372 - A Qualitative Study of PHM Leaders’ Perceptions of the 2025 ACGME Pediatric Residency Changes on the Pediatric Hospital Medicine Workforce

Publication Number: 4364.372

Anika Kumar, Cleveland Clinic Children's, Cleveland, OH, United States; Kelsey Jackson, Nationwide Children's Hospital, Columbus, OH, United States; Danni Liang, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Rachel Peterson, Cincinnati Children's Hospital Medical Center, Wyoming, OH, United States

Background: The pediatric hospital medicine (PHM) workforce has experienced noteworthy changes and growth over the past few decades. On July 1, 2025, the Accreditation Council for Graduate Medical Education (ACGME) implemented changes to pediatric residency programs, allowing for greater individualization of resident experiences. The ACGME changes have led some institutions to rely on hospitalists to provide increased coverage of hospitalized patients.

Objective: The purpose of our qualitative study was to understand the perceptions of PHM group leaders regarding the ACGME residency changes on
1. The PHM workforce,
2. Hospitalist career satisfaction,
3. Future opportunities for the PHM workforce.

Design/Methods: To understand the anticipated impact of the ACGME residency changes, we invited PHM leaders to participate in focus groups prior to the implementation of the 2025 ACGME changes. Focus groups were facilitated using a semi-structured interview guide derived from prior research and the study team's expertise.
Using a rapid qualitative approach, we developed templated summaries and a matrix analysis. The study team summarized focus group content directly from recordings, supplemented with transcriptions and field notes. Each focus group was summarized by 2 or more team members; the summaries were then used to create the matrix. Team members followed a structured mixed deductive and inductive approach to analyze the matrix. Focus group themes and sub-themes were discussed until the team reached consensus.

Results: There were 7 focus groups with a combined total of 18 participants. Focus group demographics are shared in Table 1. 5 subthemes and 12 subthemes were identified. Table 2 includes the themes, subthemes, and illustrative quotes.
This qualitative study highlights how the ACGME pediatric residency changes, directly and indirectly, may be impacting the PHM workforce. Decisions external to PHM impact clinical, educational, and operational work within PHM and vice versa. Hospital systems heavily rely on the PHM workforce's adaptability, demonstrating the value and wide skillset of PHM as a subspecialty. As a result of the ACGME residency changes, PHM groups must develop and navigate plans to modify the hiring and preparedness of the future workforce (physicians and APPs). PHM's future will require leaders to collaborate and advocate, locally and nationally, to intentionally grow the field.

Conclusion(s): PHM leaders believe there are multiple ways that the 2025 ACGME residency changes are impacting or may impact the PHM workforce currently and in the future.

Table 1: Demographic Data of the 18 PHM Leaders who participated in focus groups


Table 2: Qualitative themes and subthemes from PHM leaders around ACGME pediatric residency changes and the impact on PHM