Reported Clinical Hours Among Pediatric Critical Care K Award Recipients Versus Division Directors

Introduction: Career development awards (National Institutes of Health K awards) are integral to the development of clinical scientists, providing physicians protected time from clinical duties to develop methodologic expertise and preliminary data under the guidance of an established mentor. However, the interpretation of the mandated “9 person-months” of protected time for K award recipients is challenging in the critical care environment given its 24-hour clinical coverage and lack of standardized clinical full time equivalent (cFTE) definition. We compared clinical hours worked during the K award period as reported by pediatric critical care medicine (PCCM) K award recipients and division directors.


Methods: We conducted a cross-sectional survey of PCCM physicians who received K award between 2014-2023 and current PCCM division directors at institutions who had a PCCM K awardee. Participants were asked about award and institutional characteristics and work hours, which were standardized to the number of hours worked per year. As survey results were not paired between cohorts, we used the Wilcoxon Rank Sum test to compare the reported hours worked (overall and night shift hours) between division directors and K award recipients. Additionally, we fit a linear regression model to account for the number of PCCM faculty reported in each institution


Results: Overall, 40 of 60 (66.7%) division directors and 102 of 122 (83.6%) K award recipients completed the survey. In total, 60% (n=24) of division directors led an independent research program and 37.5% (n=15) had previously received a K award. Division directors reported significantly fewer hours worked overall (median 678 [IQR 460-804] vs. 980 [IQR 770-1127]; p< 0.001) and night shift hours (median 241 [IQR 178-331] vs. 340 [IQR 270-480]; p< 0.001) during the K award compared to recipients. Division directors reported 318 (95% CI 429, 207) fewer hours worked overall and 117 (95% CI 201, 34) fewer night shift hours by K awardees than the recipients themselves.


Conclusions: Significant variation exists in the reported hours worked by K awardees between PCCM division directors and award recipients. Efforts to standardize cFTE expectations may provide additional support to the development of independent clinician scientists within pediatric critical care.