Medical Student Training in Pediatric Hospital Medicine: A National Survey of Pediatric Clerkships.

Abstract

Medical student electives offer opportunities for career exploration; it is unknown if electives exist for the newest pediatric subspecialty, pediatric hospital medicine (PHM), or how PHM competencies are already addressed in required medical student training. Our objectives for this study were (1) to determine the prevalence of exposure to PHM competencies in medical school and (2) to inform a needs assessment for a PHM elective. A 5-item survey was distributed to members of the Council on Medical Student Education in Pediatrics as part of a larger survey in 2018. Descriptive statistics were used to report responses as proportions. Responses to 1 open-ended question were coded and grouped into categories. Of 152 total respondents, 118 (77.6%) answered at least 1 question. Respondents felt that quality improvement was addressed in preclinical years (40.4%), whereas systems-based practice was incorporated into core clerkships (32.1%). Although most indicated that leadership and education should be taught at the subinternship level (29.6% and 25%, respectively), those competencies are not currently integrated into subinternship rotations (7.4% and 4.8%, respectively). Approximately half (n = 58; 49.5% each) reported that their institution offers a PHM elective. Lack of a standardized curriculum (16%) was seen as a barrier, and in free-text responses (n = 33), respondents also noted concerns regarding saturation of inpatient settings and redundancy with required rotations. How to become a good leader and how to become a good educator were identified as PHM competencies that should be, but are not currently, taught at the fourth-year medical student level. A standardized curriculum and strategies to mitigate redundancy with existing rotations may increase satisfaction of students.