Protected Time for Research Among Academic Hospitalists: a Qualitative Study of Hospitalist Group Leaders

BackgroundProtected time is an important determinant of scholarly success in academic hospital medicine but is a limited resource.ObjectiveTo explore how hospitalists procure protected time for scholarship from the perspective of academic hospital medicine leaders.DesignQualitative, thematic analysis of in-depth, semi-structured interviews.ParticipantsTen division leaders of academic hospital medicine groups in the USA (3 female, 7 male).ApproachThematic analysis, from a realist paradigm, of individually conducted interviews to explore how hospitalists obtain protected time with a focus from the leaders' perspectives on sources and strategies. Division leaders of groups known to have a reputation for regularly publishing peer-reviewed scholarship were purposively sampled and a snowball sampling technique was used to identify subsequent participants. Trustworthiness was verified by member-check with a subgroup of participants.Key ResultsHospitalists wanting to pursue research must often start by utilizing personal time. Protected time from divisions is allocated to an individual, a project, or as administrative time. Sources of protected time are conceptualized as a hierarchy, beginning with personal time, and moving through divisional support, intramural support, and, principally for research track hospitalists, extramural support. Scaling the hierarchy is a process of demonstrating productivity and employing tactics to align projects with goals of the funders. Accessing the extramural funding tier is predicated on structured skills training, which is often acquired in early career and thus generally inaccessible to hospitalists not on a predetermined research track.ConclusionsThe prevailing paradigm for accessing protected time is one which encourages and rewards pursuing research work during non-work hours. As a hospitalist becomes more senior, the focus shifts from proving earnestness to becoming adept at navigating the institutional system as insiders.