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I read with interest the recent article by Klimpl et al. “The Current State of Advanced Practice provider Fellowships in Hospital Medicine: A Survey of Program Directors.”1 I appreciate the description of the variation in training as well as the discussion points about the driving forces behind the training programs. However, I am concerned about the terminology used, specifically “fellowship,” and how it can create confusion for patients. Accredited medical/surgical fellowships have a precise meaning and convey an assurance of standardized additional training. Even many non-Accreditation Council for Graduate Medical Education fellowships within a single field have a shared curriculum. Using the same terminology for other medical providers may be seen as equating their post-training competency with physicians who have completed fellowship training. As the authors point out, there is a wide divergence in the clinical experience required to become a licensed practitioner among NPs, PAs, and physicians. As such, using the same terminology for their respective training programs makes it difficult for the public to differentiate between them.

References

1. Klimpl D, Franco T, Tackett S, Cardin TE, Wolfe B, Wright S, Kisuule F. The current state of advanced practice provider fellowships in hospital medicine: a survey of program directors. J Hosp Med. 2019;14(7):401-406. https://doi.org/10.12788/jhm.3191.

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Tufts University School of Medicine, Boston, Massachusetts; Division of Pediatric Hospital Medicine, the Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts.

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Dr. Rauch has no conflicts to declare.

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Tufts University School of Medicine, Boston, Massachusetts; Division of Pediatric Hospital Medicine, the Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts.

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Dr. Rauch has no conflicts to declare.

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Tufts University School of Medicine, Boston, Massachusetts; Division of Pediatric Hospital Medicine, the Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts.

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Dr. Rauch has no conflicts to declare.

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I read with interest the recent article by Klimpl et al. “The Current State of Advanced Practice provider Fellowships in Hospital Medicine: A Survey of Program Directors.”1 I appreciate the description of the variation in training as well as the discussion points about the driving forces behind the training programs. However, I am concerned about the terminology used, specifically “fellowship,” and how it can create confusion for patients. Accredited medical/surgical fellowships have a precise meaning and convey an assurance of standardized additional training. Even many non-Accreditation Council for Graduate Medical Education fellowships within a single field have a shared curriculum. Using the same terminology for other medical providers may be seen as equating their post-training competency with physicians who have completed fellowship training. As the authors point out, there is a wide divergence in the clinical experience required to become a licensed practitioner among NPs, PAs, and physicians. As such, using the same terminology for their respective training programs makes it difficult for the public to differentiate between them.

I read with interest the recent article by Klimpl et al. “The Current State of Advanced Practice provider Fellowships in Hospital Medicine: A Survey of Program Directors.”1 I appreciate the description of the variation in training as well as the discussion points about the driving forces behind the training programs. However, I am concerned about the terminology used, specifically “fellowship,” and how it can create confusion for patients. Accredited medical/surgical fellowships have a precise meaning and convey an assurance of standardized additional training. Even many non-Accreditation Council for Graduate Medical Education fellowships within a single field have a shared curriculum. Using the same terminology for other medical providers may be seen as equating their post-training competency with physicians who have completed fellowship training. As the authors point out, there is a wide divergence in the clinical experience required to become a licensed practitioner among NPs, PAs, and physicians. As such, using the same terminology for their respective training programs makes it difficult for the public to differentiate between them.

References

1. Klimpl D, Franco T, Tackett S, Cardin TE, Wolfe B, Wright S, Kisuule F. The current state of advanced practice provider fellowships in hospital medicine: a survey of program directors. J Hosp Med. 2019;14(7):401-406. https://doi.org/10.12788/jhm.3191.

References

1. Klimpl D, Franco T, Tackett S, Cardin TE, Wolfe B, Wright S, Kisuule F. The current state of advanced practice provider fellowships in hospital medicine: a survey of program directors. J Hosp Med. 2019;14(7):401-406. https://doi.org/10.12788/jhm.3191.

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Daniel Rauch MD, FAAP, SFHM; E-mail: drauch@tuftsmedicalcenter.org; Telephone: 617-636-7243
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