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Early Career Experiences of Pediatricians Pursuing or Not Pursuing Subspecialty Fellowships

​Bobbi J Byrne, MD1, Sesha K Katakam, MD, MPH2, Mary Pat Frintner, MSPH3 and William L Cull, PhD3. 1Indiana University, Indianapolis, IN, United States; 2Indiana University Health La Porte, La Porte, IN, United States and 3American Academy of Pediatrics, Elk Grove Village, IL, United States.      

Background: Choosing career paths can be difficult decisions for residents contemplating fellowship training. Limited resources are available to residents to help guide their choices.     

Objective: Compare the experiences of early career pediatricians who did and did not pursue fellowships.

Design/Methods: We analyzed national, weighted data from the AAP Pediatrician Life and Career Experience Study (PLACES) of pediatricians 1-3 yrs (recent grad cohort) and 8-10 yrs (early career cohort) post-residency (n=1725). Work environment, work-life balance, and satisfaction were compared for pediatricians currently in or who had completed fellowship training (FT) and those that did not pursue fellowship training (NFT). Multivariable regression (logistic or linear) examined the independent effects of FT while controlling for demographic differences (gender, IMG, race, and children).

Results: 44% of the recent grad (384/880) and 39% of the early career (331/845) cohorts were FT. FT spent less time in direct patient care and were more likely than NFT to report learning opportunities in their work environment. FT in the early career cohort were more likely to report an income > $125,000. NFT in both cohorts were more likely than FT to work < 50 hours/wk, have flexibility with their schedules, and be satisfied with time spent with their children. Both FT and NFT generally found their work to be rewarding and were satisfied with their life. All effects remained significant in multivariable analyses.


Recent Graduates Early Career

FTNFTFTNFT
WORK ENVIRONMENT



Time in direct patient care (mean %)5690*6888*
Opportunity to gain new knowledge/skills (% strongly agree)3818*2512*
Income > $125,000 (%)1259*8467*
WORK LIFE BALANCE



Work > 50 hours/week (%)7324*6123*
Schedule allows flexibility to lead balanced life (% agree/strongly agree) 5166*5464*
Satisfied with time to spend with own children (%) 3759*4759*
SATISFACTION



Agree that work is personally rewarding (%)8882*9085
Very/completely satisfied with life as a whole (%)68647074


* p < .05

Conclusions: While important life and career differences need to be considered by residents when contemplating fellowship training, either choice usually results in overall life and career satisfaction.