Learning experiences from an online QI fellowship programme during COVID-19 - a qualitative study.

BACKGROUND: During the COVID-19 pandemic in the United Kingdom, multiple aspects of everyday human existence were disrupted. In contrast, almost all levels of educational learning continued, albeit with modifications, including adaptation to virtual-or online-classroom experiences. This pedagogic transition also occurred in the National Institute of Health and Care Research Applied Research Collaboration Northwest London's (NIHR ARC NWL) Improvement Leader Fellowship, an annual programme focusing on quality improvement (QI). This qualitative study aimed to understand how these changes impacted the Fellows' learning experience. METHODS: We explored the experiences of two cohorts of programme Fellows (n = 18, 2020-2021 and n = 15, 2021-2022) with focus groups, analysed under a constructivist qualitative research paradigm. RESULTS: The two primary and four sub-themes that emerged were: Online QI learning experience (benefits and challenges) and Implementing online QI learning (facilitators and barriers). While benefits had three further sub-themes (i.e., digital flexibility, connection between learners, and respite from impact of COVID-19), challenges had four (i.e., lack of interaction, technological challenges and digital exclusion, human dimension, and digital fatigue). While the facilitators had three sub-themes (i.e., mutual and programmatic support, online resource access, and personal resilience), barriers had one (i.e., preventing implementation and lack of protected time). CONCLUSION: Despite challenges to in-person ways of working, online learning generally worked for action-orientated QI learning, but changes are needed to ensure the effectiveness of future use of virtual learning for QI. Understanding the challenges of the translation of learning into action is crucial for implementation learning, gaining insight into how improvement Fellows navigated this translation when learning remotely and implementing directly in their workplace is key to understanding the evolving nature of implementation over the pandemic years and beyond.

Point-of-Care-Ultrasound Quality Assurance Data from Fellow-Performed Exams in a Pediatric Emergency Department: A Descriptive Study.

OBJECTIVES: Point-of-care-ultrasound (POCUS) is increasingly used by pediatric emergency medicine (PEM) fellows, but scant data exists on the accuracy of exam interpretations. Our goal was to determine whether agreement on exam interpretation between quality assurance (QA) faculty (reference standard) and PEM fellows varied by fellowship year or exam type. METHODS: Retrospective review of fellow-performed POCUS exams between January 2019 and June 2022. Negative binomial (NB) random effects regression was used to account for longitudinal measurement of individual fellow performance across 3 years. Fixed effects were exam type and fellowship year. To assess between- and within-user variability across time, a random intercept and slope were included for each fellow. RESULTS: Exactly 3032 exams, performed by 24 fellows, were included. Raw proportion agreement by fellowship year was high for all exam types (≥88%). From the NB model, there was no statistically significant effect of fellowship year on the mean count of agreement. The relative risk (RR) of agreement for exam types was greatest for cardiac vs other types. The standard deviations for the random intercept and random slope were 0.09 and 0.04, respectively, with a correlation of -0.94. CONCLUSIONS: PEM fellows generally interpret exams correctly, with little variation through fellowship, although those who began with more basic skills showed more progress over time. Fellowship year did not influence the likelihood of correct interpretation but there was variation across exam type, with the best agreement for cardiac exams. The extent to which disagreements between fellows and QA faculty represent clinically significant errors requires further study.

Professional opportunities, gender obstacles, and narrowed progression: The case of the first Social Science Research Council female fellows (1925-1934).

Between the years 1925 and 1934, the Social Science Research Council (SSRC) awarded 198 postdoctoral research fellowships to early-career social scientists, among which 29 were awarded to women. This article, which is based on the SSRC directory and Rockefeller institutions' records, examines the professional paths of these female fellows to shed light on the presence of women in the social sciences and to probe the peculiarities of their professional trajectories. The SSRC fellowships represented a significant professional prospect for brilliant young female graduates who were often denied similar opportunities in other fields. Nonetheless, they did not eradicate all gender discrimination that remained prevalent, not only in the vertical sense by preventing women from progressing in the academic hierarchy, but also in the horizontal sense by retaining them in designated spaces (specific disciplines or institutions) that were underrecognized. Ultimately, the analysis of women's professional paths underscores the importance of examining the private or intimate lives of scientists to gain a more in-depth understanding of the social structure of science and its impact on its protagonists.

Current exposure to Female Pelvic Medicine and Reconstructive Surgery faculty during urology residency.

INTRODUCTION: Contemporary US resident exposure to Female Pelvic Medicine and Reconstructive Surgery (FPMRS) faculty during urology residency is unknown. METHODS: Accredited US urology residencies were identified through the American Urological Association (AUA). Accredited, urology-based FPMRS fellowships were identified through the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction. The number of faculty and residency positions were obtained from program AUA profiles if they were last modified within the current application cycle; this information was obtained from program websites if AUA profiles were outdated. Data on faculty fellowship training was manually extracted from program websites. A quality control cross-check of program and faculty training characteristics was performed through direct communication with 5% of programs. RESULTS: Of 139 accredited residency programs assessed, 10.8% were affiliated with an accredited, urology-based FPMRS fellowship. In total, 29.5% of residency programs, representing 25% of US urology residents, had neither a FPMRS fellowship nor any FPMRS certified faculty. The national FPMRS faculty-to-resident ratio was 1:10.8, and 7.4% of faculty at all residency programs were FPMRS certified. In comparison, faculty-to-resident ratios for other subspecialties were: 1:4.7 for pediatrics, 1:3.6 for oncology, 1:5.9 for minimally invasive surgery/endourology, 1:14.2 for trauma/reconstruction, and 1:11.8 for andrology or male sexual/reproductive health. The FPMRS faculty-to-resident ratio was 1:5.1 in programs with a urology-based FPMRS fellowship compared with 1:13.4 in programs without a FPMRS fellowship. CONCLUSIONS: 30% of US urology residency programs lack FPMRS trained faculty. Even when FPMRS faculty are on staff, the field is often underrepresented relative to other urologic subspecialties. Further studies are required to ascertain if inadequate exposure to FPMRS cases and mentors during training contribute to the shortage of urology residents who choose to specialize in FPMRS. This link has important implications for the current shortage of FPMRS providers.

The case for a new post-graduate hernia designation: a review of fellowship council case logs from the past twelve-years.

BACKGROUND: The Fellowship Council (FC) is a robust accreditation body with numerous fellowships; however, no specific criteria exist for hernia fellowships. This study analyzed the case log database to evaluate trends in fellowship exposure to hernia repairs. METHODS: FC hernia case log records (2007-2019) were coded as inguinal or ventral hernias and with or without mesh repair. Retrospective analysis examined total hernia repairs logged, type of repair, program designation, and robotic adoption. Robotic adoption was categorized by quartiles of program performance according to the final year of analysis (2018-2019); yearly performance was then graphed by quartiles. RESULTS: Over this twelve-year period, 93,334 hernia repairs, 5 program designations, 152 unique programs and 1,558 unique fellows were analyzed. The number of fellows grew from 106 (2007-2008) to > 130 (2018-2019). Total hernias repairs per fellow increased from an average of 41.2 in 2007-2008 to 75.7 in 2018-2019 (183.7%). Open and robotic hernia repairs increased by 241.9% and 266.3%, respectively; laparoscopic hernia repairs decreased by 14.8%. Inguinal and ventral hernia repairs comprised 48.1% and 51.9% of total cases, respectively. Advanced GI/MIS and Advanced GI/MIS/Bariatrics programs logged the majority of hernia repairs (86.0-90.2%). 2014 began an exponential rise in robotic adoption, with fellows averaging < 1 robotic repairs before and > 25 repairs in 2019. A significant difference was found between all groups when comparing quartiles of robotic adopters (median robotic repairs per fellow; IQR): first quartile (72.0; 47.9-108.8), second quartile (25.5; 21.0-30.6), third quartile (13.0; 12.0-14.3) and fourth quartile (3.5; 0.5-5.0) (p-value < 0.05). CONCLUSIONS: This twelve-year analysis shows a near doubling in the growth of total hernia repairs, with a decrease in laparoscopic repairs as robotic repairs increased. These data show the importance of hernia repairs in FC fellows' training and warrant further granular analysis to determine specific accreditation criteria for hernia fellowship designations.

Development and Implementation of an Aesthetic Surgery Fellowship After Residency: The Universidad La Salle/Hospital Angeles Experience.

BACKGROUND: Postgraduate training in plastic surgery is heterogeneous between countries, with exposure to aesthetic surgery being a reflection of this. Fellowships in Mexico have usually consisted of tutorial teaching, providing graduates with experience but a lack of formal structure. The aim of his work is to present a University-backed program focused on aesthetic surgery and propose the expansion of this kind of program. METHODS: A retrospective cross-sectional review of surgical cases was performed over a five-year period from 2015 to 2019. Data were obtained from the senior surgeon's practice charts. Information was recorded using a data sheet including patients' demographic characteristics, procedures performed and type of anesthesia applied. Descriptive analyses of patient demographic and clinical characteristics were performed. Continuous variables are expressed in central tendency measures, and categorical values are presented as percentages. RESULTS: 1282 procedures were performed on 885 patients, 797 females (90%) and 88 males (10%). Mean age was 44.6 ± 13.8 years. Case load consisted in 545 breast procedures (42.5%), 372 body contour surgeries (29.0%), 305 facial aesthetic procedures (23.8%) and 60 miscellaneous procedures (4%). The most common surgeries were breast augmentation (249, 19.4%), alloplastic breast reconstruction (165, 12.8%), blepharoplasty (163, 12.7%), liposuction (151, 11.7%), and abdominoplasty (107, 8.3%). CONCLUSIONS: A University backed program focused on aesthetic surgery is feasible and desirable in multiple national and international institutions. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Catalyzing momentum in male contraceptive development†.

Globally, nearly half of all pregnancies are unplanned. Male contraceptives offer the potential to decrease unintended pregnancy and introduce contraceptive equity, but decades of research have yet to bring a novel product to market. New funding avenues from the philanthropic sector seek to stimulate research in male contraceptives through investments, grants, and support for trainees alongside other programs that encourage product development and ultimately commercialization. This Forum outlines the purpose of and funding opportunities provided by Male Contraceptive Initiative, a funding agency and non-profit focused on the advancement of non-hormonal, reversible contraceptive technologies for those who produce sperm.

Thriving or surviving? A critical examination of funding models for fellowship council fellowships.

BACKGROUND: Since 1997, the Fellowship Council (FC) has evolved into a robust organization responsible for the advanced training of nearly half of the US residency graduates entering general surgery practice. While FC fellowships are competitive (55% match rate) and offer outstanding educational experiences, funding is arguably vulnerable. This study aimed to investigate the current funding models of FC fellowships. METHODS: Under an IRB-approved protocol, an electronic survey was administered to 167 FC programs with subsequent phone interviews to collect data on total cost and funding sources. De-identified data were also obtained via 2020-2021 Foundation for Surgical Fellowships (FSF) grant applications. Means and ranges are reported. RESULTS: Data were obtained from 59 programs (35% response rate) via the FC survey and 116 programs via FSF applications; the average cost to train one fellow per year was $107,957 and $110,816, respectively. Most programs utilized departmental and grants funds. Additionally, 36% (FC data) to 39% (FSF data) of programs indicated billing for their fellow, generating on average $74,824 ($15,000-200,000) and $33,281 ($11,500-66,259), respectively. FC data documented that 14% of programs generated net positive revenue, whereas FSF data documented that all programs were budget-neutral. CONCLUSION: Both data sets yielded similar overall results, supporting the accuracy of our findings. Expenses varied widely, which may, in part, be due to regional cost differences. Most programs relied on multiple funding sources. A minority were able to generate a positive revenue stream. Although fewer than half of programs billed for their fellow, this source accounted for substantial revenue. Institutional support and external grant funding have continued to be important sources for the majority of programs as well. Given the value of these fellowships and inherent vulnerabilities associated with graduate medical education funding, alternative grant funding models and standardization of annual financial reporting are encouraged.

A survey of labour epidural practices at obstetric anesthesia fellowship programs in the United States.

PURPOSE: Labour epidural analgesia (LEA) is an evolving field. Various neuraxial techniques and dosing regimens are available to the modern obstetric anesthesia provider, allowing for significant practice variability. To begin a search for consensus on optimal care, we sought to query fellowship training practices for LEA. METHODS: We conducted an electronic survey of institutions with American Council for Graduate Medical Education-accredited obstetric anesthesiology fellowship programs. We studied the frequency of epidural initiation techniques, including combined spinal epidural (CSE), dural puncture epidural, and epidural bolus. For maintenance techniques, we appraised the use of continuous epidural infusion, programmed intermittent bolus (PIEB), and patient-controlled epidural analgesia (PCEA). RESULTS: Of 40 institutions surveyed, we received 32 responses (80% response rate). Twenty-eight of 40 (70%) were included in the analysis. A plurality of institutions (12/28; 43%) preferred CSE, and among those who used CSE, 23/27 (85%) included intrathecal opioids. A majority of institutions used protocols with PIEB (55%), while almost all (92%) used PCEA. Most participants (88%) reported using dilute concentration maintenance infusions of 0.1% bupivacaine/ropivacaine or less. CONCLUSION: Despite significant variability in LEA practice, some clear patterns emerged in our survey, including preference for opioid-containing CSE and maintenance with PIEB, PCEA, and dilute epidural solutions.

RéSUMé: OBJECTIF: L'analgésie péridurale obstétricale (APO) est un domaine en évolution. Diverses techniques neuraxiales et posologies sont disponibles pour le praticien en anesthésie obstétricale moderne, ce qui permet une variabilité significative de la pratique. Pour démarrer une recherche de consensus sur les soins optimaux, nous avons cherché à déterminer les pratiques d'APO dans le cadre de formation des fellows. MéTHODE: Nous avons réalisé une enquête électronique auprès d'établissements possédant des programmes de fellowship en anesthésiologie obstétricale accrédités par l'American Council for Graduate Medical Education. Nous avons étudié la fréquence des techniques de péridurale, notamment de rachi-péridurale combinée (RPC), de péridurale avec ponction durale et de bolus péridural. Pour les techniques de maintien, nous avons évalué l'utilisation de l'analgésie péridurale par perfusion continue, l'administration programmée de bolus périduraux (PIEB; programmed intermittent epidural bolus) et l'analgésie péridurale contrôlée par la patiente (APCP). RéSULTATS: Sur les 40 établissements sondés, nous avons reçu 32 réponses (taux de réponse de 80 %). Vingt-huit des 40 (70 %) établissements ont été inclus dans l'analyse. Plusieurs institutions (12/28; 43 %) ont répondu qu'elles préféraient la RPC, et parmi celles qui utilisaient la RPC, 23/27 (85 %) incluaient des opioïdes intrathécaux. La majorité des établissements utilisaient des protocoles avec le PIEB (55 %), tandis que presque tous (92 %) utilisaient l'APCP. La plupart des établissements participants (88 %) ont rapporté utiliser des perfusions de maintien à des concentrations diluées de bupivacaïne/ropivacaïne de 0,1 % ou moins. CONCLUSION: Malgré une variabilité significative dans la pratique de l'APO, certaines tendances claires ont émergé dans notre sondage, notamment une préférence pour les RPC contenant des opioïdes et le maintien avec un PIEB, une APCP et des solutions péridurales diluées.

Assessment of physician training and prediction of workforce needs in paediatric cardiac intensive care in the United States.

OBJECTIVE: To assess the training and the future workforce needs of paediatric cardiac critical care faculty. DESIGN: REDCap surveys were sent May-August 2019 to medical directors and faculty at the 120 US centres participating in the Society of Thoracic Surgeons Congenital Heart Surgery Database. Faculty and directors were asked about personal training pathway and planned employment changes. Directors were additionally asked for current faculty numbers, expected job openings, presence of training programmes, and numbers of trainees. Predictive modelling of the workforce was performed using respondents' data. Patient volume was projected from US Census data and compared to projected provider availability. MEASUREMENTS AND MAIN RESULTS: Sixty-six per cent (79/120) of directors and 62% (294/477) of contacted faculty responded. Most respondents had training that incorporated critical care medicine with the majority completing training beyond categorical fellowship. Younger respondents and those in dedicated cardiac ICUs were more significantly likely to have advanced training or dual fellowships in cardiology and critical care medicine. An estimated 49-63 faculty enter the workforce annually from various training pathways. Based on modelling, these faculty will likely fill current and projected open positions over the next 5 years. CONCLUSIONS: Paediatric cardiac critical care training has evolved, such that the majority of faculty now have dual fellowship or advanced training. The projected number of incoming faculty will likely fill open positions within the next 5 years. Institutions with existing or anticipated training programmes should be cognisant of these data and prepare graduates for an increasingly competitive market.

Evaluating ACGME-accredited addiction psychiatry fellowship online content: A critical analysis of addiction psychiatry fellowship program websites in the US.

Introduction: There is an extreme shortage of addiction psychiatrists and a lack of representation of addiction psychiatry (ADP) fellows from racial/ethnic minoritized backgrounds. ADP fellowship websites are integral in engaging potential applicants. It is therefore critical to understand the quality of engagement that trainees are having with ADP fellowship websites. The aim of this study was to investigate the accessibility and content of ADP fellowship program websites in the U.S. Methods: A list of ADP Fellowship programs was obtained from the Accreditation Council for Graduate Medical Education. A critical textual analysis of 42 unique factors within four categories (accessibility, recruitment, education, and health equity) was performed for each ADP fellowship website. Results: Of 51 ADP fellowships, 47 (92.2%) had websites. Information about social media accounts was largely missing from ADP fellowship websites. For recruitment, program description (95.7%) and program director name (76.6%) were most readily available, while interview day (0.00%) and vacation details (10.6%) were least available. For education, a list of rotations (55.3%) and didactics/lectures (40.4%) were most readily available, while post fellowship placement (6.4%), call schedule (4.3%), and responsibility progression (2.1%) were least available. The most prevalent health equity factors were gender-inclusive language (100%) and an absence of stigmatizing addiction language (100%). The least listed were statements of commitment to health equity (0.0%), antiracism training (2.1%), and harm-reduction strategies (4.3%). Conclusions: There are considerable gaps in the amount and types of information provided by ADP fellowship websites. Many existing websites are poorly interfacing with potential leaders in the field. The development of ADP fellowship websites could serve as a low-cost recruitment tool to engage potential addiction specialists. Our findings underscore the need for ADP fellowships to optimize their websites to engage bourgeoning leaders in addiction and optimize access to more comprehensive information.

Current Status of the Workforce and Training at Fetal Therapy Centers in North America.

INTRODUCTION: We sought to characterize the current workforce and training for fetal intervention procedures at fetal centers in North America. METHODS: An anonymous electronic survey was developed to query the 34 centers in the North American Fetal Treatment Network regarding the demographics and training of their faculty. Telephone surveys were conducted with directors of known fetal intervention fellowships. RESULTS: More than 50% of maternal-fetal medicine (MFM) faculty at fetal centers were female; more than two-thirds of pediatric surgical faculty were male. Most of the training of faculty was undertaken by visiting more experienced centers or having new faculty work with more experienced ones at the same center. Current fetal intervention fellowships appear to achieve levels of competency for intrauterine transfusions and laser therapy for twin-twin transfusion syndrome. Two-thirds of centers stated that they would be able to offer a position to an MFM who completed a formal fellowship in fetal intervention. CONCLUSION: A collaborative effort should be undertaken to establish formal fellowships in fetal medicine and intervention.

Enhancing International Cancer Organization Collaborations: King Hussein Cancer Center and Princess Margaret Cancer Centre Model for Collaboration.

Collaborative partnerships, which link two health organizations with shared characteristics to achieve common goals and to improve healthcare quality, are becoming increasingly common in oncology. The purpose of this study is to review the collaboration between King Hussein Cancer Center (KHCC) and Princess Margaret Cancer Centre (PM). The context, input, process, and product (CIPP) model, a quasi-experimental form of program evaluation, has been applied to the KHCC-PM collaboration. This model is well suited to evaluate complex collaborations as it does not assume linear relationships. Data sources include stakeholders' judgements of the collaboration, assessment of achievements, and informal interviews with key participants involved in the program. KHCC and PM are recognized as high-caliber comprehensive cancer centers, with a common goal of delivering high-quality care to patients. Through personal relationships among faculty in the centers and the perceived opportunities for mutual benefit, KHCC and PM signed a memorandum of understanding in 2013 to enter into a formal partnership. This partnership has been an evolving process that started with collaboration on education and grew to include clinical care. Research is an area for potential future collaboration. Enabling factors in the collaboration include dedication of individuals involved, trusting relationships amongst faculty, and the reciprocal nature of the relationship. Challenges have been financial, competing interests, and the absence of a successful collaborative model to follow. The KHCC and PM collaboration has been successful. A strategic plan is being developed and followed to guide areas of expansion.

Increasing evidence-based substance use interventions globally: The National Institute on Drug Abuse postdoctoral fellowships.

As of April 2020, 121 individuals from 47 nations had completed 124 NIDA International Program INVEST Drug Abuse Research Fellowships. This is the first comprehensive effort to assess the fellowships from the combined perspectives of career outcomes, migration patterns, publications, cost per publication, and funding. We searched electronic sources such as university websites, ResearchGate, LinkedIn, PubMed, and NIH databases to find current curriculum vitae, journal articles published in 2018 and 2019, and funding records. We found electronic records for 94.2% of former NIDA INVEST fellows (n = 114); 55.5% were male (n = 67). The majority are at least partially involved in addiction research, prevention, or treatment (85.9%; n = 98), primarily at academic institutions (73.7%, n = 84) as faculty members (65.8%, n = 75) conducting research (86%, n = 98). Nearly three-fourths (74.6%, n = 85) are still working in their home countries; and 74.6% (n = 85) coauthored at least one research article indexed in PubMed during 2018 or 2019. Of the 656 unique research articles, 52.4% (n = 344) were published by multinational groups. The average cost to NIDA for each peer-reviewed publication was $19,677. More than half (53.5%, n = 61) of the fellows received funding through 431 unique grants-led by NIDA (55), other NIH Institutes and Centers (57) and other U.S. funders (55). Using the measures of career outcomes, migration patterns, publications, cost per publication, and funding INVEST fellowships are cost-effective mechanisms to advance scientific knowledge, build addiction research capacity, foster international cooperation, and promote adoption of evidence-based addiction policies and interventions around the world.

Clinical Case Presentation and Discussion During ESO-ESMO Masterclass: a 10-Year Interactive Educational Experience.

In this article, we report on the clinical case presentations that have been delivered during the ESO or ESO-ESMO Masterclasses in Clinical Oncology in the last 10 years. Masterclasses have been held in three different geographical continents including Europe, Middle East, and Latin America, in which participants had to submit a clinical case and present it either in front of a tumor board (multidisciplinary-like sessions) or in small groups. Clinical case presentation is a unique part of the educational program preparing young oncologists to present and discuss their own patients with distinguished experts. In each Masterclass, between 40 and 55 clinical cases-depending on the number of participants-are presented. All presentations are assessed and evaluated by faculty members as well as by the rest of the participants.

A National Survey of Wilderness Medicine Curricula in United States Emergency Medicine Residencies.

INTRODUCTION: Wilderness medicine (WM) is a growing subspecialty of emergency medicine. In 2018, we surveyed all 240 emergency medicine residencies in the United States to assess the scope of WM education in emergency medicine training programs in light of the nearly 30% increase in the number of residencies since 2015. METHODS: A survey was e-mailed to the Council of Residency Directors in Emergency Medicine listserv and individual program directors of each of the 240 residencies. The survey included questions on educational content, format, number of hours taught, availability of conference credit, offering of an elective or fellowship, and several predefined WM curricula. We evaluated differences between 3-y and 4-y residencies using the χ2 test, where P<0.05 was considered significant. RESULTS: We had a response rate of 57% for completed surveys. Analysis showed 63% of respondent programs teach WM material. The majority (86%) partially or completely developed their curriculum, with 33% offering at least 1 of the predefined curricula. Thirteen percent taught with lecture only, 2% taught by hands-on only, and 85% used a combination of the 2. WM electives were significantly more likely to be offered by 4-y than 3-y residencies (P=0.009). CONCLUSIONS: Almost two-thirds of respondent residency programs teach WM material. Of these, only one-third teach any of the predefined curricula. Four-year residencies are more likely to offer WM electives but are otherwise comparable to 3-y programs.

The interprofessional Veterans Affairs Quality Scholars program pre- and postdoctoral nurse fellow outcomes.

BACKGROUND: The Department of Veterans Affairs (VA) Quality Scholars (VAQS) program, an interprofessional fellowship that includes pre- and postdoctoral nurses, aims to inspire practice change leaders. Fellows participate in a national curriculum, lead improvement/research teams, and establish professional development plans with expert mentor guidance. PURPOSE: To describe the distinctive elements of the VAQS program, nurse fellow outcomes, and accomplishments of nurse alumni as leaders, researchers, and educators. METHODS: Data were reviewed and aggregated from past and current fellow surveys. FINDINGS: Nurse fellows completed research and improvement projects that benefitted both the VA and the local health systems. Scholarly outcomes include publications, conference presentations, grant submissions, teaching/leading quality improvement, and research initiatives. Graduates transition to positions as nurse scientists, academic faculty, and operational leaders. DISCUSSION: Fellows contribute to the strategic priorities of local and national VA and external health care organizations providing a pipeline of health system expert leaders, educators, and researchers. CONCLUSION: Doctoral nursing fellowship experiences build human capital for enhancing the science of improvement and implementation, interprofessional collaboration, and leadership.

The current state of general paediatric fellowships in Canada.

INTRODUCTION: The field of Paediatric Medicine has grown tremendously over the last two decades. Several niche areas of practice have emerged, and opportunities for focused training in these areas have grown in parallel. The landscape of 'General Paediatric Fellowship' (GPF) Programs in Canada is not well described; this knowledge is needed to promote standardization and high-quality training across Canada. This study explores the structure and components of existing GPFs in Canada and identifies the interest and barriers to providing such programs. METHODS: A questionnaire was created to explore the landscape of GPF Programs in Canada. Invitations to participate were sent to leaders of General Paediatric Divisions across Canada, with a request to forward the survey to the most appropriate individual to respond within their local context. RESULTS: A total of 19 responses (95%) representing 17 different Canadian universities were obtained. Eight universities offered a total of 13 GPF Programs in 2019, with one additional university planning to start a program in the coming year. Existing programs were variable in size, structure and curriculum. Most programs identified as Academic Paediatric Programs, with an overlap in content and structure between Academic Paediatrics and Paediatric Hospital Medicine programs. The majority of respondents felt there was a need for GPF Programs in Canada but cited funding as the most common perceived barrier. CONCLUSION: A growing number of GPF Programs exist in Canada. Current fellowship programs are variable in structure and content. Collaboration between programs is required to advance GPF training in Canada.

The Proving Ground: Colombo Plan Fellowships and the Changing Landscape of Health Education in Canada, 1951-69.

This article examines the history of the Colombo Plan fellowship program in Canada during the 1950s and 1960s. It will argue that this program had a visible impact on Canadian institutions of learning and health care for three reasons. First, it brought an unprecedented number of students and health care professionals from South and Southeast Asia to Canada; second, it fostered a sense of mission within Canadian institutions about the role education should play in contributing to health and international development overseas; and third, it revealed the challenges and tensions inherent in fulfilling this mission in the context of differences between the objectives of Canadian officials and those of the fellows themselves. With its focus on South and Southeast Asia, the Colombo Plan fellowship program anticipated broader trends regarding the international migration of health workers from that region in later years.