Teaching time in short supply: Preferred strategies for allocating traditional teaching duties among academic hospitalists across six institutions.

Abstract

Clinical growth is outpacing educational growth at academic medical centers (AMCs) reducing traditional teaching opportunities, especially in rapidly expanding fields like hospital medicine. Despite these pressures, little guidance exists on how leadership should allocate limited teaching time. To explore academic hospitalists' preferences for allocating traditional teaching time (i.e., time on services with interns and residents) amid clinical expansion. A cross-sectional survey of academic adult hospitalists at six large AMCs across the United States with survey responses and free-response questions analyzed qualitatively. Of 572 hospitalists surveyed, 156 academic hospitalists responded (27%). Respondents averaged 8.9 years' experience and spent 25% of their clinical time on traditional teaching services. Teaching was a strong professional priority: 74% rated it very or extremely important when considering new job positions, and 66% preferred it as their primary service role. Most respondents (81%) preferred a merit-based model that rewards teaching skill development and learner engagement beyond clinical care. An external recognition-based model (i.e., teaching evaluations) was also supported (64%), although respondents raised concerns about bias. Equal distribution, seniority-based, and split-group models were less favored. Only 6% of respondents preferred working exclusively on direct care services (i.e., a service without learners). In this exploratory sample, academic hospitalists highly value teaching but most spend little time on it. Hospitalists preferred a merit-based model, where faculty demonstrate their interest in and commitment to education by improving their teaching skills.