Industry Electives in Clinical Informatics Fellowship: Early Experiences from a Multi-Institution Survey

Clinical informatics (CI) fellowship training equips physicians to design, implement, and evaluate health information systems in support of patient care. While core curricula emphasize academic health system experiences, fellows may benefit from exposure to industry settings where much health technology innovation originates.This study aimed to characterize the structure, perceived value, and logistical challenges of industry electives among CI fellowship programs and to synthesize best practices for integrating these experiences into training.We surveyed current and former CI fellows and their program directors from two Accreditation Council for Graduate Medical Education (ACGME)-accredited programs between September 2024 and March 2025. To be included, fellows were required to complete at least 4 weeks of an industry elective. Free-text responses were analyzed using inductive thematic analysis. A consensus-driven process was used to generate practical considerations for program design.Eight fellows reported on industry electives at non-health-center sites such as startups, vendors, and standards bodies. Their responses revealed four themes: (1) Enhanced skill development and exposure to technologies and workflows not available in academic settings; (2) logistical barriers, including limited institutional support, short duration, and complex legal agreements; (3) tangible deliverables such as dashboards, analytic tools, abstracts, and grants; and (4) professional networking that often shaped career trajectories, with some fellows receiving job offers. Practical considerations included identifying partner sites, designating supervisors, negotiating agreements early, defining objectives and deliverables, and addressing financial and logistical support.Industry electives provide career-shaping experiences for CI fellows, expanding exposure to innovation and fostering collaboration between academia and industry. With clear objectives, aligned competencies, and institutional support, these rotations can strengthen training and prepare fellows for diverse roles across health care and technology.