Background/Purpose: Fellows are expected to teach patients, trainees and colleagues, regardless of what type of practice they join. The Accreditation Council for Graduate Medical Education (ACGME) Internal Medicine subspecialty milestones reflect that graduating fellows demonstrate the ability to teach effectively.¹ Yet, fellows frequently learn how to teach during their training through trial and error or observation.² Rheumatology fellows’ experience and attitudes regarding teaching and teacher training have not been previously assessed. We evaluated fellows’ interest in and access to training in education during their fellowship.

Methods: An anonymous survey was administered during the Fellows education session at the 2017 American College of Rheumatology national conference. The survey assessed fellows’ career plans, interest and confidence in teaching, as well as experience with training in education during fellowship.

Results: Of the 150 surveys distributed, 107 were returned (response rate 71%). Seventy percent of those surveyed were adult rheumatology fellows, 12% were in pediatric rheumatology; 25% were 1^st year fellows and 67% were 2^nd year fellows. About 75% fellows demonstrated interest in pursuing a career that would involve teaching: 50% in “private practice with academic affiliation or teaching role” and 25% in “clinical educators in an academic program.” Regarding fellowship training, over half reported that their program did not provide structured training in education, but notably, about 49% of programs were reported to “offer direct observation and feedback of [fellow’s] teaching ability by attending physicians.” Almost all fellows (94%) agreed or strongly agreed with the statement “If I had more time, I would do more teaching” and 97% felt that their “Teaching skills can be improved.” About 88% of fellows reported that “learning how to teach effectively will be valuable to [his/her] career” and about 80% of fellows “would be willing to participate in a program to improve [their] teaching skills if no additional years of training required.” Finally, while the majority (84%) of fellows felt confident in their ability to teach Rheumatology to a medical student/resident, 36% did not feel confident in their ability to give feedback to students/residents.

Conclusion: This is the first national needs assessment of rheumatology fellows’ attitudes regarding experience as teachers. The majority of fellows are interested in pursuing careers where teaching would be a vital part of their profession and most felt that their teaching skills could be improved. However, over half of fellowship programs do not provide structured training in education, demonstrating a gap between fellows’ needs and fellowship resources. Our study suggests a significant need to develop programs aimed at enhancing fellows’ teaching skills.

1. Internal Medicine Subspecialty Milestones-ACGME https://www.acgme.org/Portals/0/PDFs/Milestones/InternalMedicineSubspecialtyMilestones.pdf
2. Miloslavsky EM, Boyer D, Winn AS, Stafford DE, McSparron JI. Fellows as Teachers: Raising the Educational Bar. Ann Am Thorac Soc. 2016 Apr;13(4):465-8. doi: 10.1513/AnnalsATS.201601-026PS. PubMed PMID: 26835749.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/needs-assessment-of-a-structured-teaching-program-for-fellows-as-teachers-rheumatology-fellows-perspective/