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Is a hospital medicine fellowship right for you?

May 2010

Published in the May 2010 issue of Today’s Hospitalist

WANT TO HONE YOUR RESEARCH SKILLS or further your career with deeper ICU experience? Or do you have visions of directing a hospitalist program or working in hospital administration?

Advanced fellowships in hospital medicine are designed to help hospitalists tailor a more focused career, says Ami Joshi, DO, MBA, who directs the one-year hospital medicine fellowship program under the division of hospital medicine at Cooper University Hospital in Camden, N.J.

While internal medicine residencies provide a good clinical grounding in inpatient work, she says, a fellowship allows physicians to conduct clinical research, focus on performance improvement and gain more clinical experience “all while learning about the business side of hospital medicine.

“Quality improvement and providing more efficient care are critical for health care in the future,” Dr. Joshi points out. “A fellowship allows you to get that experience.”

Launched several years ago, Cooper’s fellowship program was one of the first in the country. The full-time, on-site program accepts just one candidate a year, who receives a salary comparable to first-year fellows in other departments.

Over the course of that year, Dr. Joshi explains, a fellow must complete a few months on both teaching and non-resident services; a month of critical care; and a month with the hospitalist-run utilization management department.

The rest of the time, she adds, fellows are free to tailor the program to their interests. That can include developing a curriculum for internal medicine education (Cooper is affiliated with the Robert Wood Johnson School of Medicine as well as with three community hospitals); conducting research in critical care, hospital medicine or a subspecialty; or participating in performance improvement.

Eventually, Dr. Joshi adds, Cooper would like to expand the program to take more fellows and combine it with either an MBA or a master’s degree in health administration.

Cooper’s program, which is one of several dozen around the country, does not have ACGME-accredited status because hospital medicine isn’t a separate subspecialty. However, Dr. Joshi says that hospitalists should expect to see more fellowships springing up.

“That’s the wave of the future,” she says. While the American Board of Internal Medicine is about to offer its first recertification exam with a focused practice in hospital medicine, Dr. Joshi says she expects the field to move toward being a board-certified internal medicine subspecialty.

“We’re pleased that we started early and have all the ACGME requirements in place for fellowships, when hospital medicine is an acknowledged subspecialty,” she says. “Because our hospital allowed us to start this process sooner, it will be an easier transition for us.”