Hospitalist

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Seadollar3

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So I’m part of the group who won’t be eligible for Board cert if I don’t do a fellowship for hospitalist medicine. What do u guys think this will mean? Am I not going to be able to get a job as a hospitalist at a children’s hospital?

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So I’m part of the group who won’t be eligible for Board cert if I don’t do a fellowship for hospitalist medicine. What do u guys think this will mean? Am I not going to be able to get a job as a hospitalist at a children’s hospital?
Depends on the children’s hospital and how badly they need staff. I think the options will be more limited though without board certification or eligibility.
 
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What a complete joke. Can't wait for the two year outpatient fellowship to pop up a couple years from now.
 
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As surfing doc mentioned it depends. Large, academic children's hospitals will likely move to all boarded hospitalists if they haven't already. Smaller and more community centered hospitals probably won't. My question is whether this will generate legal liability or vulnerability. I think over all the point of providing a board was to force most people to undergo fellowship training, which I agree is ridiculous.
 
As surfing doc mentioned it depends. Large, academic children's hospitals will likely move to all boarded hospitalists if they haven't already. Smaller and more community centered hospitals probably won't. My question is whether this will generate legal liability or vulnerability. I think over all the point of providing a board was to force most people to undergo fellowship training, which I agree is ridiculous.
Speaking to this, I doubt there would be any legal ramifications to the individual or institution. Most of the clinical aspects of hospitalist fellowship training don’t provide any sort of competency outside general inpatient care. For instance, the curriculum has rotations on child abuse and critical care, yet every major children’s hospital already has those subspecialty services. Limited extra exposure doesn’t provide competency and doesn’t allow for a work around. I mean a pediatric hospitalist isn’t going to intubate a children with abusive head trauma, create photographs of the injury and go to a deposition. I’m actually not really sure what the clinical goal of the fellowship is, but it’s not to provide better hands on care. What it is designed to do is to teach better system based practices across a hospital enterprise, ie administration and pQI related stuff. Now whether that is a worthy goal, who knows, I could see a yes and no argument. But what is it is not designed to do, at least from the curriculum I’ve seen, is to provide better direct patient care by an individual. In fact, unlike other boarded subspecialites, PHM boarded individuals aren’t required to maintain general pediatric certification due to overlap. Thus, the legal aspects from a clinical competency standpoint are negligible, at least at this juncture. Maybe someone in the future people will make a legal argument but it probably wouldn’t have any teeth to it given the ABP seems to suggest that PHM boarding equates to general boarding for climcal competency. Alternatively, I could see a different legal argument of a PHM boarded individual attempting an intubation because they had “additional training” that goes foul. Practicing outside a scope is likely to be where more legal challenges would come from.
 
In fact, unlike other boarded subspecialites, PHM boarded individuals aren’t required to maintain general pediatric certification due to overlap.

Whoa, whoa. I'm fairly certain a number of my subspecialty attendings in residency did not maintain their gen peds certification unless they were interested in program administration (which I believe requires gen peds certification). Since I've started fellowship, I've also been asked if I plan on maintaining my gen peds certification, indicating that several people in my subspecialty do not. So I'm not convinced that that is unique to PHM.
 
Whoa, whoa. I'm fairly certain a number of my subspecialty attendings in residency did not maintain their gen peds certification unless they were interested in program administration (which I believe requires gen peds certification). Since I've started fellowship, I've also been asked if I plan on maintaining my gen peds certification, indicating that several people in my subspecialty do not. So I'm not convinced that that is unique to PHM.
Maintaining both is hospital specific for the purposes of credentialling, but you are right that you aren’t required to maintain general boards to maintain subspecialty certification. However if one wants to go back and do gen pediatrics if they let it lapse, they have to recertify. My understanding of the PHM is that that board certification supplants the gen Peds boards. Maybe I misunderstood it, but that’s how I read it on the ABP website.

Edit: on second reading of the ABP website for PHM, maybe they weren’t saying that it supplants gen Peds, just that you don’t need a gen Peds to practice PHM if you are certified in the latter, which is true for all subspecialites. Why it’s only explicitly stated in the PHM certification page was my confusion.
 
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Maintaining both is hospital specific for the purposes of credentialling...

To clarify, by 'program administration', I meant being a program director for our gen peds residency. I vaguely remember our coordinator mentioning that you had to maintain gen peds certification to be a gen peds program director. I also don't remember reading anything in the ACGME materials about it, so that might not be a thing, though it makes sense.

It is weird that they point that out for PHM but not the others.
 
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