Unfit for a Single Prism: Procedural Education and Career Development Training.

Abstract

In Reply: We are pleased to learn that Nayahangan and colleagues find our research study titled, “Career Development Training for Interventional Fellows: Are they ready for the workforce?” interesting and we would like to thank them for their comments. Although we are not intimately familiar with the details of interventional pulmonology (IP) training in Denmark, we would be glad to explore with our Danish educator colleagues any future opportunities to meet, exchange ideas, and collaborate for the mutual benefit of our respective trainees in IP. In the United States, formal IP training comprises 12 months dedicated to interventional pulmonary procedures and consultation in a supervised setting.1 This IP fellowship follows at least 3 years of separate fellowship training in general pulmonary and critical care medicine, which is accredited by the Accreditation Council for Graduate Medical Education (ACGME). All IP fellowship training programs are expected to meet consensus-based minimum standards in terms of procedural volumes as well as other metrics.2 Most if not all of this journal’s esteemed readership would likely agree with the points made by Nayahangan and colleagues, and so do we. However, we would like to point out that the subject of our study was altogether different from that of their commentary. Our educational intervention did not comprise clinical or procedural training, nor did we measure clinical or procedural skills to evaluate the impact of our intervention. Rather, our study was focused on career development training of advanced IP fellows. Career development training included topics such as understanding the hiring process, developing a job search strategy, making a business plan, personal branding, research funding, purchasing capital equipment, engaging in mentorship, and pathways to promotion or partnership.3 Nayahangan and colleagues also make valid comments about the pitfalls of using self-assessment instead of other assessment tools and that, “Luckily, a vast selection of such dedicated assessment tools with proven evidence of validity are available in the field of IP.” We would again like to point out that those validated assessment tools of clinical or procedural skills are not relevant to this study. To conclude, the subject of our study was not clinical or procedural competence in IP but rather career development of advanced IP fellows. These are 2 different sets of competencies that must not be viewed from the same prism. Majid Shafiq, MD, MPH* Jason Akulian, MD, MPH† Neeraj Desai, MD‡ Kim French, MHSA‡ Ashutosh Sachdeva, MBBS§ Carla Lamb, MD∥ Samira Shojaee, MD, MPH¶ Angela C. Argento, MD# Hans J. Lee, MD***Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston∥Division of Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA†Division of Pulmonary and Critical Care Medicine, University of North Carolina Chapel Hill, NC‡Chicago Chest Center#Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL§Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine**Division of Pulmonary and Critical Care Medicine, Johns Hopkins University Baltimore, MD¶Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, Richmond, VA