Beyond One-Size-Fits-All: Redesigning Research Training in Pediatric Cardiology Fellowship

Research training is a required component of pediatric cardiology fellowship in the United States, intended to foster scholarly productivity, critical thinking, and academic development. However, two national surveys of fellows and fellowship program directors suggest that the current model may not be meeting these goals. Fellows report substantial barriers, including limited protected mentor time, inadequate statistical support, absent formal curricula, and insufficient funding. Program directors identify parallel challenges in mentorship and competing clinical demands, and many question the value of a uniform 12-month research requirement. We synthesize these complementary surveys and examine the disconnect between the intended and actual experience of research training. We argue that a one-size-fits-all approach does not reflect the diverse career goals of contemporary trainees, who may become physician-scientists, clinician-educators, procedural specialists, or primarily clinical practitioners. The landscape has shifted. The American Board of Pediatrics has approved a competency-based blueprint permitting a two-year clinical pathway with an optional scholarly third year and removing the required scholarly work product, while the Society of Pediatric Cardiology Training Program Directors recommends preserving a three-year scholarly pathway in pediatric cardiology for now. For programs that retain a scholarly third year, these developments shift the focus toward how protected scholarly time can be made meaningful. We propose a framework combining a standardized national research curriculum with individualized training pathways aligned with trainee interests and career objectives. This may improve trainee satisfaction, optimize scholarly productivity, and better prepare the next generation of pediatric cardiologists while preserving the educational value of research exposure.