Fellows as teachers: the teacher-assistant experience during pulmonary subspecialty training

Physicians undergoing medical subspecialty training, referred to as "fellows" in the United States, often serve as small group tutors. There are few reports, however, on whether fellows benefit from their experience teaching in the classroom. The purpose of this article is to describe the teacher-assistant requirement for fellows in a pulmonary and critical care training program and gain the perspectives of program graduates on their experiences as teacher assistants.

The structure of the teacher-assistant requirement is described in detail. We also surveyed 55 consecutive graduates of our Pulmonary and Critical Care Fellowship program located in the United States on the educational value of teaching pathophysiology to preclinical medical students.

Fellows and one or two faculty members co-teach groups of 15 to 25 second-year medical students during 22 h of case-based conferences over a 6-week period. Weekly meetings for teacher assistants foster improved teaching skills and provide insight into the basic tenets of structuring and implementing the course. Fellows receive formal and informal feedback on their performance. Fifty of 55 graduates (91%) returned the survey. Respondents rated the acquisition of teaching skills and knowledge of pulmonary pathophysiology as the most useful aspects of their experience. Eighty-seven percent rated their overall experience favorably, and 90% agreed that teaching the course should remain a curriculum requirement. The responses of physicians in academic and community practice were comparable.

Graduates of our Pulmonary and Critical Care Fellowship valued their teacher-assistant experience. This article may serve as a model for other subspecialty programs that are interested in formally incorporating teaching into their training program and may provide an impetus for the additional exploration of teacher-assistant experiences at other institutions.