• Vishruti Patel, Angela Keniston, Lauren McBeth, Sagarika Arogyaswamy, Catherine Callister, Khooshbu Dayton, Neelam Mistry, Sarah Mann, and Marisha Burden.
• University of Colorado School of Medicine, Aurora, Colorado (V.P.).
• Ann. Intern. Med. 2023 Nov 1; 176 (11): 152615351526-1535.

BackgroundClinical growth is outpacing the growth of traditional educational opportunities at academic medical centers (AMCs).ObjectiveTo understand the impact of clinical growth on the educational mission for academic hospitalists.DesignQualitative study using semistructured interviews that were analyzed using a mixed inductive and deductive method at the semantic level.SettingLarge AMCs across the United States that experienced clinical growth in the past 5 years.ParticipantsDivision heads, section heads, and other hospital medicine (HM) leaders who oversaw and guided academic and clinical efforts of HM programs.MeasurementsThemes and subthemes.ResultsFrom September 2021 to January 2022, HM leaders from 17 AMCs participated in the interviews, and 3 key themes emerged. First, AMCs' disproportionate clinical growth highlighted the tension between clinical and educational missions. This included a mismatch in supply and demand for traditional teaching time, competing priorities, and clinical growth being seen as both an opportunity and a threat. Second, amid the shifting landscape of high clinical demands and evolving educational opportunities, hospitalists still strongly prefer traditional teaching. To address this mismatch, HM groups have had to alter recruitment strategies and create innovative solutions to help build academic careers. Third, participants noted a need to reimagine the role and identity of an academic hospitalist, emphasizing tailored career pathways and educational roles spanning well beyond traditional house staff teaching teams.LimitationThe study focused on large AMCs.ConclusionAlthough HM groups have implemented many creative strategies to address clinical growth and keep education front and center, challenges remain, particularly heavy clinical workloads and a continued dilution of traditional teaching opportunities.Primary Funding SourceSociety of Hospital Medicine Student Scholar Grant.

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