Background: Hospital Medicine is a growing field and integral part of the evolving healthcare system. Hospitalists are challenged to provide high-quality, effective, and efficient care to complex hospitalized patients, which requires medical knowledge in evidence-based practices, the attitudes to work in interdisciplinary healthcare teams, and skills to perform safe transitions in care. Given the rapid growth of hospital medicine and the vast scope of what a career in hospital medicine entails, many are questioning the need to re-define the appropriate training for hospitalists.
Purpose: Due to the complexity of the field and demands on hospitalists, it seems inevitable that advanced training will be crucial for the hospitalist of the future. The key is to create an innovative program that will deliver the knowledge, skills, and attitudes needed by hospitalists to practice in the future of hospital medicine, and to deliver this content in a manner to keep learners engaged and motivated. The Baystate Health Advanced Hospital Medicine Fellowship provides the already practicing hospitalist with the scaffolding needed to fast track their professional development as career hospitalists.
Description: We developed a novel approach to training career hospitalists “on-the-job.” The Baystate Health Advanced Hospital Medicine Fellowship is an educational experience designed to provide professional development to already practicing Baystate Health (BH) hospitalists, who maintain their current clinical FTE and complete the program on their own time. This 22-month program combines the opportunity to enhance one’s hospital medicine skills via educational experiences built on the Society of Hospital Medicine’s designated core competencies and also provides professional development for career advancement through participation in one of three tracks: Hospital Medicine Leadership, Medical Education/Leadership, and Quality Improvement/Leadership. For each block there is a syllabus that includes a variety of topics to be covered including medical knowledge and/or healthcare systems, leadership, quality improvement, or medical education depending on one’s designated track. The fellows are responsible for reviewing the learning objectives for the month, determining their own educational needs, and via designated readings expand their knowledge, skills, and attitudes on the designated monthly topics. Each group meets monthly for 5 hours, on their own time, to learn more about the designated topics, via educational discussions with subspecialists and a variety of other content experts. For each monthly meeting there is an opportunity to meet with a variety of institutional leaders and the Quality Improvement and Medical Education track curricula are delivered at each monthly meeting by experts in those fields.
Conclusions: We instituted this program in 2016 and have found this model to be very successful as we currently have 4 graduates and a total of 10 more hospitalists currently participating in the program as of December 2018. To date 3 of our Advanced Hospital Medicine Fellows have received leadership positions within our institution and 5 are currently participating in a hospital-wide quality improvement initiative on appropriate telemetry utilization.