Scholarly Activity during Neonatal–Perinatal Medicine Fellowship

Abstract

Objective This study aimed to describe scholarly activity training during neonatal–perinatal medicine (NPM) fellowship and factors associated with scholarship productivity.

Study Design NPM fellowship program directors (FPDs) were surveyed between March and October 2019, as part of a larger study of all pediatric subspecialty programs, to define barriers, resources, and productivity for fellow scholarly activity. High productivity was defined as >75% of fellows in a program in the last 5 years having a manuscript accepted for publication based on fellowship scholarly work.

Results Fifty-four percent (54/100) of NPM FPDs completed the survey. Nineteen fellowship programs (35%, 19/54) met the definition for high productivity. High productivity in scholarly activity was associated with a greater likelihood of having funds to conduct scholarship (p = 0.011), more protected months dedicated to scholarly activity (p = 0.03), and fellow extramural grant applications (submitted or accepted, p = 0.047). FPDs of productive programs were less likely to report lack of an adequate core research curriculum (p = 0.018), lack of adequate expertise on the fellowship scholarly oversight committee (p = 0.048), and lack of sufficient divisional mentorship (p = 0.048) as barriers to completion of scholarly activity during fellowship.

Conclusion Research funding, protected research time, established research mentors, and a research curriculum are associated with higher scholarly activity productivity among NPM fellowship programs. Further investment in these resources may improve scholarly activity productivity during fellowship training.

Key Points

• Fellow productivity depends on protected time.

• Inadequate funding impacts fellow productivity.

• Mentorship is important for fellow scholarship.

• A research curriculum impacts research outcomes.

 

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Keywords

scholarship - research - graduate medical education - physician-scientists - physician-investigators

The pathway of physicians pursuing academic research careers is diminishing.[1] [2] [3] [4] [5] [6] Academic physicians participating in scholarly activity are needed to advance fields essential to population health such as basic/translational science, clinical science, quality improvement and/or patient safety (QI/PS), and medical education. Exposure of trainees to research and successful scholarly products are associated with increased likelihoods of choosing academic and/or research-oriented careers.[7] [8] [9]

Scholarly activity is an essential part of neonatal–perinatal medicine (NPM) subspecialty training. The Accreditation Council of Graduate Medical Education (ACGME) mandates that NPM fellows conduct a scholarly project under the guidance of a mentor and scholarly oversight committee (SOC) over a minimum of 12 research/scholarly months during fellowship training.[10] [11] In addition to requiring participation in scholarship, the American Board of Pediatrics (ABP) requires the submission of a “written work product” and verification by the fellow's SOC that the ABP's requirement for scholarly activity has been met to achieve certification in NPM.[12] Furthermore, the ACGME Next Accreditation System has continued to shift its focus towards outcome measures of scholarship such as grants, presentations, and publications.[13]

Despite common program requirements, an individual fellowship program's approach to the integration of scholarly activity during training varies greatly[14] as do beliefs regarding whether the amount of time dedicated to scholarship during fellowship training should be changed.[15] [16] This study aimed to investigate factors affecting scholarly activity productivity during NPM fellowship training. The knowledge gained from this study can provide NPM fellowship program directors (FPDs) with best practices to increase scholarship within their own programs and provide important insight to inform national discussions on the scholarship experience during NPM fellowship training, particularly surrounding the resources needed for and perceived barriers to the scholarly activity productivity of NPM fellows.

Materials and Methods

All pediatric FPDs of ACGME-accredited 3-year fellowship programs from 14 subspecialties were anonymously surveyed between March and October 2019. The sample, survey instrument, and survey administration descriptions have been previously reported.[17] Responses from NPM FPDs were isolated for data analysis for this report.

Data included program demographics, fellows' pursuits after graduation, type of scholarly activity proposed to the ABP for graduating fellows, resources for and barriers to scholarly activity, time allocated for scholarly activity, fellow productivity, and FPD's beliefs about and satisfaction with scholarly activity training during fellowship. NPM fellowship programs were categorized by whether the programs were highly productive, defined as >75% of fellows in the last 5 years having a manuscript accepted for publication based on fellowship scholarly work. Data analysis included descriptive statistics and comparisons using Wilcoxon rank-sum tests, Fisher's exact tests, and Pearson's chi-square tests. We used descriptive qualitative analysis to identify categories of answers to the survey's two free-text response questions.[18]

 

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Results

Respondent Characteristics

Fifty-four percent (54/100) of NPM FPDs that were surveyed responded and represented all four geographic regions ([Table 1]). The majority of responses came from FPDs of NPM fellowship programs affiliated with an academic medical center (89%, 48/54). Most respondents represented programs with four to six fellows (31%, 17/54) or seven to nine fellows (37%, 20/54). There were no differences between responding and nonresponding programs among program characteristics.

Table 1 Characteristics of nonresponding and responding neonatal–perinatal fellowship program directors

	Nonresponding (n = 46)	Responding (n = 54)	p	Overall (n = 100)
Region, n (%)			0.5
Midwest	13 (28)	11 (20)		24 (24)
Northeast	10 (22)	18 (33)		28 (28)
South	18 (39)	17 (31)		35 (35)
West	5 (11)	8 (15)		13 (13)
Number of fellows, median (range)	6 (2–20)	7 (1–19)	0.15	7 (1–20)
Number of fellows, n (%)			0.3
0–3	10 (22)	5 (9)		15 (15)
4–6	15 (33)	17 (31)		32 (32)
7–9	13 (28)	20 (37)		33 (33)
> 9	8 (17)	12 (22)		20 (20)
Setting, n (%)			0.13
Military	0 (0)	3 (6)		3 (3)
Community	5 (11)	2 (4)		7 (7)
Academic	41 (89)	48 (89)		89 (89)
Other	0 (0)	1 (2)		1 (1)

 

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Initial Positions That Fellows Pursued after Graduation

For many programs, a substantial proportion of graduates pursued solely clinical positions, whether academic or nonacademic ([Table 2]). Specifically, over half of FPDs (54%, 29/54) reported that >25% of their graduating fellows over the past 5 years pursued nonacademic or private practice positions, and over a third of FPDs (35%, 19/54) reported >25% of their graduating fellows in the past 5 years pursued a 100% academic clinical career. For the trainees who pursue academic positions, most programs report having at least one graduate focus on QI/PS (60%, 32/54), medical education (70%, 37/54), or basic, translational, or clinical research (80%, 43/54).

Table 2 Type of postgraduate position and the percentage of fellows in each program who pursued the position type in the previous 5 years

	Number (%) of FPDs who reported the proportion of fellows in their program who pursued the position
	No fellows	1–25% of fellows	26–50% of fellows	51–75% of fellows	76–100% of fellows
Nonacademic or private practice career: 100% clinical	6 (11%)	19 (35%)	23 (43%)	6 (11%)	0 (0%)
Career in industry (pharmaceutical, health care consulting)	54 (100%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)
Academic career: 100% clinical	13 (24%)	22 (41%)	11 (20%)	7 (13%)	1 (2%)
Academic career with basic/translational/clinical research as primary nonclinical component	11 (20%)	24 (44%)	14 (26%)	4 (7%)	1 (2%)
Academic career with QI/safety as primary nonclinical component	22 (41%)	29 (54%)	3 (6%)	0 (0%)	0 (0%)
Academic career with education as primary nonclinical component	17 (31%)	23 (43%)	8 (15%)	5 (9%)	1 (2%)

Abbreviation: FPD, fellowship program director; QI, quality improvement.

 

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Type of Scholarly Activity Proposed to the American Board of Pediatrics for Graduating Fellows

There was a large variety of scholarly activity completed by graduating fellows over the last 5 years. Only a few FPDs reported a focus of scholarship in which >50% of fellows in the program engaged ([Table 3]). Clinical research was the most common area of scholarly activity with 91% of FPDs (49/54) reporting that at least one of their fellows engaged in it over the past 5 years followed closely by basic science research at 85% (46/54). Other types of scholarly activity were less frequently undertaken by fellows. Clinical care guideline development was the only proposed area of scholarship in which some FPDs (6/54, 11%) reported that this was not an acceptable pathway to fulfill the scholarly activity requirement of their program.

Table 3 Type of scholarly activity and percentage of the fellows in each program who pursued the activity in the past 5 years

Scholarly activity	Percentage of fellows in program who pursued activity in the past 5 years	N (%)
Basic science
	1–25%	22 (41)
	26–50%	18 (33)
	51–75%	3 (6)
	76–100%	3 (6)
	None	8 (15)
Clinical
	1–25%	14 (26)
	26–50%	19 (35)
	51–75%	7 (13)
	76–100%	9 (17)
	None	5 (9)
Translational
	1–25%	26 (48)
	26–50%	7 (13)
	51–75%	1 (2)
	76–100%	2 (4)
	None	18 (33)
Health services and policy
	1–25%	16 (30)
	26–50%	2 (2)
	51–75%	0 (0)
	76–100%	0 (0)
	None	37 (69)
Medical education
	1–25%	21 (39)
	26–50%	2 (4)
	51–75%	0 (0)
	76–100%	0 (0)
	None	31 (57)
Quality improvement
	1–25%	22 (41)
	26–50%	3 (6)
	51–75%	1 (2)
	76–100%	7 (13)
	None	21 (39)
Clinical care guideline development
	1–25%	10 (19)
	26–50%	5 (9)
	51–75%	3 (6)
	76–100%	2 (4)
	None	28 (52)
	Not an acceptable area of scholarly work	6 (11)
Bioethics
	1–25%	15 (28)
	26–50%	2 (4)
	51–75%	0 (0)
	76–100%	0 (0)
	None	37 (69)

 

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Resources for and Barriers to Scholarly Activity

Resources to support fellow scholarly activity were variable across programs ([Fig. 1]). The most common resources were funding for fellows to present their work (93%, 50/54) and statistical support (91%, 49/54). The least common resources were funding to support an extra research year (30%, 16/54) and fellow salary funding through T32 training grants (15%, 8/54). Almost a quarter of FPDs described their resources as only somewhat adequate (22%, 12/54), while 1.9% (1/54) characterized them as not at all adequate.

Fig. 1 Resources available across programs to support fellow scholarly activity.

Major and minor barriers identified by FPDs to complete scholarly activity are depicted in [Fig. 2]. The survey also contained a free-response question asking FPDs to describe barriers further; half of FPDs (26/54, 48%) provided responses. Lack of funding for various aspects of fellow scholarly work continued to be the most frequently mentioned barrier (14/26, 54%) followed closely by different barriers pertaining to mentorship (13/26, 50%) such as lack of faculty protected time to provide mentorship, lack of faculty experience with mentorship, and lack of faculty (especially basic science faculty) to serve as mentors.

Fig. 2 Barriers across programs to complete scholarly activity.

 

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Time Allocated for Scholarly Activity

The median total number of months that had reduced clinical obligations (such as having only clinic or call) was 18 (interquartile range [IQR]: 3–20; [Supplementary Table S1] [available in the online version]). Very few FPDs reported months completely free of clinical obligations. The vast majority of FPDs (96%, 52/54) reported that the amount of time allocated to scholarly activity during fellowship was sufficient with the two FPDs that disagreed reporting “it limits the types of projects that can be completed during fellowship” and “too much clinical work interrupts research time—particularly impedes those pursuing basic science research.”

All FPDs either strongly disagreed or disagreed that fellowship training should be shortened to 2 years for all NPM fellows, regardless of career intentions. However, 11% (6/54) of FPDs either strongly agreed or agreed that fellowship training should be shortened to 2 years for those interested in pursuing clinical or clinician-education careers. Approximately one quarter of FPDs (12/54, 22%) provided additional details on their rationale for their beliefs regarding the length of fellowship training. Those in favor of shortening fellowship argued that the development of tracks will result in improved research funding allocation and alleviate certain trainee's financial debts. Those arguing against shorter fellowship training believed it would result in decreased trainee competence, neonatologists who are unable to critically appraise the literature, and a field unable to advance due to a lack of researchers. Other opinions included the shortening of pediatric residency for those interested in pursuing NPM fellowship and the need to strengthen trainee interest in scholarly activity nationally.

 

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Fellow Productivity

The vast majority of FPDs reported that all their fellows in the past 5 years completed a scholarly project (94%, 51/54). The most common accomplishment was presentation of scholarly work from fellowship at a national or international meeting with 80% (43/54) of FPDs reporting that >75% of their fellows in the past 5 years had done so. Only 35% (19/54) of FPDs reported that >75% of their fellows in the past 5 years had a manuscript accepted in a peer-reviewed journal based on work completed during fellowship. Submission/acceptance of an extramural grant application and completion of an additional degree during fellowship were the least common products of fellowship with 30% (16/54) and 61% (33/54) of FPDs, respectively, reporting that no fellows had achieved these metrics.

 

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Factors Associated with Fellow Productivity

The factors associated with fellow scholarly activity productivity can be seen in [Table 4]. Highly productive fellowship programs were more likely to have funding for fellows to conduct scholarly activity, an increased number of protected months dedicated to scholarly activity, and more robust faculty mentorship. Programs graduating more fellows in the last 5 years were more likely to be highly productive (median 10 vs. 15, p = 0.043). Additionally, FPDs' belief in their program's financial security was associated with high productivity, and FPDs in highly productive programs were more likely to be satisfied with the scholarly activity experience provided by their program and the scholarly activity products completed by their fellows.

Table 4 Factors associated with fellow scholarly activity productivity

	Not highly productive[a] (n = 35)	Highly productive[a] (n = 19)	p
Scholarly activity engagement and work products
Submission or acceptance of extramural grant			0.047
None/1–50%, n (%)	34 (97)	15 (79)
51–100%, n (%)	1 (3)	4 (21)
Resources
Funds to conduct scholarly activity, n (%)	22 (63)	18 (95)	0.011
Total months free + reduced, median (IQR)	18 (17–21)	20 (16–21)	0.04
Total months free + reduced + mixed, median (IQR)	20 (18–21)	21 (19.5–21.5)	0.03
Total months clinical, median (IQR)	13 (12–15)	12 (12–13)	0.048
Barriers
Lack of adequate core curriculum			0.018
Not a barrier, n (%)	14 (40)	14 (74)
Minor/Major barrier, n (%)	21 (60)	5 (26)
Lack of adequate expertise on SOC			0.048
Not a barrier, n (%)	16 (46)	14 (74)
Minor/Major barrier, n (%)	19 (54)	5 (26)
Lack of sufficient divisional faculty mentorship			0.048
Not a barrier, n (%)	9 (26)	10 (53)
Minor/Major barrier, n (%)	26 (74)	9 (47)
Fellowship program director beliefs
Financial security makes funding fellows difficult			0.006
Strongly disagree/Disagree, n (%)	16 (46)	16 (84)
Agree/Strongly agree, n (%)	19 (54)	3 (16)
Fellowship program director satisfaction
Satisfaction with scholarly products from fellows			0.037
Not at all/somewhat, n (%)	13 (37)	2 (11)
Very/extremely, n (%)	22 (63)	17 (89)
Satisfaction with scholarly activity experience provided			0.037
Not at all/somewhat, n (%)	13 (37)	2 (11)
Very/extremely, n (%)	22 (63)	17 (89)

Abbreviation: SOC, scholarly oversight committee.

^a Highly productive defined as >75% of fellows over the past 5 years having a peer-reviewed manuscript accepted based on work completed during fellowship.

High productivity was not associated with program setting (p = 0.9)/region (p = 0.4) or the postfellowship graduate positions of fellows, nor was it associated with the type of scholarly activity fellows pursued, whether they presented their scholarly work at national/international meetings (p = 0.6), or whether they obtained additional degrees during fellowship (p = 0.2). Neither the existence of any research curriculum (p = 0.15), statistical support for fellows (p = 0.6), funding for fellows to present their scholarly work (p = 0.3), funding for an extra year of fellowship (p = 0.14), nor the existence of T32 training grants (p = 0.11) were associated with higher productivity.

 

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Discussion

With the dwindling pathway of physicians pursuing research-focused careers,[1] [2] [3] [4] [5] [6] it has become imperative to identify those factors that promote successful scholarship during fellowship since scholarship productivity has been associated with stronger desires to pursue academic and research-focused careers.[7] [8] [9] [19] In our study, we found that highly productive fellowship programs were more likely to have funding for fellows to conduct scholarly activity, an increased number of protected months dedicated to scholarly activity, and more robust faculty mentorship. Fellowship programs that were less productive were more likely to report a lack of an adequate core research curriculum and extramural grant submission or acceptance.

To sustain and rebuild the physician scientist pathway, it is critical to acknowledge the challenges of financially supporting fellow scholarship. Our study showed that those fellows in fellowship programs with a perceived lack of financial support were less academically productive. Among the funding challenges pediatric fellowship programs are facing are the decrease in T32 training grants,[20] the increased reliance on individual faculty research mentors financially supporting their trainee's scholarly activity,[21] and trainee's reluctance to submit scholarly work for presentation in the face of perceived financial limitations.[14] With potentially limited financial resources, section chiefs, FPDs, and hospital leadership should develop an institutional plan to identify successful research mentors and focus funding on trainees that have either declared an interest in a research career or demonstrated academic success.

Our study also identified other factors that improve fellows' scholarship productivity such as the implementation of a core research curriculum and supporting fellow extramural grant submissions. The existence of research curricula as part of training has previously been associated with increased scholarly productivity among residents[22] [23] [24] and should be a part of each fellowship core curriculum. The NPM FPDs are creating a national core curriculum that will cover the entire ABP NPM content specifications[25] [26] [27] and may be the perfect venue to create a national research curriculum for trainees. As our study shows that higher productivity is associated with fellow submission of grants, this proposed research curriculum could also cover the basics of grant writing and help section leadership institute grant writing as part of the requirements for fellows interested in an academic career. Grants that are accepted or favorably reviewed are recognized by the ABP as fulfillment of the required scholarly work product to sit for the boards which provides additional benefits to the FPD and trainee.[11] [12]

NPM fellowship programs with increased mentorship and protected time for scholarly activity also had greater fellow productivity. This contrasts with the majority of NPM FPDs (96%) who feel that the time allocated to scholarly activity during fellowship training was sufficient.[22] This dissonance may be a result of the conflicting demands of having the same fellowship training curriculum for both clinical and research focused neonatologists and suggests consideration for creating these two different pathways for fellows. Our results and those of others[14] emphasize that many NPM fellows enter private practice or obtain 100% clinical academic positions after graduating. Whether graduate medical education programs should be restructured to allow for research or clinical tracks continues to be the subject of debate. What is clear is that sufficient protected time for those trainees pursuing research careers should be explicitly structured into each fellowship program's curriculum and transparently outlined in the interview process.

A more fundamental problem to reestablish the NPM research pathway may be the challenges of engaging pediatric residents or medical students in scholarly activity. Early exposure to scholarship is associated with stronger academic identity formation,[7] [19] [28] [29] yet only 30% of graduating pediatric residents feel adequately prepared to pursue research after residency.[30] Additionally, less than 10% of NPM FPDs feel that entering fellows are adequately prepared to pursue research projects.[31] For residents interested in research, it is important that pediatric program directors are aware of scientist training programs and provide this information as well as adequate mentoring to these residents. Postgraduate physician scientist training programs, usually spanning resident and fellowship training, are carefully crafted and have different recruitment goals, focusing on previous research experience and a balanced commitment to both science and medicine.[32] In Pediatrics, the accelerated and integrated research pathways[33] are options for research interested trainees and implemented to fill the pathway of physician scientists in Pediatrics.[34] [35]

There are several limitations to our study. In cross-sectional survey studies, only associations, not causality, can be described. Our response rate was 54% which could introduce nonresponse bias; however, we demonstrated no differences between responders and nonresponders in program characteristics. While 94% of FPDs stated that fellows had completed a scholarly project, individual FPDs may have had different definitions of a “completed” scholarly project which would introduce measuring error. Additionally, some fellow manuscripts are accepted after fellowship completion which may result in an underestimate of scholarly productivity by FPDs. Lastly, our results reflect the perspective of FPDs which may or may not align with that of NPM fellows.

 

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Conclusion

The challenges to increasing NPM fellowship scholarship productivity are not insignificant but improved research funding, protected research time, well-established research mentors, and a dedicated research curriculum are associated with increased fellowship scholarly productivity. The addition of local and national curricula to support research among NPM fellows and the early identification and support of research focused trainees with integrated scholarly training programs may help improve the physician scientist pathway in neonatology.

 

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Conflict of Interest

None declared.

Acknowledgments

We thank SPIN for support in facilitating this project. We also thank all the FPDs who participated by completing the survey.

Authors' Contributions

N.F.D. contributed to the methodology, investigation, data curation, visualization, formal analysis, and writing (of the original draft) of the study. As corresponding author, N.F.D. has full access to the data in the study and final responsibility for the decision to submit for publication.

P.M. contributed to the study's methodology, investigation, data curation, formal analysis, and writing, reviewing, and editing.

C.E.L.D. contributed to the study's methodology, investigation, data curation, formal analysis, and writing, reviewing, and editing.

P.C. contributed to the study's methodology, investigation, data curation, formal analysis, writing, reviewing, and editing.

E.L.A. helped to conceptualize the study, methodology, investigation, data curation, formal analysis, and writing, reviewing, and editing.

C.A. contributed to the study's methodology, investigation, data curation, formal analysis, review, and editing.

P.W. helped to conceptualize the study, methodology, investigation, data curation, visualization, formal analysis, and writing, reviewing, and editing.

All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

• References

• 1 Gitterman DP, Langford WS, Hay Jr WW. The Fragile State of the National Institutes of Health Pediatric Research Portfolio, 1992-2015: doing more with less?. JAMA Pediatr 2018; 172 (03) 287-293
• 2 Good M, McElroy SJ, Berger JN, Wynn JL. Name and characteristics of National Institutes of Health R01-funded pediatric physician-scientists: hope and challenges for the vanishing pediatric physician-scientists. JAMA Pediatr 2018; 172 (03) 297-299
• 3 Chesney RW, Dungy CI, Gillman MW. et al; Committee on Pediatric Research. Promoting education, mentorship, and support for pediatric research. Pediatrics 2001; 107 (06) 1447-1450
• 4 Frintner MP, Cull WL. Pediatric training and career intentions, 2003-2009. Pediatrics 2012; 129 (03) 522-528
• 5 Rimsza ME, Ruch-Ross HS, Clemens CJ, Moskowitz WB, Mulvey HJ. Workforce trends and analysis of selected pediatric subspecialties in the United States. Acad Pediatr 2018; 18 (07) 805-812
• 6 Bauserman M, Vasquez M, Chess PR, Carbajal M, Good M. ONTPD Fellowship Directors Writing Group. Essentials of neonatal-perinatal medicine fellowship: scholarship perspective. J Perinatol 2022; 42 (04) 528-533
• 7 Cull WL, Yudkowsky BK, Schonfeld DJ, Berkowitz CD, Pan RJ. Research exposure during pediatric residency: influence on career expectations. J Pediatr 2003; 143 (05) 564-569
• 8 Crowley RW, Asthagiri AR, Starke RM, Zusman EE, Chiocca EA, Lonser RR. Research Committee of the Congress of Neurological Surgeons. In-training factors predictive of choosing and sustaining a productive academic career path in neurological surgery. Neurosurgery 2012; 70 (04) 1024-1032
• 9 Macknin JB, Brown A, Marcus RE. Does research participation make a difference in residency training?. Clin Orthop Relat Res 2014; 472 (01) 370-376
• 10 Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Pediatrics. 2024 . Accessed February 23, 2024 at: https://www.acgme.org/globalassets/pfassets/programrequirements/2025-prs/320_pediatrics_2025_tcc.pdf
• 11 Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Neonatal-Perinatal Medicine. 2020 . Accessed June 5, 2023 at: https://www.acgme.org/globalassets/pfassets/programrequirements/329_neonatalperinatalmedicine_2020.pdf
• 12 The American Board of Pediatrics. General Criteria for Subspecialty Certification. Accessed November 13, 2023 at: https://www.abp.org/content/general-criteria-subspecialty-certification
• 13 Philibert I, Lieh-Lai M, Miller R, Potts III JR, Brigham T, Nasca TJ. Scholarly activity in the next accreditation system: moving from structure and process to outcomes. J Grad Med Educ 2013; 5 (04) 714-717
• 14 Gray MM, Bruno C, French H. et al. Changes, challenges, and variations in neonatal-perinatal medicine fellowship: a view from the program directors. Am J Perinatol 2024; 41 (S 01): e163-e173
• 15 Freed GLDK, Moran LM, Spera L, McGuinness GA, Stevenson DK. Pediatric subspecialty fellowship clinical training project: recent graduates and midcareer survey comparison. Pediatrics 2014; 133 (Suppl. 02) S70-S75
• 16 Freed GLDK, Moran LM, Spera L, McGuinness GA, Stevenson DK. Fellowship program directors perspectives on fellowship training. Supplement article. Pediatrics 2014; 133 (Suppl. 02) S64-S69
• 17 Abramson EL, Weiss P, Naifeh M. et al. Scholarly activity during pediatric fellowship. Pediatrics 2021; 147 (01) e2020013953
• 18 Kiger ME, Varpio L. Thematic analysis of qualitative data: AMEE Guide No. 131. Med Teach 2020; 42 (08) 846-854
• 19 Burkhardt J, Kowalenko T, Meurer W. Academic career selection in American emergency medicine residents. Acad Emerg Med 2011; 18 (Suppl. 02) S48-S53
• 20 French HM, Leeman KT, Wambach JA, Malik SK, Reber KM. ONTPD Fellowship Directors Writing Group. Essentials of Neonatal-Perinatal Medicine fellowship: an overview. J Perinatol 2022; 42 (02) 269-276
• 21 Weiss P, Myers AL, McGann KA. et al. Funding sources and perceived financial insecurity in pediatric subspecialty fellowship programs. Acad Pediatr 2019; 19 (07) 815-821
• 22 Abramson EL, Naifeh MM, Stevenson MD. et al. Research training among pediatric residency programs: a national assessment. Acad Med 2014; 89 (12) 1674-1680
• 23 Stevenson MD, Smigielski EM, Naifeh MM, Abramson EL, Todd C, Li ST. Increasing scholarly activity productivity during residency: a systematic review. Acad Med 2017; 92 (02) 250-266
• 24 Wood W, McCollum J, Kukreja P. et al. Graduate medical education scholarly activities initiatives: a systematic review and meta-analysis. BMC Med Educ 2018; 18 (01) 318
• 25 Gray MM, Dadiz R, Izatt S. et al. Comparison of knowledge acquisition and retention following traditional didactic vs. flipped classroom education utilizing a standardized national curriculum: a randomized controlled trial. J Perinatol 2022; 42 (11) 1512-1518
• 26 Izatt S, Gray M, Dadiz R, French H. Development and implementation of a national neonatology flipped classroom curriculum. J Grad Med Educ 2019; 11 (03) 335-336
• 27 French H, Gray M, Gillam-Krakauer M. et al. Flipping the classroom: a national pilot curriculum for physiology in neonatal-perinatal medicine. J Perinatol 2018; 38 (10) 1420-1427
• 28 O'Sullivan PS, Niehaus B, Lockspeiser TM, Irby DM. Becoming an academic doctor: perceptions of scholarly careers. Med Educ 2009; 43 (04) 335-341
• 29 Bauler L, Jones S. Supporting medical student scholarship: a novel case report elective to teach the writing and publishing process. Acad Med 2023; 98 (07) 790-794
• 30 Schumacher DJ, Frintner MP, Cull W. Relationships between program size, training experience, and career intentions: pediatrics resident reports from 2010 to 2014. Acad Pediatr 2016; 16 (07) 630-637
• 31 Backes CH, Bonachea EM, Rivera BK. et al. Preparedness of pediatric residents for fellowship: a survey of US neonatal-perinatal fellowship program directors. J Perinatol 2016; 36 (12) 1132-1137
• 32 Blanchard M, Burton MC, Geraci MW. et al. Best practices for physician-scientist training programs: recommendations from the Alliance for Academic Internal Medicine. Am J Med 2018; 131 (05) 578-584
• 33 The American Board of Pediatrics. Integrated Research Pathway (IRP). Accessed March 11, 2024 at: https://www.abp.org/content/integrated-research-pathway-irp
• 34 Hurst JH, Barrett KJ, Kelly MS. et al. Cultivating research skills during clinical training to promote pediatric-scientist development. Pediatrics 2019; 144 (02) e20190745
• 35 Dermody TS, Hirsch R, Hostetter MK, Orange JS, St Geme III JW. Expanding the pipeline for pediatric physician-scientists. J Pediatr 2019; 207: 3-7.e1

Publication History

Received: 19 March 2024

Accepted: 14 May 2024

Accepted Manuscript online:
15 May 2024

Article published online:
10 June 2024