Preparedness to practice paediatric hospital medicine

The Secret Life of Junior Pathologists: Challenges and Future Directions

CONTEXT.—

Transition from pathology trainee to independent pathologist is stressful. No study has examined junior pathologists' challenges and concerns during this transition.

OBJECTIVE.—

To identify challenges and concerns of junior pathologists.

DESIGN.—

Junior pathologists were defined as those who had been practicing independently for up to 5 years after completion of residency/fellowship. An institutional review board-approved electronic survey was created and distributed to recent pathology graduates of MD Anderson Cancer Center (Houston, Texas) and MedStar Georgetown University Hospital (Washington, District of Columbia). The survey was open from October 13, 2022, to January 31, 2023. The survey included 16 multiple-choice and free-text questions.

RESULTS.—

Responses were received from 39 junior pathologists. Participants working in academic settings indicated independence, work-life balance, and professional identity formation as challenges; those in nonacademic settings indicated pathology reporting, efficiency, and administration as challenges. Areas where participants wished they received more guidance differed by practice setting: participants in academic settings more often chose effective time management and importance of turnaround time (35% [7 of 20] versus 0% [0 of 14], P = .03) and tumor board conference presentation skills (25% [5 of 20] versus 0% [0 of 14], P = .06), while those in nonacademic settings more often chose Current Procedural Terminology (CPT) coding, billing, and cost-effective patient care (79% [11 of 14] versus (35% [7 of 20]; P = .02). More female than male participants indicated that they wished they had received more guidance in leadership and soft skills (79% [11 of 14] versus 28% [5 of 18]; P = .01).

CONCLUSIONS.—

This study identified challenges experienced by junior pathologists. Collective efforts from training programs, experienced pathologists, and professional organizations can explore ways to improve the transition experience.

The current state of general paediatric fellowships in Canada

Introduction

The field of Paediatric Medicine has grown tremendously over the last two decades. Several niche areas of practice have emerged, and opportunities for focused training in these areas have grown in parallel. The landscape of 'General Paediatric Fellowship' (GPF) Programs in Canada is not well described; this knowledge is needed to promote standardization and high-quality training across Canada. This study explores the structure and components of existing GPFs in Canada and identifies the interest and barriers to providing such programs.

Methods

A questionnaire was created to explore the landscape of GPF Programs in Canada. Invitations to participate were sent to leaders of General Paediatric Divisions across Canada, with a request to forward the survey to the most appropriate individual to respond within their local context.

Results

A total of 19 responses (95%) representing 17 different Canadian universities were obtained. Eight universities offered a total of 13 GPF Programs in 2019, with one additional university planning to start a program in the coming year. Existing programs were variable in size, structure and curriculum. Most programs identified as Academic Paediatric Programs, with an overlap in content and structure between Academic Paediatrics and Paediatric Hospital Medicine programs. The majority of respondents felt there was a need for GPF Programs in Canada but cited funding as the most common perceived barrier.

Conclusion

A growing number of GPF Programs exist in Canada. Current fellowship programs are variable in structure and content. Collaboration between programs is required to advance GPF training in Canada.