July 1, 2024 marked the start of Yale’s Adult Hospital Medicine Fellowship, a two-year program that prepares graduates for successful career longevity in hospital medicine as an academic hospitalist, especially when it comes to clinical care and academic pursuits. Academic hospitalists are physicians who have the support and protected research time for academic work. The new program was created by Chris Sankey, MD, FACP, SFHM, who serves as the fellowship’s program director.
“There is an immense need for academic hospitalists throughout the country,” says Dr. Sankey. “Hospital systems are more complex than ever before,” he explains. “We need to have data to inform what we do both in terms of patient care, trainee education, and [hospital] operations. Without that scholarship piece, [we’re] missing a huge chunk.”
The fellowship is structured with multiple pillars of experience. The first is the clinical pillar during which fellows rotate through a wide variety of internal medicine services. The structure of these services includes both the traditional academic (medical student, intern, residents, and attendings) and the hospitalist medicine model, which pairs a senior resident with a hospitalist attending.
The second pillar of experience is designed to provide fellows with the opportunity for structured and mentored scholarly work, involving a capstone research requirement on the topic of the fellow’s choosing. Topics will likely range from medical education, quality improvement, and patient safety.
The third pillar is mentorship and preparation for a career in academic medicine. A recent national survey published by the Society of Hospital Medicine found that the highest rate of burnout for hospitalists is within the first five years. “There is no evidence for causation, but it is reasonable to presume that a lack of adequate training for jobs in academic hospital medicine is part of it. Many [residency] graduates are underprepared for how to navigate academic hospital medicine,” says Sankey. This pillar of the fellowship will provide mentorship involving individual learning plans, which will be co-created by Sankey and the fellow.
The fourth and final pillar of the fellowship is wellness. Sankey explained that specific didactics will focus on “how we take care of ourselves and how we set ourselves up for the long career. "
The principal requirement of the fellowship is 20 weeks of inpatient attending service per academic year. This opportunity leaves room for fellows to explore other interests and specialties to better shape their career. Fellows are invited to rotate on elective consult services such as addiction medicine or palliative care or spend more time on research.
The first fellow to matriculate to Yale’s new Adult Hospital Medicine Fellowship is Necia Hunter, MD. A graduate of Yale’s Internal Medicine Traditional Residency Program, Dr. Hunter completed a year as chief resident before matriculating to the fellowship on July 1. She is drawn to hospital medicine because of the acuity of the problems and the ability to see the results of medical decisions in real-time. Her main scholarly focus is quality improvement, especially in clinical care. “How do we know if we are improving or doing a good job as clinicians? I’m interested in ways we can improve the quality of care that we provide to our patients in an evidence-based manner,” explains Hunter.
Similarly to other specialties, there is ample literature, research, and knowledge that is specific to hospital medicine. “It can be difficult to go into hospital medicine directly from residency because you don’t get the research, mentorship, and guidance that you would in another specialty. I think it’s a good sign that Yale is embracing the field of hospital medicine as a specialty in its own right.”
The fellowship will train one fellow per year. For more information, visit the Yale Adult Hospital Medicine Fellowship Program website.
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