Implementing a Full Time Equivalent-Supported Hematology/Oncology Fellowship Core Faculty Program May Improve Faculty Engagement in Education, Mentorship, and Recruitment

Background:

The American Council of Graduate Medical Education (ACGME) requires every U.S. residency and fellowship training program to designate Core Faculty (CF) who participate in teaching and mentoring trainees. With increasing recognition of competing faculty responsibilities in academic medicine, many groups have recently recommended providing CF with salary support in exchange for their educational efforts, yet few programs have implemented such initiatives. During the 2020-2021 academic year (AY), the Hematology and Medical Oncology Fellowship Program at Yale School of Medicine created a CF program with 10% full time equivalent (FTE) support to 18 CF selected for their dedication to teaching and mentoring fellows. These CF were given responsibilities in participation in fellow conferences, fellow mentorship, and fellowship recruitment. Mentorship Committees (MC) were also launched during the 2020-2021 AY, with each first-year fellow assigned to a group of CF members for career planning and guidance throughout the AY.

Methods:

We performed a mixed-methods study to explore the impact of our FTE-supported CF program utilizing a combination of faculty and fellow survey data, free-text written comments, and data on faculty participation in educational activities. At the end of the 2020-2021 AY, an online survey utilizing the Qualtrics platform was sent via email to all 18 CF members and all 24 Hematology/Oncology fellows. All CF members and fellows were asked questions about the CF program, while only the CF members and the eight first-year fellows were asked questions regarding the MC. The surveys consisted of multiple choice and open-ended questions with free-text responses and were distributed from June-July 2021. Quantitative data was obtained regarding faculty attendance at the fellowship program's weekly New Patient conference and availability of faculty for fellowship recruitment interviews for both the 2019-2020 AY and the 2020-2021 AY.

Results:

A total of 14 (77.8%) CF members and 13 (54.2%) fellows responded to the survey. Among CF respondents, 11 (78.5%) reported that both their overall job satisfaction and sense of involvement in the fellowship program and its educational mission increased by either "a little" or "a lot" as a result of becoming a CF member. In free-text comments, positive aspects of being a CF member included "satisfaction in being an integral part of fellowship education," a "sense of commitment" to the educational mission of the fellowship program and improved "communication with colleagues and house staff." As a result of being a CF member, seven (21.1%) reported increased attendance at fellow conferences, nine (27.3%) devoted more time to mentoring and advising fellows, and seven (21.1%) increased their participation in fellowship recruitment compared to prior years. Five (15.5%) CF members felt that they had not appreciably changed their activities, but rather that they received much appreciated recognition and support for activities they were already engaged in prior to becoming a CF member.

Among fellow respondents, six (46.2%) noted that following implementation of the CF program, faculty attendance at fellow educational conferences increased. One fellow praised the CF program for "identifying teachers who are very committed to educating fellows" and another commented "fantastic faculty and education overall". Three (37.5%) first year fellows responded to questions about MC, with all three indicating that the MC assisted "a little" or "a lot" in identifying or elucidating their career path.

Thirty-eight (36.5%) faculty participated in New Patient conference in 2019-2020 vs. 50 (46.7%) in 2020-2021. Of faculty who were designated CF in 2020, 12 (75%) attended New Patient conference a median of 9 times in 2019-2020 vs. 18 (100%) a median of 20.5 times in 2020-2021. In terms of recruitment, 14 (87.5%) CF reported availability to interview a median of 2 times during 2019-2020 vs. 17 (94.4%) a median of 8.5 times during 2020-2021.

Conclusions:

Our FTE-supported CF program was viewed enthusiastically by fellows and participating faculty, resulting in increased faculty conference attendance, mentorship of trainees, and involvement in recruitment. MCs may hold promise in guiding career decisions for first year Hematology/Oncology fellows.