Using Structured Interviews to Develop Strategies for Pediatric Hospitalist Career Progression

Background: Pediatric hospital medicine (PHM) is the newest and fastest growing pediatric specialty, but lack of career focus can affect job performance and retention. Defining a focused track (e.g. expert clinician, medical education, quality/safety, administrative leadership) can improve job satisfaction, however limited studies outline strategies to promote PHM career progression. The objective of this study is to characterize key factors that have guided local hospitalists’ career progression to inform faculty development needs for early and mid-career hospitalists.

Methods: This observational study used grounded theory and quantitative methods to identify factors that led to career focus selection and optimization. A survey and structured interview tool were developed from literature review and group consensus. Members of the PHM division were invited to complete a demographic survey and participate in a one-on-one semi-structured interview about their career trajectory (Table 1). Responses were recorded, transcribed, deidentified, and independently reviewed by 2 study group members and coded into themes. Themes were compared and discussed until general consensus was reached. Due to small sample size, categorical sub-group analyses could not be done. Themes were then divided into sub-groups of factors that are: 1) under PHM division control versus external control; 2) institution-specific versus generalizable; and 3) track-specific versus universal.

Results: Ten PHM members participated; 3 to 6 themes were identified for each question (Table 2). The major theme associated with choosing a career path was ‘influence of others’, with subthemes of ‘passive influence’ (e.g. encouragement) and ‘direct influence’ (e.g. mentors) When asked what they might have done differently to accelerate their careers, participants commonly said ‘seek further education’. Finally, advice most frequently offered to early- and mid-career hospitalists to gain success included the theme ‘build professional relationships’ (e.g. networking).

Conclusion: Semi-structured interviews identified main themes influencing career decisions for pediatric hospitalists. Factors under the division’s control, generalizable, and with universal import informed next steps for physician development programming, such as building formal mentorship programs and creating networking opportunities. Adaptation of this model may assist other institutions in identifying factors relevant to local physician career progression.