Survey of U.S. Fellows Suggests Exposure to Hematology in Medical School, Mentorship Vital to Future of the Field
ASH reinforces commitment to future of
hematology workforce by commissioning three-year longitudinal study
Published on: October 31, 2019
31, 2019) – A survey of U.S. hematology-oncology fellows suggests medical
school plays an important role in shaping their interest in pursuing careers in
hematology, particularly when students are exposed to hematology and oncology
as part of core clerkships in internal medicine and pediatrics. The study, funded by
the American Society of Hematology (ASH) and published today in Blood Advances, also indicates
that having a hematologist as a mentor during medical education and training is
associated with an increased likelihood of fellows specializing in hematology
when they complete their hematology-oncology fellowship.
also found that one out of three fellows from the classes of 2018-2020
indicated they were interested in hematology-only careers, with only 4% indicating
an interest in focusing on non-malignant hematology.
findings give us a better understanding of why trainees pursue hematology and
suggests ways we can be proactive to ensure the supply of hematologists keeps
up with demand, particularly in non-malignant blood diseases, such as sickle
cell disease, hemophilia, and other bleeding and clotting disorders,” said
Alfred Lee, MD, PhD, senior author of the study and a hematologist at Yale
School of Medicine in New Haven, Connecticut.
leads the recruitment and retention working group at ASH, which was created to
examine the workforce and spearhead the Society’s efforts to ensure a strong
pipeline of talent in hematology, specifically non-malignant hematology.
manuscript published today is the first report of a three-year longitudinal
study that began in 2018 in partnership with the Fitzhugh Mullan Institute for
Health Workforce Equity at George Washington University in Washington, DC. Of
1,899 U.S. hematology/oncology fellows surveyed (representing the classes of 2018-2020),
44.7% responded, and those responses were equally distributed across the three
years of fellowship. Researchers compared the educational, mentorship, and job
market experiences among fellows who planned to enter hematology-only careers (encompassing
both malignant and non-malignant hematology), oncology-only careers (focused on
malignant hematology and solid tumors), or both/undecided specialties.
found that 42% of fellows first considered a career in hematology-oncology
before or during medical school, while 32% first considered these career types
of fellows reported having a hematology-oncology rotation as part of their core
internal medicine or pediatrics clerkships in medical school.
who co-authored papers or engaged in other research related activities with
mentors in hematology were significantly more likely to pursue careers in
hematology than fellows who did not have those types of mentorship experiences.
who planned to pursue careers focused in hematology were significantly more
likely to have been encouraged to pursue a career in hematology during internal
medicine residency training and to have had increased clinical exposure to
hematology during fellowship.
past 25 years, the fellowship training landscape has changed dramatically.
While in 1995 there were 74 accredited U.S. hematology training programs and 75
hematology-oncology programs, in 2018, there were only two single-specialty
hematology programs compared to 146 combined hematology-oncology programs.
changing landscape of hematology fellowship programs over time is a concern for
ASH, as fellows may not be receiving adequate preparation and exposure to
hematology patients with non-malignant diseases, which are often complex and
require specific expertise to manage,” said Dr. Lee. “This effort demonstrates
that the Society is being proactive in ensuring the future of the field is
strong. Already, ASH has committed to several initiatives to address the issues
highlighted by the survey results.”
these initial findings, ASH will hold two summits in 2020: one focused on strategies
for increasing the number of single-track hematology fellowship programs, and
another focused on strengthening mentorship in the field. ASH has also expanded
its ASH Ambassadors Program, which enlists faculty members at institutions to
serve as formal ASH representatives to promote the Society’s career development
and training programs to trainees.
“By conducting this survey of hematology and
oncology fellows, ASH gained important actionable insights on how to foster
interest in the field, such as increasing the availability of mentorship
programs and identifying strategies for increasing exposure to hematology and
oncology during medical school,” said Clese Erikson, M.P.Aff., Principal
Investigator of the ASH workforce study, and lead research scientist at the
Fitzhugh Mullan Institute for Health Workforce Equity at George Washington
this year, ASH and the Fitzhugh Mullan Institute for Health Workforce Equity at
George Washington University surveyed 2,500 randomly selected licensed U.S.
hematology-oncology practitioners. The survey results and analysis are
addition, ASH and the Fitzhugh Mullan Institute for Health Workforce Equity at
George Washington University are in the process of collecting data for year two
of the study, which includes surveying all of ASH’s US resident and medical
student members, and re-surveying the fellowship class of 2020 (now in its
second year of fellowship) and the fellowship graduating class of 2018 (now in
the workforce) to understand how career preferences may change over time.
The American Society of Hematology (ASH) (www.hematology.org)
is the world’s largest professional society of hematologists dedicated to
furthering the understanding, diagnosis, treatment, and prevention of disorders
affecting the blood. For more than 60 years, the Society has led the
development of hematology as a discipline by promoting research, patient care,
education, training, and advocacy in hematology. ASH publishes Blood (www.bloodjournal.org),
the most cited peer-reviewed publication in the field, and Blood Advances (www.bloodadvances.org),
an online, peer-reviewed open-access journal.
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Andrea Fischer, American Society of Hematology