I don't agree with PHM board certification being a requirement for current(and prospective) residents especially candidates who can't qualify for practice pathway by 2023. PHM fellowship seems to be cheap labor for academic places instead of hiring staff hospitalists (heck they even have to pay PA/NPs more than fellows). In reality, even for adult hospitalists our jobs are being replaced by NP/PA in some settings, as it's cheaper for the employers. I don't understand how pediatric residents and medical students are okay with 4 yrs of medschool+5 yrs of GME (earning 50-60k) for a job that pays 170-200k at the most. You will probably come out ahead being a PNP or PA. Being a hospitalist you are a generalist, you don't learn any skill or subject matter or procedure enough to be called a specialist. A fellowship in PHM won't make you consult less for complicated patients. All this is pure stupidity. If your board feels like they need a fellowship to do a job which can be done by a PA then they need to reform residency curriculum (which is good enough for being a hospitalist). If this is because of research requirement, or leadership roles then not everyone likes research or QI. I am not opposing PHM fellowship or having a board certification exam but it should not be mandatory. If big centers like CHOP, CHB want hospitalists with fellowship that's fine. It's not fair for us to have more and more added requirements while making things easier for NP/PA. PHM looks as competitive as PEM in NRMP match stats, I don't know if people are naive or really interested to go into this. It's clearly an act of resident/fellow abuse. You really don't need a fellowship to do this job. You are losing 200-400k income or loan repayment by doing this useless fellowship. I know this is already discussed in reddit, sdn etc. What are we doing to oppose this? Can we start a change.org petition to voice our opinion or start a email thread with signatures from all pediatric residents all over the US. If your only job opportunity is being a primary care physician after 4+3 yrs what makes you sure you won't lose your job to a PNP in 10 years? Can your board control midlevel encroachment in PHM or primary care pediatrics? They can't control who employers choose to hire but by having these addition requirements (more training) will only deter medical students from choosing pediatrics.
Reference
pubmed.ncbi.nlm.nih.gov
www.the-hospitalist.org
Reference

The evolving role of the pediatric nurse practitioner in hospital medicine - PubMed
There is evidence to suggest that PNP hospitalists provide inpatient care comparable to resident teams at a lower cost for patients with uncomplicated bronchiolitis, pneumonia, and asthma.


Why Required Pediatric Hospital Medicine Fellowships Are Unnecessary - The Hospitalist
A few reasons why a required pediatric hospital medicine fellowship is unnecessary and potentially harmful