Hematology-Oncology Program Directors

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1 HematologyOncology Program Directors Table 169. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: How long have you been a director of a pediatric fellowship program? (N=579) (N=50) (N=529) < 5 years 56 (28) 49 (261).37 > 5 years 44 (22) 51 (268) Table 170. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: What do you believe is the minimum length of training time for establishing clinical competence in your subspecialty during pediatric fellowship training? (N=579) (N=51) Minimum time in months (36) (N=528) (148) Table 171. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Do you believe that the clinical training time should be the same for all fellows in your subspecialty, regardless of career path (i.e., those who pursue primarily a clinical vs. primarily a research career)? (N=586) (N=51) (N=535) Yes 61 (31) 66 (351).49 No 39 (20) 34 (184) Ideal clinical training time for fellows who will be primarily clinicians Ideal clinical training time for fellows who will be primarily clinician educators Ideal clinical training time for fellows who will be primarily researchers (1648) 18 (48) (60) (236) (348) 36 (354) Table 172. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: The RRC currently expects at least months of clinical experience. Do you believe that there is a need to change the expected amount of clinical training time in your subspecialty? (N=583)

2 (N=51) (N=532) Yes, I believe that the expected amount of clinical training time should be increased 43 (22) 49 (258) Yes, I believe that the expected amount of clinical training time should be decreased 0 (0) 1 (7).51 No, I believe that the expected amount of clinical training is appropriate 57 (29) 50 (267) Table 173. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Why do you believe that the expected amount of clinical training time in your subspecialty should be increased? Please choose all that apply. (N=279) Increase in types of procedures and/or complexity of patient care Duty hour restrictions and other changes during residency have reduced fellow s initial clinical competence Duty hour restrictions during fellowship have reduced fellow s clinical competence Need for further development of clinical independence (N=22) (N=257) 68 (15) 64 (164) () 49 (7) (5) 32 (82) (15) 64 (164).68 Additional supervisory experience is needed 27 (6) 27 (69).97 Additional time is needed for longitudinal case management 50 (11) 27 (70).02 Other 0 (0) 6 (15). Table 174. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Why do you believe that the expected amount of clinical training time in your subspecialty should be decreased? Please choose all that apply. (N=7) Takes less time than what is currently required to establish clinical competence (N=0) (N=7) 0 (0) 29 (2) Fellows should be spending more time in research 0 (0) 100 (7) It would increase applicants to fellowship in my subspecialty 0 (0) 0 (0) Other 0 (0) 0 (0)

3 Table 175. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: As a program director, I am comfortable assessing the clinical competence of fellows in my program to practice without direct supervision at the end of training. (N=580) Please indicate the extent to which you agree or disagree with the following statement related to assessing clinical competence during fellowship training. Strongly Disagree Disagree Agree Strongly Agree % (N) % (N) HematologyOncology (N=51) 4 (2) 2 (1) 43 (22) 51 (26).73 (N=529) 3 (18) 6 (30) 42 (222) 49 (259) Table 176. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Please indicate the extent to which you agree or disagree with the following statement related to assessing clinical competence during fellowship training. (N=586) Strongly Disagree Disagree Agree Strongly Agree Hem Onc All Other SS Hem Onc All Other SS Hem Onc All Other SS Hem Onc All Other SS (N=51) (N=535) (N=51) (N=535) (N=51) (N=535) (N=51) (N=535) % (N) % (N) % (N) % (N) % (N) % (N) % (N) % (N) P value Training future researchers in my subspecialty is an important component of fellowship 0 (0) 1 (3) 2 (1) 2 (9) 18 (9) 40 (217) 80 (41) 57 (306).01 training Training ALL subspecialists to be able to critically appraise new literature is an important 0 (0) 0 (1) 0 (0) 1 (3) 6 (3) 14 (74) 94 (48) 85 (457).39 component of fellowship training Training ALL subspecialists to be competent educators/teachers is an important component of 0 (0) 0 (2) 2 (1) 5 (26) 48 () 42 (2) 50 (25) 53 (283).69 fellowship training Training ALL subspecialists in quality improvement activities is an important component of 2 (1) 2 (11) 16 (8) 10 (51) 59 (30) 55 (294) 23 () 33 (178).36 fellowship training Scholarly activity during fellowship should be tailored to the career goals and interests of 0 (0) 1 (5) 0 (0) 5 (26) 10 (5) 27 (147) 90 (46) 67 (357).007 the individual fellows ALL fellows in my subspecialty should complete a scholarly activity project as part of 0 (0) 1 (7) 2 (1) 8 (41) () 29 (157) 74 (38) 62 (330).21 fellowship training Scholarly activity requirements should be more broadly defined 0 (0) 3 (18) 31 (16) 31 (167) 37 (19) 40 (2) 31 (16) 26 (136).49 Scholarship Oversight Committees gave programs a greater ability to tailor scholarly activity to each fellow s 6 (3) 4 (23) 14 (7) 26 (136) 55 (28) 50 (263) 25 (13) 20 (105).27 individual needs than in the past

4 Advanced clinical training, such as cardiac electrophysiology and transplant hepatology, should be offered AS PART OF the current three year training program WITH DIMINISHED scholarly activity requirements The core curriculum as currently required is a valuable part of fellowship training 20 (10) 21 (105) 62 (31) 52 (255) 16 (8) 22 (111) 2 (1) 5 ().45 4 (2) 2 (11) (6) 15 (78) 59 (30) 63 (338) 25 (13) 20 (105).59 Table 177. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: What do you believe is the minimum length of training time needed in scholarly activity in your subspecialty during pediatric fellowship training? (N=577) Minimum time in months (N=50) (636) (N=527) (040) Table 178. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Do you believe that the amount of scholarly activity should be the same for all fellows in your subspecialty, regardless of career path (i.e., those who pursue primarily a clinical vs. primarily a research career)? (N=584) (N=51) (N=533) Yes 47 () 42 (222) No 53 (27) 58 (311).45 Ideal amount of scholarly activity for fellows who will be primarily clinicians (636) (0) Ideal amount of scholarly activity for fellows who will be primarily clinician educators 18 (636) (0) Ideal amount of scholarly activity for fellows who will be primarily researchers (1848) (642) Table 179. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: The RRC recommends that programs provide fellows with approximately months for scholarly activity. Do you believe that there is a need to change the recommended amount of scholarly activity time in your subspecialty? (N=582) (N=51) (N=531)

5 Yes, I believe that the expected amount of time in scholarly activity should be increased Yes, I believe that the expected amount of time in scholarly activity should be decreased, but not eliminated Yes, I believe that the expected scholarly activity requirement should be eliminated No, I believe that the current expected amount of time in scholarly activity is appropriate 49 (25) 28 (150) 10 (5) 17 (91) 0 (0) 2 (8) 41 (21) 53 (282).02 Table 180. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Why do you believe that the expected amount of time devoted to scholarly activity should be increased? Please choose all that apply. (N=173) (N=25) (N=148) Fellows are not adequately prepared to begin junior faculty research positions under current model Duty hour restrictions have adversely limited fellow s research time 88 (22) 87 (9) (7) 34 (50).57 Other (3) 14 (20).84 Table 181. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Why do you believe that the expected amount of time devoted to scholarly activity during fellowship should be decreased or eliminated? Please choose all that apply. (N=104) (N=5) (N=99) Scholarly activity requirements discourage pediatric residents from pursuing fellowship training Fellows who plan to pursue primarily clinical careers do not need the current amount of scholarly activity during training It would allow us to shorten fellowship training, making our subspecialty more attractive to potential fellows It would allow more time to be devoted to additional clinical training 20 (1) 30 (30) (4) 88 (87).60 0 (0) 44 (44) (4) 65 (64).48 Other 0 (0) 9 (9).48

6 Table 182. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Which of the following activities do you believe fall within the scope of what is, or should be, acceptable to meet scholarly activity requirements during fellowship? Please choose all that apply. (N=586) (N=51) (N=535) Bench or clinical research 100 (51) 99 (529).45 Health services research 86 (44) 92 (490).20 Quality improvement activities or clinical care guideline development Educationbased activities (e.g., Developing an educational module on CDROM) 59 (30) 76 (407) (26) 64 (340).08 Master of Public Health or Master of Education 88 (45) 82 (440).28 Master of Business Administration or other business/financial training 37 (19) 38 (205).88 Other 6 (3) 9 (49).43 Table 183. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Does your fellowship program have a core scholarly activity or research curriculum for fellows? (N=586) (N=51) (N=535) Yes 80 (41) 86 (459).30 Average hours fellow spends in core curriculum over the course of training Table 184. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Please indicate which years in training a fellow participates in the core curriculum. Please choose all that apply. (N=494) (N=41) (N=453) Year one 83 (34) 91 (4).10 Year two 93 (38) 83 (378). Year three 80 (33) 76 (345).53 Table 185. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Is the core curriculum strictly didactic? (N=490) (N=40) (N=450)

7 Yes 40 (16) 48 (216).33 Table 186. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Do fellows from all subspecialties in your pediatrics department participate in the same core curriculum together? (N=493) (N=41) (N=452) Yes 71 (29) 67 (305).67 Table 187. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Please indicate if any of the following components are an expected part of your fellowship program core curriculum. Please choose all that apply. (N=583) (N=51) (N=532) Biostatistics Epidemiology Quality improvement modules Journal club Master of Public Health or Master of Education Master of Business Administration or other business/financial training Grant or proposal writing course/training Training in other aspects of research: Institutional Review Board, developing research protocols, etc. Adult learning, teaching, and curriculum development Other 92 (47) 95 (504) (37) 73 (386) (44) 74 (395) (39) 81 (432).41 6 (3) 7 (37).77 0 (0) 1 (5) (36) 66 (351) (41) 84 (449) (20) 50 (266).14 4 (2) (62).09 Table 188. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Do you believe that there is a need to increase or decrease the required overall length of fellowship training in your subspecialty? (N=583) (N=49) (N=534)

8 No, I believe that the required training duration, regardless of career path, should remain at three years Yes, I believe that the required training duration, regardless of career path, should be shortened to fewer than three years Yes, I believe that there should be two different tracks, a shorter duration track for clinicians or clinicianeducators and a longer duration track for fellows who plan to pursue academic research Yes, I believe that the required training duration, regardless of career path, should be extended to more than three years 70 (34) 57 (307) 0 (0) 2 (10) 14 (7) 35 (187) 16 (8) 6 (30).001 Table 189. HEMATOLOGYONCOLOGY: PROGRAM DIRECTORS: Do you believe that all pediatric subspecialty trainees (across all pediatric subspecialties) should have the same required overall length of fellowship training (currently 3 years)? (N=583) (N=50) (N=533) No, I believe that it should be the decision of each subspecialty to determine the appropriate amount of overall required length of fellowship training Yes, I believe that all subspecialty fellowship training should have the same required overall length 82 (41) 77 (408) 18 (9) 23 (5).38

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