A Survey of Program Directors on Neonatal-Perinatal Medicine Fellowship Training in the United States: Programmatic Structure, Learning Environment, and Wellness Activities.

We aim to describe the current programmatic structure and learning environment of US neonatal-perinatal medicine (NPM) fellowship programs.All U.S. NPM program directors (PDs) and associate program directors (APDs) were surveyed. Descriptive statistics for quantitative questions and thematic qualitative analysis of free-text responses were used to summarize findings.Out of 102 programs 99 (97%) responded. Out of 99 PDs 25 (25%) reported not receiving minimum ACGME full-time equivalent (FTE) for program administration. Fellows perform a median of 52 weeks (48-54) and 150 (120-165) night calls during training, with clinical time skewing more toward the 1st year. All programs report interaction with front-line clinicians (FLCs), and 81% (80/99) of fellowships reported conflict between fellows and FLCs. A minority of programs formally evaluated or instructed FLCs on teaching skills. PDs and APDs most commonly lead the planning of wellness activities, with only 37% of programs describing a fellow wellness leader. A minority of programs reported wellness committees at the university (40%), department (19%), or division (17%) level. About 25% of programs reported no wellness budget.Broadened institutional support toward program requirements and administration and further collaborative efforts with trainees and multidisciplinary providers are opportunities for growth in NPM fellowship programs. · Program administration time varies in NPM fellowships, with 25% below ACGME FTE standards.. · Benchmarking clinical service time shows varied exposure, with more clinical focus in year one.. · Fellow and front-line clinician conflict exists; efforts to improve this dynamics are needed.. · Many programs support fellow wellness, but limited funding and support remain key barriers..