559 - Perspectives on Global Health Education in Pediatric Hospital Medicine Fellowships in the U.S.

Interest in global health (GH) among pediatric residents and fellows continues to grow. Pediatric fellowship programs perceive GH opportunities to improve fellow education and recruitment; however, such opportunities in pediatric hospital medicine (PHM) fellowships have not been described.

Objective:

To determine attitudes toward and extent of GH education in PHM fellowships among current fellows and fellowship directors [FDs].

Design/Methods:

A cross-sectional survey was conducted in 2022 of PHM fellowship directors and current fellows. Surveys included questions on demographics, GH-specific programming in PHM fellowships, and barriers to GH training. We distributed surveys in REDCap© via PHM and PHM FDs listservs and email, using a database of all 61 national PHM FDs with a request to forward to current fellows. Statistical calculations were performed with Stata and Excel.

Results:

29 FDs responded (48% response rate). Fifteen fellowships (52%) offer global health experiences, most commonly international clinical experiences (93%); few offer a GH curriculum (n=2, 7%). Offering GH experiences to fellows was associated with older PHM fellowships (p=0.03). While 83% of FDs would allow fellows to pursue a scholarly project in GH, only 2 (8%) FDs reported completion of such by a PHM fellow. Of the 14 programs without GH electives, 11 (79%) expressed interest in doing so in the future; they reported barriers included the lack of global health curricula, insufficient funding, insufficient protected time for faculty and competing educational demands (82%, 73%, 73% and 73%, respectively).

Of 87 current fellows (49% response rate of an estimated 178; data from ACGME match data), 70% expressed interest in participating in a global health experience, particularly in an international clinical experience, followed by local-global clinical elective and internships with NGOs (85%, 77% and 70% respectively). Of interested PHM fellows, 21% had the opportunity to participate in any global health experience during fellowship. Sixty percent of current fellows expressed interest in the integration of GH content into PHM fellowship curriculum.

75% of FDs and 52% of current fellows believe GH experiences would improve recruitment to the program. 79% of FDs and 63% of current fellows agree that integrating GH education during fellowship improves overall fellow education.

Conclusion(s):

GH experiences are desired by a majority of PHM fellows. However, only some fellowships currently offer them, leaving many interested PHM fellows without this educational opportunity. Studies about ways to close this mismatch are needed.
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