Abstract
OBJECTIVE: In October 2016, the American Board of Medical Specialties approved the petition for pediatric hospital medicine (PHM) to become the newest pediatric subspecialty. Knowledge about residents entering the PHM workforce is needed to inform certification and fellowship accreditation. This study describes the characteristics of graduating pediatric residents with PHM positions and identifies factors associated with postresidency position choices. METHODS: We analyzed data from the American Academy of Pediatrics Annual Survey of Graduating Residents, 2006-2015. Chi-square tests were used to compare responses between residents entering PHM to those entering subspecialty fellowships, and to compare residents entering PHM at community and tertiary-care hospitals. We used multivariable logistic regression to identify associations between resident and training characteristics and position choices. RESULTS: A total of 5969 respondents completed the survey (60.6% response rate); 593 (10.3%) reported that they were entering PHM and 1954 (33.9%) reported subspecialty fellowships. Of residents entering PHM, 345 (60.7%) reported positions at tertiary-care hospitals and 194 (34.2%) reported positions at community hospitals. Seventy percent of residents entering PHM envisioned long-term PHM careers, with PHM career goals more frequently reported among residents entering community hospitalist positions (P < .01). In multivariable analysis, residents entering PHM were significantly more likely to be female, to have children, to report that family factors limited their job selection, and to have higher levels of educational debt than residents entering fellowships. CONCLUSIONS: Factors associated with postresidency PHM positions, including substantial educational debt and sociodemographic characteristics, may influence the development of the field as the specialty pursues fellowship accreditation.