The current state of pediatric transplant hepatology fellowships: A survey of recent graduates

Development of a national Zoom-based lectureship for pediatric transplant hepatology trainees

BACKGROUND

Previous publications identified a gap in standard education on topics related to advanced hepatology and liver transplantation for pediatric transplant hepatology trainees. The Society of Pediatric Liver Transplantation (SPLIT) Education Committee designed a Zoom-based lectureship series for all advanced pediatric transplant hepatology trainees. We aim to describe the educational series and feedback from fellow participants.

METHODS

Pediatric transplant hepatology trainees from across the United States and Canada were invited to attend 25 Zoom-based lectures on a broad list of topics pertaining to pediatric transplant hepatology. At the completion of the lectureship, a 53-item REDcap survey using single-answer, Likert-scale, and open-ended questions was distributed via email to all participants.

RESULTS

A total of 16 fellows from broad geographic areas responded to the survey. Nineteen percent (n = 3/16) of fellows attended all 25 lectures and 31% (n = 5/16) attended 16-20 lectures. Majority of fellows (88%, n = 14/16) reported the lecture series increased knowledge of liver disease, increased confidence in managing children with liver disease, and aided with board preparation. Additionally, over half of the fellows (81%, n = 13/16) reported the series served as a platform for networking and mentoring from peers and experts in the field. All fellows recommended the lecture series for future fellows.

CONCLUSION

The SPLIT educational lectureship for advanced pediatric transplant hepatology trainees provided a national education curriculum that not only led to increased knowledge and confidence in the diagnosis and management of common conditions encountered in pediatric transplant hepatology but also provided a unique networking and mentorship environment.

Assessment of Pediatric Kidney Transplant Experience and Exposure During Pediatric Nephrology Fellowship Training

There have been no published studies evaluating competency or perceived competency in kidney transplant–related knowledge and skills among graduates of pediatric nephrology fellowships. There are also no uniform specific transplant requirements within the pediatric nephrology fellowship. We aim to further understand this potential gap to rectify it in the future.

Demographics, motivations, and experiences of participants in transplantation or cellular therapy fellowships

BACKGROUND

Recent ASTCT guidelines have sought to establish clinical and research expectations for participants in blood and marrow transplantation (BMT) and cellular therapy (CT) fellowships. However, little is known about participants in BMT/CT fellowships and the value they find from this additional training.

OBJECTIVES

To characterize the demographics, motivations, and experiences of recent participants in BMT/CT fellowships.

METHODS

We developed a 27-item online survey addressing backgrounds, application processes, training experiences, and perceived benefits among physicians who had started a clinical US-based BMT/CT fellowship between 2012-2021. Anonymous responses were solicited through program director outreach, society website postings, targeted emails, and social media.

RESULTS

Of 105 respondents (44% pediatric trainees), 4% were underrepresented minorities (URM) and 39% were non-US international medical graduates (IMGs). The most important motivations for applying were comfort with allogeneic BMT, improved career prospects, and opportunities for research and publication. Almost all respondents (92%) attended donor selection meetings, while smaller proportions visited cell processing facilities (65%), HLA labs (57%), or GMP facilities (22%). Most respondents reported ≥1 publication (26% reported 4+) based on research or experiences during their fellowship. Respondents reported improved post-fellowship comfort with all queried BMT/CT-related competencies. Seventy percent of respondents stated that they would recommend their fellowship highly to others; this corresponded to a Net Promoter Score of +65%, consistent with a strongly positive experience. Most respondents reported currently being in clinical practice (89% at academic centers), with a median of 70% of time currently spent caring for BMT/CT recipients.

CONCLUSIONS

While limited by recruitment methods and recall bias, our study demonstrated that BMT/CT fellowships are effective at increasing comfort with BMT/CT management and that most participants would highly recommend this BMT/CT training to others. Nevertheless, our study identified substantial heterogeneity in clinical responsibilities and BMT/CT-related laboratory exposure. The high representation of non-US IMGs underscores the distinct role of BMT/CT fellowships for this group, while improved URM recruitment remains an important future direction for the field. Whether advanced fellowships will ever become required for the future BMT/CT workforce, analogous to the additional training required for solid organ transplantation in other medical and pediatric subspecialties, remains uncertain.