Fellowship Program Directors Research Articles

Accreditation Council for Graduate Medical Education Milestone Scores in Pediatrics: Pilot Study Exploring the Relationship Between Residency and Early Fellowship Scores.

The Accreditation Council for Graduate Medical Education requires Milestone-based assessments of residents and fellows. In pediatrics, 11 subcompetencies are common to both residency and subspecialty fellowship training. It is unknown whether Milestone scores achieved during residency are related to Milestone scores achieved in early fellowship. To assess the relationship between final residency Milestones scores and first-year fellowship Milestones scores in the 11 common subcompetencies (CSCs) across pediatric subspecialties. This was a retrospective single-institution cohort study of pediatric fellows beginning fellowship training between July 2016 and July 2019. De-identified Milestone score sets for final residency scores (R), mid-year first-year fellowship scores (F1), and final first-year fellowship scores (F2) were collected. Spearman correlation and regression analyses were used to assess score relationships. Data for 85 of 98 eligible fellows were collected. Consistently, the F1 scores were lowest, and the R scores were highest. There was a weak positive correlation between the composite R scores and the composite F1 scores. There was a weak positive correlation between residency and fellowship scores for 6 CSCs and no significant correlation for the remaining 5. For the 11 pediatric CSCs, the final residency Milestone scores are consistently higher than and only weakly associated with early fellowship Milestone scores. There may be limitations to the use of residency scores for fellowship program directors in guiding individualized education for early fellows. This study provides groundwork for additional study of Milestone relationships and may help inform the next iteration of pediatric subspecialty Milestones.

Longitudinal Assessment of Modern Spine Surgery Training: 10-Year Follow-up of a Nationwide Survey of Residency and Spine Fellowship Program Directors.

This study is a cross-sectional survey distributed to all PDs of ORTH and NSGY residencies and spine fellowships in the United States. Participants were queried regarding characteristics of their program, ideal characteristics of residency training, and opinions regarding the current training environment. χ2 tests were used to compare answers over the years. In total, 241 PDs completed the survey. From 2013 to 2023, NSGY increased the proportion of residents with >300 spine cases (86%-100%) while ORTH remained with >90% of residents with < 225 cases (p < 0.05). A greater number of NSGY PDs encouraged spine fellowship even for community spine surgery practice (0% in 2013 vs. 14% in 2023, p < 0.05), which continued to be significantly different from ORTH PDs (∼88% agreed, p > 0.05). 100% of NSGY PDs remained confident in their residents performing spine surgery, whereas ORTH confidence significantly decreased from 43% in 2013 to 25% in 2023 (p < 0.05). For spinal deformity, orthopaedic PDs (92%), NSGY PDs (96%), and fellowship directors (95%), all agreed that a spine fellowship should be pursued (p = 0.99). In both 2013 and 2023, approximately 44% were satisfied with the spine training model in the United States. In 2013, 24% of all PDs believed we should have a dedicated spine residency, which increased to 39% in 2023 (fellowship: 57%, ORTH: 38%, NSGY: 21%) (p < 0.05). Spine surgery training continues to evolve, yet ORTH and neurological surgery training remains significantly different in case volumes and educational strengths. In both 2013 and 2023, less than 50% of PDs were satisfied with the current spine surgery training model, and a growing minority believe that spine surgery should have its own residency training pathway. IV.

Contributions of Surgical Critical Care Program Directors Society to the training of surgeons.

In 1986, Surgical Critical Care (SCC) was formally recognized as a specialty by the American Board of Surgery (ABS), however it took another two decades to develop a formal national training structure in SCC. In 2003, the program directors of SCC fellowships began to meet and the Surgical Critical Care Program Directors Society (SCCPDS) was officially formed in 2004, with recognition of the SCCPDS as a non-profit organization in 2008. Over the next several years, and in conjunction with other interested groups, such as the American Association for the Surgery of Trauma (AAST) and the Society of Critical Care Medicine (SCCM), SCCPDS created a formal curriculum, developed a unified system for the fellowship application process, and increased recruitment and match such that now approximately 1 in 6 general surgery graduates are pursuing training in SCC. In discussion with past and present leadership of SCCPDS, there are several ongoing initiatives to further improve the educational opportunities of the fellows and increase inclusion of other organizations and other specialties interested in SCC. The purpose of this article is to discuss the role of SCCPDS in the development and evolution of SCC and Acute Care Surgery (ACS) training. Expert Opinion; Level V.

1303. Making Infectious Disease Fellowship More Rashional: A Needs Assessment of Program Directors

Abstract Background Many infectious diseases present with rashes. Despite this, limited data have been published regarding dermatology training in infectious disease (ID) fellowships. We aimed to understand the perceived importance, current effectiveness, and existence of dermatology curricula for ID fellows in the United States (US). Methods Over four weeks in March-April 2022, we emailed US ID fellowship program directors (PDs) individualized links to a Qualtrics survey. Up to two reminder emails were sent. Using NRMP Match Results and Data, we identified 151 PDs. Email addresses were found for 147 PDs. Descriptive data analysis was performed. This study was IRB exempt. Results Response rate was 91/147 (62%). Most PDs (79/91, 87%) felt like it was very-to-extremely important for ID fellows to know basic dermatologic manifestations of infections (Image 1), though 91% (82/90) felt that they were only slightly-to-moderately effective at preparing fellows for this (Image 2). Most (55/90; 61%) programs do not have a formal dermatology curriculum for their fellows. Lack of faculty capacity, lack of reliable resources, and other topics taking priority were most commonly selected as significant barriers to implementing a dermatology curriculum (Image 3). Of the programs that do not have a dermatology curriculum, 76% (41/54) of PDs were interested in incorporating an externally produced dermatology curriculum with synchronous lectures (81%), asynchronous content (78%), and flipped classroom guides (72%) being the most favored educational strategies. For programs that currently have a dermatology curriculum (35/90, 39%), 67% (22/33) of PDs felt their fellows found their current dermatology curriculum very-to-extremely valuable. Conclusion These data indicate that current ID training often does not include formal dermatology-ID training. This data, along with a planned focus group of fellows, will help inform the development of a dermatology-ID curriculum to help address this content gap and improve ID fellowship education. Disclosures All Authors: No reported disclosures.

Applying Practice Analysis to Develop a New Test Content Outline for the Pediatric Cardiology Certification Examination.

The evolving breadth and complexity of the contemporary pediatric cardiology specialty requires regular, systematic analysis of the practice to ensure that training and certification requirements address the demands of real-world clinical experience. We report the process of the American Board of Pediatrics (ABP) for conducting such a practice analysis and revising the test content outline (TCO) for the pediatric cardiology subspecialty certification exam. A panel of 15 pediatric cardiologists conducted seven 2-h virtual meetings, during which they identified 37 unique tasks that represent the work a pediatric cardiologist may reasonably expect to perform within the first 5years after training. These tasks were grouped into nine performance domains, similar to the entrustable professional activities (EPA), previously endorsed by the ABP in collaboration with the pediatric cardiology education community, and which represent the critical activities of the profession. The panel then enumerated the knowledge, skills, and abilities necessary to perform each task. These deliberations resulted in two work products: a practice analysis document (PAD) and subspecialty board TCO based on testable knowledge, skills, and abilities. Survey assessments of the panel's work were then distributed to pediatric cardiology fellowship program directors and to practicing pediatric cardiologists for their input, which largely aligned with the panel's recommendations. Survey responses were considered in the final revisions of the PAD and TCO. This approach to practice analysis proved to be an efficient process for describing the work performed by today's pediatric cardiologists and the knowledge, skills, and abilities needed to competently perform that work.

Education Research: Evaluation of Epilepsy Surgery Education in Epilepsy and Clinical Neurophysiology Fellowship Programs

Background and Objectives To assess the scope of surgical epilepsy exposure and training among fellows in Epilepsy and Clinical Neurophysiology (CNP) fellowship programs in the United States. Characteristics associated with increased fellow involvement in epilepsy surgery were evaluated. Methods A 10-question multiple-choice survey was designed to characterize individual fellowship programs, epilepsy surgery programs, trainee involvement, and assessment of trainee performance. The survey was distributed to program directors of adult Epilepsy and CNP-EEG track fellowships between November 2021 and April 2022. Epilepsy surgery procedures included resective approaches, neurostimulation modalities, and palliative interventions approved for drug-resistant epilepsy. Associations between categorical variables were evaluated using the Fisher exact test. Results There were 37 responses from a total of 72 survey recipients (51% response rate). The majority (68%) of surgical programs performed &gt;30 surgical procedures per year. The range of procedures was overall similar across programs. At most programs, fellows were personally involved in 1–10 (49%) or 11–30 (46%) surgical procedures per year. Institutions with &gt;50 surgical cases/year were more likely to expose fellows to &gt;10 cases/y compared with institutions with volumes ≤50 per year (77% vs 33%, p = 0.017). Fellows had the greatest involvement in presurgical planning with more variable involvement in perioperative and postoperative activities. Competency in surgical management was primarily investigated through faculty assessments (97%), whereas oral (46%) and written (30%) assessments were less frequently used. Discussion High-volume epilepsy surgery centers provide trainees with increased exposure despite also having more fellowship positions. There is variability in surgical epilepsy exposure, trainee involvement, and performance evaluation metrics between institutions. We identify specific areas that programs may focus on to improve fellow competency in the surgical management of epilepsy.

Pediatric Cardiology Fellowship Standards for Training in Exercise Medicine and Curriculum Outline.

Over the past 2 decades, fundamentals of exercise medicine, including clinical exercise testing, assessment and promotion of physical activity, exercise prescription, and supervised exercise training/rehabilitation programming have demonstrated considerable clinical value in the management of children and adolescents with congenital and acquired heart disease. Although the principles of exercise medicine have become an integral component in pediatric cardiology, there are no standardized training recommendations for exercise physiology during pediatric cardiology fellowship at this time. Thus, the Pediatric Cardiology Exercise Medicine Curriculum Committee (PCEMCC) was formed to establish core and advanced exercise physiology training recommendations for pediatric cardiology trainees. The PCEMCC includes a diverse group of pediatric cardiologists, exercise physiologists, and fellowship program directors. The expert consensus training recommendations are by no means a mandate and are summarized herein, including suggestions for achieving the minimum knowledge and training needed for general pediatric cardiology practice.

Clinical competency committee perceptions of entrustable professional activities and their value in assessing fellows: A qualitative study of pediatric subspecialty program directors

Objectives To examine the composition and processes of Clinical Competency Committees (CCCs) assigning entrustable professional activity (EPA) levels of supervision for pediatric subspecialty fellows and to examine fellowship program director (FPD) perspectives about using EPAs to determine fellows’ graduation readiness. Methods A qualitative study was performed using one-on-one interviews with a purposeful sample of pediatric subspecialty FPDs to yield a thematic analysis. Semi-structured interview guides were used for participants who self-identified as EPA users or non-users. Inductive analysis and coding were performed on transcripts until theoretical sufficiency was attained. Results Twenty-eight FPDs were interviewed. There was significant variability in the composition and processes of CCCs across subspecialties. FPDs felt that CCCs intuitively understand what entrustment means, allowing for ease of application of level of supervision (LOS) scales and consensus. FPDs perceived that EPAs provided a global assessment of fellows and are one tool to determine graduation readiness. Conclusions Although there was variability in the makeup and processes of CCCs across subspecialties, FPDs believe EPAs are intuitive and relatively easy to implement. Consensus can be reached easily using EPA-specific LOS scales focusing on entrustment. FPDs desire a better understanding of how EPAs should be used for graduation.

Evaluating the Impact of a Year-Long External Mentorship Pilot Program in Classical Hematology

Introduction: Mentorship and access to role models in hematology/oncology (H/O), particularly in classical hematology (CH), are important factors in positively influencing trainee career decisions. However, mentorship opportunities are perceived as more accessible in oncology than hematology. Most mentorship experiences occur within an institution; therefore, creating access to external mentors may benefit trainees interested in CH if these opportunities are lacking. In April 2021, a year-long external mentorship pilot program (EMPP) developed through the ASH Medical Educators Institute was implemented to pair H/O fellows pursuing CH careers with faculty at external institutions. This mixed methods study aims to evaluate feasibility and impact of the program on personal satisfaction, academic productivity, access to networking opportunities, and career development of trainees interested in CH. Methods: Details about the EMPP were disseminated to fellowship program directors, social media, and listservs; 35 adult and pediatric H/O fellows applied, and all were accepted. Fellows were paired by 1 investigator (S.J.P.) with 34 mentors who were recruited based on hematology expertise and academic productivity (Figure 1). A 34- and 25-item survey was distributed to mentees and mentors, respectively, at the end of the program. Multiple choice, 5-point Likert-type Scale, and free text items were used to gather quantitative and qualitative data on their experiences. Participants were assumed to agree to a statement if they chose "agree" or "strongly agree" for Likert-type Scale items. Free text comments were analyzed by 2 investigators (Z.Q. and S.J.P.) with themes identified and agreed upon by both. Results: Twenty-eight (80.0%) mentees self-identified as female and 7 (20.0%) as male. Sixteen (45.7%) were White, 12 (34.3%) were Asian, 2 (5.7%) were Black, 1 (2.9%) was Arab, and 1 (2.9%) was White and Native American. Three (8.6%) were Hispanic. Thirteen (37.1%) and 22 (62.9%) were in or accepted into an adult or pediatric H/O program, respectively. There were 10 first-year (28.6%), 16 second-year (45.7%), 7 third-year fellows (20.0%), and 2 third-year pediatrics residents (5.7%); following inception of the program, all participants advanced a year in their training. Each mentee was paired with 1 mentor, with 1 mentor matched to 2 mentees. Thirty-three pairs (94.3%) completed the program. Thirty-one mentees (91.2%) and 26 mentors (78.9%) completed a post-program survey, which was distributed to 34 mentees and 33 mentors, as 1 pair started the program 4 months off cycle. Twenty-nine (93.5%) mentees and 22 (84.6%) mentors agreed that their pairing was a good match. In free text comments, mentees and mentors wrote that "similar interests" made their pairings successful. Mentees noted "approachability", "significant experience in mentoring," and similar "personality" as reasons why their mentor was a good match. Twenty mentees (64.5%) believed that this program increased their academic productivity, and 23 (74.2%) indicated that they had scholarly work published, submitted, or in progress as a result of the program (Table 1). Eighteen mentees (58.1%) connected with other faculty outside of their mentor through the program. Twenty-four mentees (77.4%) indicated that the program facilitated their career development, through obtaining "career advice" and finding a "sense of community." One participant wrote "[a]s a Black male meeting [mentor] and getting his direct mentorship provided me safety and permission to live up to my dream of being a physician scientist." Over half of mentees (54.8%) and mentors (53.8%) plan to continue their mentoring relationship beyond the required 1 year duration. Thirty mentees (96.8%) and 24 mentors (92.3%) agreed that they would recommend this program to other fellows and faculty, respectively. Conclusion: This EMPP was feasible as all applicants were matched with a mentor and most pairs completed the program. The program positively impacted the experience of fellows interested in CH in terms of personal satisfaction, academic productivity, access to networking opportunities, and career development. Factors leading to the program's success included strong mentee-mentor pairings, involvement in scholarly work, and connecting with CH faculty. Given the feasibility and positive reception, we plan to continue and expand the program beyond its pilot sites. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Closing the gender gap in gastroenterology leadership: the need for effective and comprehensive allyship

There are clear gender disparities in leadership positions at gastroenterological organisations, with women representing only 19% of all gastroenterology fellowship programme directors and divisional or departmental chairs in academic institutions in the USA1 and only 20% of editorial board members in gastroenterology and hepatology journals.2 To date, the American Gastroenterological Association, the American College of Gastroenterology, the American Society of Gastrointestinal Endoscopy, and the American Association for the Study of Liver Diseases have each had five or fewer female presidents since they were founded more than 70 years ago.

VIRTUAL INTERVIEWS beyond COVID-19: Applicant and Program directors’ Perspectives

The 2020-21 interview cycle for Reproductive Endocrinology and Infertility (REI) fellowship was transitioned to a virtual format due to COVID-19. A previous study established that both fellowship applicants and program directors (PDs) had favorable experiences and perceptions of virtual interviews (VIs) and endorse its continued use.1

Applicant characteristics and interview-day structure of shoulder and elbow surgery fellowships

Background: The purpose of this study was to determine the selection criteria and interview-day structure used by shoulder and elbow fellowship program directors. Methods: An anonymous 14-question survey was distributed to the program directors of the 31 American Shoulder and Elbow Surgeons (ASES) recognized orthopaedic shoulder and elbow fellowship programs. Surveys were sent via email, and responses were collected from March 31, 2021 to May 10, 2021. Results: All 31 fellowship directors responded (100%). The most valuable selection criteria for applicants were subjective measures: quality of interview, letters of recommendation, and quality of residency program. Objective criteria such as United States Medical Licensing Examination (USMLE) scores and Orthopaedic In-Training Examination (OITE) scores were less important. Fifteen (50%, 15/30) programs required applicants to have one to two publications, while 15 (50%, 15 of 30) required three to five publications. Programs most commonly interviewed 16 to 20 residents (38.7%). The interview day was a half day for the majority of programs (n=20; 64.5%), with most programs utilizing three (25.8%) or four (45.2%) separate interviews. Current fellows interviewed applicants in about half of the programs (51.6%). Conclusions: Shoulder and elbow fellowship program directors prioritize subjective over objective attributes when selecting applicants. The interview day is most commonly a half day with each applicant undergoing multiple interviews at each institution. Understanding the selection process used by shoulder and elbow fellowship directors provides a valuable resource for residents. Level of Evidence: Level V.

Kidney Pathology Education for Nephrology Fellows: Past, Present, and Future.

Kidney pathology education is a critical component in training of nephrology fellows, as well as for continuing medical education for practicing nephrologists. Kidney pathology images are included on nephrology fellow board exams, and clinicopathologic correlation of kidney biopsy findings is critical in everyday clinical practice. Nephropathology training is a requirement by the American College of Graduate Medical Education within nephrology fellowship curricula. However, greater than one-third of fellowship program directors believe that nephropathology training for their fellows is not sufficient. During the Coronavirus Disease-19 pandemic, the use of digital learning has become commonplace with virtual conferences (local, national, and international) and online meetings becoming the norm for education. Nephrology has become a leader in free open-access online medical education, both prior to and, to even a greater extent, during the pandemic. Here, we review available resources to nephrology fellows and other learners to supplement nephropathology training, which includes medical blogs, journal clubs, interactive quizzes and games, online conferences, podcasts, and mentorship opportunities. These resources are archived and provide durable content to learners of all stages of training, even beyond the pandemic.

Current practices in delaying testing for IgE-mediated food allergy after anaphylaxis.

General recommendations for delaying allergy testing, especially skin testing, in the weeks following anaphylaxis have been proposed owing to concern for false-negative results. However, no specific guidelines exist to aid clinicians in the decision regarding when to perform postanaphylactic food allergy testing and which test to use. The current practices of allergists regarding a delay in testing for food allergy after anaphylaxis are unknown. We aimed to quantify the use of different approaches to postanaphylactic food allergy testing among allergists across the United States. A clinical scenario was presented to 82 allergy and immunology fellowship program directors via e-mail survey. They were asked whether they avoid skin prick and/or blood-specific IgE testing in a child in the 6 weeks following suspected food-induced anaphylaxis owing to concern for false-negative results. The survey response rate was 33%. Of the 27 respondents, 4 (14.8%) avoid both blood and skin testing, 7 (25.9%) avoid skin testing only, and 16 (59.3%) do not avoid any testing. Given the paucity of published evidence, a spectrum of opinions exists regarding testing in the weeks following food-induced anaphylaxis. About 40% of the allergy and immunology fellowship program directors in the United States who responded to the survey in this study avoid some allergy testing in the first 6 weeks after food-induced anaphylaxis owing to concern for false-negative results.

A Descriptive Analysis of Pediatric Ophthalmology Fellowship Program Directors

There is limited literature on the characteristics of pediatric ophthalmology leadership. The authors examined the demographics, academic backgrounds, and scholarly output of pediatric ophthalmology fellowship program directors. Despite a positive trend in gender equity in this position, efforts remain to resolve the "leaky pipeline" of women into ophthalmology leadership. [J Pediatr Ophthalmol Strabismus. 2022;59(6):e69-e72.].

Training Characteristics, Academic Accomplishments, and Motivation of Current Program Directors in Physical Medicine and Rehabilitation.

This study aimed to report the training characteristics, academic accomplishments, and motivation of current US academic physical medicine and rehabilitation program directors.A 22-question survey was developed and disseminated via email in May 2020 to 91 current residency program directors who are members of the Association of Academic Physiatrists Residency Fellowship Program Director Committee. Follow-up emails were sent 2 and 4 wks after initial distribution, and the survey was closed after 6 wks in June 2020. Data collected were deidentified. Descriptive analysis was performed.Response rate was 49.5% (45/91); 64.4% of program directors were men, and 35.6% were women. Of the respondents, 75.4% were White/Caucasian, 6.7% were Hispanic/Latinx, 15.6% were Asian, and 2.2% were Black/African American. Moreover, 56% (9/16) of female program directors vs. 0% (0/29) of male program directors reported experiencing sex discrimination in the workplace.Four percent of program directors were full professors in physical medicine and rehabilitation when first appointed, 17% were associate professors, and 72% were assistant professors. Thirty-four percent of program directors had at least six peer-reviewed publications when first appointed.This survey provides insight to the training characteristics, accomplishments, and motivation of current program directors for physiatrists aspiring to enter these ranks and highlights the underrepresentation of women/minorities among leadership positions in physical medicine and rehabilitation.

Editorial introductions.

Current Opinion in Gastroenterology was launched in 1985. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of gastroenterology is divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Jocelyn A. SilvesterJocelyn A. SilvesterDr Jocelyn A. Silvester, MD PhD, is Assistant Professor of Pediatrics at Harvard Medical School, USA, and Director of Research for the Celiac Disease Program at Children's Hospital (BCH) in Boston, Massachusetts, USA. She also maintains a general pediatrics practice in Northern Manitoba and Nunavut through the Ongomiizwin Health Services JA Hildes Northern Medical Unit. Dr Silvester completed her PhD in Biology at the University of Cambridge in England, UK, where she studied mitochondrial ATP synthase under the supervision of Professor Sir John E. Walker. She earned her medical degree from Dalhousie University in Canada and completed her residency in general pediatrics at the University of Manitoba, Canada. She came to the United States for pediatric gastroenterology fellowship training at Boston Children's Hospital. Dr Silvester is co-Chair of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Celiac Disease Special Interest Group and serves on the American Gastroenterological Association Council for section for basic and clinical intestinal disorders. Her research interests include the diagnosis and management of celiac disease with a particular interest in what happens after the diagnosis of celiac disease is made. She is co-Investigator on the Manitoba Celiac Disease Cohort Study, involved in clinical trials for alternative therapies to a gluten-free diet and is leading a consortium of pediatric celiac centers across the United States to develop tools to improve follow-up care. Tilak U. ShahTilak U. ShahDr Shah is an Associate Professor of Medicine at Virginia Commonwealth University (VCU) Health Science Center, USA, as well as Director of Endoscopy and Interventional Endoscopy at the Central Virginia VA Healthcare system in Richmond, VA, USA. He serves as Associate GI Fellowship Program Director at VCU, and is a member of the Development and Therapeutics section of VCU Massey Cancer Center. Dr Shah graduated from the University of North Carolina (UNC) at Chapel Hill, USA, in 1997, and UNC School of Medicine in 2006. He completed internal medicine residency and fellowship training in gastroenterology at Duke University Medical Center, USA. Dr Shah also obtained a master's degree in clinical research from the Duke-NIH Clinical Research Training Program, and underwent formal training in Advanced Endoscopy at Emory University Medical Center, USA. He joined the medical faculty at Virginia Commonwealth University in 2014. Dr Shah has served on American College of Gastroenterology (ACG), American Society of Gastrointestinal Endoscopy (ASGE), and Veterans Administration (VA) Committees. He has served as a reviewer for several journals including American Journal of Gastroenterology, Clinical Gastroenterology and Hepatology, Digestive Diseases and Sciences, World Journal of Gastroenterology, and Cochrane Database of Systematic reviews, and is section editor for Current Opinion in Gastroenterology. Dr Shah's research interests involve endoscopic approaches to diagnose and treat esophageal and colorectal neoplasia, including advanced imaging, artificial intelligence, endoscopic resection, and cryotherapy. Dr Shah is the recipient of research awards from the ASGE and McGuire Research Institute, and is site investigator for VA Co-Operative and Merit studies. He is an author on over 30 original papers, and has authored two board preparation textbooks, “NMS Medicine Casebook,” and “Acing the Pancreaticobiliary Questions on the GI Boards.”

1.55 Child and Adolescent Psychiatry Fellowship Program Directors: A Descriptive Analysis

1.55 Child and Adolescent Psychiatry Fellowship Program Directors: A Descriptive Analysis

Breast Surgical Oncology Fellowship applicant selection and ranking: A survey of Society of Surgical Oncology programs.

In 2003, the Society of Surgical Oncology (SSO) initiated a breast surgical oncology fellowship, which has now grown to 60 SSO accredited programs as of 2021. Limited knowledge exists on the traits of successful applicants and the factors influencing the rank list. A web-based, anonymous survey was sent to all SSO Breast Surgical Oncology Fellowship program directors. The survey consisted of 26 questions. Descriptive statistics were used to analyze survey responses and evaluate impact on applicant interview and rank list. Thirty-four programs (57% response rate) completed the survey. Programs received an average of 70 applications and granted 24 interviews. Most programs reported a minimum ABSITE cut-off score (n = 28, 82%) and a defined publication requirement (n = 22, 65%), including a first-author requirement (n = 18, 53%) to extend an invitation to interview. For postinterview rank, applicant interpersonal skills were highly valued. The interview was the most important aspect for the rank list. Many programs have ABSITE and publication thresholds before offering an interview. Upon receiving interview invitation, the applicant's interview performance, interpersonal skills, and letters of recommendation were the most important aspect in rank list decision making.

Perspectives on Current Mechanical Ventilation Use and Training in Pediatric Critical Care Medicine Fellowship Programs in the United States

AbstractMechanical ventilation (MV) is an integral part of the care of the critically ill child, and contemporary MV includes a myriad of sophisticated modalities that should be tailored to specific disease pathology and severity. This requires Pediatric Critical Care Medicine (PCCM) physicians to have comprehensive training and experience with various modes. We sought to assess and describe the current landscape of MV practices and training from PCCM fellowship programs. To describe current MV practices and training in PCCM fellowship programs and assess the different modes of MV to which trainees are exposed, a piloted survey was sent to all 67 American PCCM fellowship program directors (PDs) in 2019. Forty-eight (71.6%) of PCCM PDs responded. Our survey shows that PCCM fellows are not uniformly exposed to the same MV modalities, and PDs' perception of fellows' competency in managing MV is variable. Our results suggest that there is a lack of exposure to the various modes of “conventional” MV, as well as inconsistent education about less-utilized “nonconventional” MV. Additionally, we found that PDs are aware of their fellows' limited exposure to various modalities, as many practice patterns are institution specific. This study identified gaps in MV education and training and advocates for PCCM fellowship programs to identify these deficiencies to equip all trainees with a solid knowledge base that will prepare them to utilize any mode of MV in their future practice.