Reducing Trainee Stress by Delaying the Pediatric Fellowship Start Date.

* Abbreviations:\n ABP — : American Board of Pediatrics\n COBRA — : Consolidated Omnibus Budget Reconciliation Act\n CoPS — : Council of Pediatric Subspecialties\n DIO — : designated institutional official\n FPD — : fellowship program director\n\nGraduating residents are under contract until June 30 and may be assigned patient care responsibilities up until this date. However, those pursuing subspecialty training are often expected to begin fellowship on July 1, posing a significant hardship, especially for those who must relocate to another region. In addition, many programs require incoming fellows to attend institutional orientation while they are still residents.1 Thus, programs and trainees must make difficult decisions that potentially disregard contractual obligations, jeopardize patient care, and limit orientation, all adding to the stress of starting fellowship.2\n\nThere is no requirement for fellowships to start on July 1. In fact, since the 1990s, orthopedic surgical fellowships have begun on August 1. Delaying the fellowship start date would provide time for trainees to relocate, reduce stress and improve wellness, and allow for a more comprehensive orientation to the new environment.\n\nIn 2013, the Council of Pediatric Subspecialties (CoPS) convened a multispecialty action team to examine the current July 1 start date for fellowships and … \n\nAddress correspondence to Richard B. Mink, MD, MACM, Harbor–University of California, Los Angeles Medical Center, 1000 W Carson St, Box 491, Torrance, CA 90509. E-mail: rmink{at}ucla.edu