Many Pediatric Subspecialty Fellows Are Not Ready to Graduate From Fellowship in 2 Years

Area of Science:

• Medical Education
• Pediatric Subspecialty Training
• Competency Assessment

Background:

• The American Board of Pediatrics mandates competency assessment for changes in training duration.
• This study examines Entrustable Professional Activity (EPA) supervision levels in pediatric fellowships.

Purpose of the Study:

• To determine if pediatric subspecialty trainees meet graduation thresholds after two years of fellowship.
• To analyze clinical EPA supervision ratings across three-year fellowships.

Main Methods:

• Clinical Competency Committees (CCCs) and Fellowship Program Directors (FPDs) rated EPA supervision levels.
• Trainees self-reported supervision needs.
• Ratings were compared against established graduation thresholds.

Main Results:

• Fewer than 50% of fellows met clinical EPA thresholds at two years.
• By three years, 86%-100% met clinical EPA thresholds across subspecialties.
• FPDs reported 64%-68% met scholarship EPA thresholds at two years, increasing to 99%-100% at three years.

Conclusions:

• Current pediatric fellowship structures and EPA frameworks indicate many trainees are not ready for graduation after two years.
• A three-year duration appears necessary for trainees to achieve required competencies.