Impact of the 2025 Accreditation Council for Graduate Medical Education Pediatric Residency Changes on the Pediatric Hospital Medicine Workforce

OBJECTIVE: The 2025 Accreditation Council for Graduate Medical Education (ACGME) changes to the pediatric residency curriculum may impact the clinical workforce caring for hospitalized children. Prior to these changes, we sought to assess how pediatric hospital medicine (PHM) leaders anticipated the changes would impact staffing, clinical operations, and career satisfaction for their groups. METHODS: In 2024, we developed and distributed a survey to Hospital Medicine division directors asking about their pre-ACGME changes to staffing models, any anticipated ACGME change-related staffing adjustments and accommodation plans. The survey included questions on perceived group career satisfaction and institutional support. Data were analyzed using descriptive statistics, and open-ended responses were categorized. RESULTS: Of 165 distinct PHM programs, leaders from 101 PHM programs completed surveys. Regarding residency staffing related changes, 31% of leaders anticipated a decrease in pediatric resident presence on PHM services, and 23% were unsure about changes in resident presence. Most PHM leaders (70%) were contemplating, exploring, or implementing the hiring of hospitalists prior to the ACGME's execution of residency changes. Anticipated staffing changes, increased hiring of advanced practice providers, and increased current hospitalist shift coverage were all significantly correlated with leaders' concern for decreased hospitalist career satisfaction. CONCLUSION: PHM group leaders anticipated additional staffing hires prior to the implementation of the 2025 ACGME pediatric residency changes. Increased workload and staffing concerns correlated with lower anticipated career satisfaction, highlighting the need for additional support for PHM groups.