowship training. PDs reported a significant decrease in the core components of pulmonary training, whereas certain aspects of critical care training increased. It is likely that targeted mitigation strategies will be needed to ensure no gaps in PCCM training while optimizing well-being.
| S-EPMC8787736 | biostudies-literature
Project description:Background and aimsAdvanced endoscopy (AE) fellowship interviews during the 2020 application cycle were held virtually due to COVID-19 pandemic. This study aimed to characterize the application experience with virtual interviews.MethodsApplicants and programs participating in the 2020 AE fellowship match were prospectively sent separate 17-question surveys. Responses were collected using Research Electronic Data Capture.ResultsIn total, 63/104 applicants (60.6%) matched and 64/71 (90.1%) positions filled within the match. The survey was completed by 37/87 (42.5%) applicants and 71 interviewers from 43/65 (66.2%) participating programs. Most applicants (64.7%) preferred a 1:1 applicant:faculty ratio and a 20-minute interview (73.5%), which was used by programs 50.7% and 47.8%, respectively. The majority of applicants (82.4%) and interviewers (76.8%) reported overall satisfaction with virtual interviews. The biggest limitations for applicants were getting a "feel" for the program and endoscopy unit. In the future, 41.2% of applicants preferred only virtual interviews compared to 7.2% of interviewers (P< 0.01). Conversely, 14.7% of applicants preferred only in-person interviews compared to 39.1% of interviewers (P= 0.01). Half of the interviewers (50.7%) would negatively view applicants who chose a virtual option over an in-person interview if both were offered.ConclusionThe majority of AE fellowship applicants and programs reported overall satisfaction with virtual interviews during the COVID-19 pandemic. Given the potential benefits, virtual interviews may have an increasing role in future residency and fellowship applications. Programs that conduct virtual interviews need to be aware of its limitations and have measures to improve the applicant experience and mitigate potential biases of interviewers.
| S-EPMC8528488 | biostudies-literature
Project description:BackgroundTravel restrictions amidst the COVID-19 pandemic reshaped interviewing for fellowships into a predominantly virtual process. How this impacts Obstetrics and Gynecology (OB/GYN) resident approaches to fellowship application and Match navigation is largely unknown.MethodsWe performed a cross-sectional survey study of fourth year OB/GYN residents in the United States who participated in at least one virtual fellowship interview in 2020. We collected information regarding demographics, application strategy, perceived strengths and weaknesses of virtual interviews, and confidence with rank list creation. Descriptive statistics were used for categorical variables and responses pre- and post-Match were compared using Fisher's exact test.ResultsSeventy-five out of an estimated 490 applicants (~ 15% response rate) completed the survey. Of the respondents, 65.3% felt they interviewed at more programs virtually than they would anticipate completing in person, but perceived less confidence in having the necessary information (n = 45, 60%) or understanding the culture of programs (n = 59, 78.7%) to create a rank list. Cost savings were the main benefit of virtual interviews (n = 50, 66.7%), and inability to get a true "feel" for a program was the biggest limitation (n = 43, 57.3%). A majority (46.7%) advocate for a future hybrid interview process.ConclusionsOB/GYN residents pursuing fellowship reported interviewing at more programs during the virtual season, but had less confidence with rank list creation. Cost savings benefits are weighed against difficulty getting a "feel" for programs virtually. Most would advocate for a future hybrid interview process.
| S-EPMC8789205 | biostudies-literature
Project description:Background: Social media is ubiquitous as a tool for collaboration, networking, and dissemination. However, little is known about use of social media platforms by pulmonary and critical care medicine fellowship programs.Objective: We identify and characterize pulmonary and critical care fellowship programs using Twitter and Instagram, as well as the posting behaviors of their social media accounts.Methods: We identified all adult and pediatric pulmonary, critical care medicine (CCM), and combined pulmonary and critical care medicine (PCCM) programs in the United States using the Electronic Residency Application Service. We searched for Twitter profiles for each program between January 1, 2018, and September 30, 2018. Tweets and Twitter interactions were classified into the following three types: social, clinical, or medical education (MedEd) related. We collected data about content enhancements of tweets, including the use of pictures, graphics interchange format or videos, hashtags, links, and tagging other accounts. The types of tweets, content enhancement characteristics, and measures of engagement were analyzed for association with number of followers.Results: We assessed 341 programs, including 163 PCCM, 36 adult CCM, 20 adult pulmonary, 67 pediatric CCM, and 55 pediatric pulmonary programs. Thirty-three (10%) programs had Twitter accounts. Of 1,903 tweets by 33 of the 341 programs with Twitter accounts, 476 (25%) were MedEd related, 733 (39%) were clinical, and 694 (36%) were social. The median rate of tweets per month was 1.65 (interquartile range [IQR], 0.4-6.65), with 55% programs tweeting more than monthly. Accounts tweeting more often had significantly more followers than those tweeting less frequently (median, 240 followers; 25-75% IQR, 164-388 vs. median, 107 followers; 25-75% IQR, 13-188; P = 0.006). Higher engagement with clinical and social Twitter interactions (tweets, retweets, likes, and comments) was associated with more followers but not for the MedEd-related Twitter interactions. All types of content enhancements (pictures, graphics interchange format/videos, links, and tagging) were associated with a higher number of followers, except for hashtags.Conclusion: Despite the steadily increasing use of social media in medicine, only 10% of the pulmonary and critical care fellowship programs in the United States have Twitter accounts. Social and clinical content appears to gain traction online; however, additional evaluation is needed on how to effectively engage audiences with MedEd content.
| S-EPMC8357066 | biostudies-literature