Background: Hospital medicine is a growing field, including the subset of academic hospital medicine. Little is known about the characteristics of academic hospitalist programs, leadership, structure and faculty.
Methods: A multifaceted survey was developed, piloted and refined to explore and define characteristics of academic hospital medicine. It was sent electronically, with follow up email and paper reminders to non-responders, to hospitalist leaders at all American Association of Medical Colleges (AAMC) with at least one primary teaching hospital. Schools were excluded if a primary teaching hospital could not be identified, lacked a hospitalist program, were run by Veteran’s Affairs or private, external corporations. For this first report, simple statistics of mean, median and standard deviation were calculated.
Results: 146 programs were identified. 11 programs were excluded. Of the 135 leaders surveyed, 78 of 135 responded (58%). Leadership: Respondents were in their leadership role for a mean of 6.3 years; 63% described their title as “hospitalist director;” academic rank was evenly divided among assistant, associate, and professor. Program: The number of hospitals covered by a program varied: one (38%), two (31%), three (15%) more than 3 (16%). Half of programs report being their own division (51%), 41% were part of general internal medicine divisions, 3.9% were their own department. A majority of programs (65%) cover at least half of all medicine beds, with the mean number of beds at the primary teaching hospital being 453. The average number of hospitalists in a group is 42.8. Faculty: 46% of hospitalists are female. 39% are on a clinical track, 41% on Clinician-Educator/Educator track and 10% on research track; only 4% are not on promotion paths. On average academic hospitalists spend 53% of their clinical time on teaching services. Most hospitalists have identified hospital medicine as a career with 62% of programs reporting more than 75% of their faculty plan to remain 3 years or more. Promotion: The vast majority of programs (77%) have the same promotion criterion regardless of site. 60% have less than 10 percent protected time for non-clinical activities; 20% had no protected time.
Conclusions: Academic hospitalist programs are diverse, with different structures, leadership and expectations at different institutions. Academic programs may staff more than a single tertiary or quaternary hospitals and faculty have to balance time among clinical care duties (both direct and in supervision of trainees), teaching, and scholarly activities, with most having limited protected time.. Therefore, academic hospitalists have unique faculty development needs. Better characterizing and understanding these differences, will help us better understand the programmatic and faculty development needs for academic hospitalists to be successful in academic medicine