Doing More With Less: A Centralized Model for Fellowship Program Coordination

Pediatrics fellowship programs typically are small, embedded in divisions, and vary in their approach to education. Program coordination usually falls to division administrators who operate in silos despite common requirements across programs, creating redundancy and inefficiency.

We examined the feasibility, acceptability, and impact of a centralized administrative model for pediatrics fellowship support at a large university-based institution.

In 2014, administrative support for the pediatrics fellowships at the University of California, San Francisco, was restructured from a model with division-level support to a centralized model. In the new model, a team of 6 full-time administrators supports 19 fellowship programs with a total of 80 fellows. The fellowship support team consists of 3 program coordinators, a data coordinator, a human resource coordinator, a team manager, and a faculty advisor. The team meets twice a month to discuss program issues and innovative ideas. Quarterly meetings are held with all coordinators and directors to discuss changes across fellowships and foster further collaboration. We surveyed program directors to examine the acceptability of the model and assessed its impact on finances and turnover.

Of 19 eligible fellowship program directors, 15 (79%) completed the survey. The majority indicated that the new administrative model was "better" or "much better" than the prior model. The new model resulted in decreased costs (an estimated $250,000 per year in salary support) and lower staff turnover.

Centralization of fellowship administration is feasible and offers substantial benefits for all stakeholders involved.