LAUSR

Background Pediatric subspecialty fellowships are common pathways for graduating pediatric residents. While some subspecialties continue to grow, others struggle to fill their spots. Objective Examine factors of importance in residency graduates’ decision to pursue fellowship by resident characteristics. Methods A random sample of 1000 residency graduates across the US via the 2019 AAP Annual Survey of Graduating Residents were surveyed. Residents were asked about their plans after residency and importance of 12 factors in the decision to pursue their specific fellowship. Chi-square examined variations in importance by gender, children, medical school location, debt, location of residency training and program size. Results 504 (51%) responded. 189 (38%) reported they would be starting pediatric subspecialty fellowships following residency. Future job opportunities and interest in specific disease/organ system were the 2 highest rated factors, with most reporting them as essential or very important (90% and 88%, respectively). Other important factors included subspecialty exposure and mentorship during residency. Factors with the lowest ratings were ability to stay at same institution and education debt, with 1/3 reporting essential or very important. No variation in importance was found by gender, region and program size; few were found by medical school location and debt. Most variation was found among residents with children. E.g., residents with children were more likely than those without to report family considerations and control over work hours as essential/very important (86% vs 48%, p Conclusion Four in 10 graduating residents report starting fellowship training after residency. Residents prioritize factors important in choosing their subspecialty similarly across gender, region and program size, with top factors being job opportunities and interest in specific disease/organ systems. Family considerations and control over work hours are particularly important for residents with children. Understanding of these factors is critical in advising and recruiting trainees into fellowship.