Survey of clinical informatics fellows graduating 2016-2024: experiences before and during fellowship

Job search strategies and early careers of clinical informatics fellowship alumni (2016-2022)

OBJECTIVE

To report on clinical informatics (CI) fellows' job search and early careers.

MATERIALS AND METHODS

In the summer of 2022, we performed a voluntary and anonymous survey of 242 known clinical informatics fellowship alumni from 2016 to 2022. The survey included questions about their initial job search process; first job, salary, and informatics time after training; and early career progression over the first 1-6 years after fellowship.

RESULTS

Nearly half (101, 41.7%) responded to the survey. Median informatics time was 50%; most were compensated similar/better than a purely clinical position. Most reported CI fellowship significantly impacted their career, were satisfied with their first and current job after training, and provided advice for current fellows and CI education leaders. Graduates in 2022 had a median job search of 5 months, beginning 3-15 months before graduation; most had a position created for them. Nearly all graduates from 2016-2021 (61, 93.8%) had at least one change in roles/benefits since finishing training, with a trend for increased informatics time and salary.

DISCUSSION

There was a wide variety of roles, salary, and funding sources for CI positions. This highlights some of the unique challenges CI fellows face and the importance of networking. These results will help CI education leaders, fellows, alumni, and prospective fellowship applicants.

CONCLUSION

Graduates felt that CI fellowship had a significant impact on their career, were pleased with their first jobs and early career trajectory. Continued follow-up of the experience of new graduates and alumni is needed to assess emerging patterns over time.

Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors

BACKGROUND

In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by the American Board of Pathology and the American Board of Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet the growing need for informaticists. Although many programs share similar features, there is considerable variation in program funding and administrative structures.

OBJECTIVES

The aim of our study was to characterize CI fellowship program features, including governance structures, funding sources, and expenses.

METHODS

We created a cross-sectional online REDCap survey with 44 items requesting information on program administration, fellows, administrative support, funding sources, and expenses. We surveyed program directors of programs accredited by the Accreditation Council for Graduate Medical Education between 2014 and 2021.

RESULTS

We invited 54 program directors, of which 41 (76%) completed the survey. The average administrative support received was $27,732/year. Most programs (85.4%) were accredited to have two or more fellows per year. Programs were administratively housed under six departments: Internal Medicine (17; 41.5%), Pediatrics (7; 17.1%), Pathology (6; 14.6%), Family Medicine (6; 14.6%), Emergency Medicine (4; 9.8%), and Anesthesiology (1; 2.4%). Funding sources for CI fellowship program directors included: hospital or health systems (28.3%), clinical departments (28.3%), graduate medical education office (13.2%), biomedical informatics department (9.4%), hospital information technology (9.4%), research and grants (7.5%), and other sources (3.8%) that included philanthropy and external entities.

CONCLUSION

CI fellowships have been established in leading academic and community health care systems across the country. Due to their unique training requirements, these programs require significant resources for education, administration, and recruitment. There continues to be considerable heterogeneity in funding models between programs. Our survey findings reinforce the need for reformed federal funding models for informatics practice and training.

A Systematic Approach to the Design and Implementation of Clinical Informatics Fellowship Programs

Clinical Informatics (CI), a medical subspecialty since 2011, has grown from the initial four fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) in 2014 to more than 50 and counting in the present day. In parallel, the literature guiding Clinical Informatics Fellowship training and the curriculum evolved from the original core content published in 2009 to the more recent CI Subspecialty Delineation of Practice and the updated ACGME Milestones 2.0 for CI. In this paper, we outline this evolution and its impact on CIF Curricula. We then propose a framework, specific processes, and tools to standardize the design and optimize the implementation of CIF programs.