Background: In 2023, the Accreditation Council for Graduate Medical Education (ACGME) proposed changes to Pediatric Residency programs allowing for greater individualization of resident experiences and increased ambulatory care time. The ACGME changes may lead some institutions to expand pediatric hospital medicine (PHM) services to provide coverage of hospitalized children previously cared for by residents. We sought to understand the perceptions of PHM division and service-line leaders regarding (1) anticipated staffing challenges facing their PHM service lines and (2) the leaders’ approaches to addressing these challenges.
Methods: We distributed a survey to PHM division directors and service line leaders via REDCap. We asked about anticipated program changes and action steps to date in the implementation of them. The survey was distributed in August 2024 by email through the American Association of Pediatrics Section on Hospital Medicine Division Director’s email list. This project was determined to be exempt from IRB review. We used descriptive statistics and chi-square analyses to analyze our results.
Results: A total of 101 surveys were completed. Demographic data from respondents showed representation from all regions of the country in both university-based and community-based PHM programs (Table 1). Most programs anticipated increasing hospitalist shifts (72%), hiring additional hospitalist physicians (68%), and hiring additional advanced practice providers (=20%). One third (31%) of programs anticipate a decrease in pediatric resident hours on the PHM service as a result of the ACGME changes. Both anticipated shift increase and hiring of APPs were associated with more negative responses for career satisfaction (Table 2). Despite most PHM hospitalist programs anticipating needing to hire new providers, only 26% have completed the planning stage, with a minority having secured funding for additional practitioners (12%) or implemented hiring (7%).
Conclusions: Many PHM program leaders believe ACGME changes will impact pediatric hospitals nationally. Leaders reporting decreased career satisfaction amongst their PHM division team members correlated with shift increases, APP hiring, concerns about hiring in light of these ACGME residency changes.
