Background: Pediatric Hospital Medicine (PHM) fellowship programs must train leaders to address local and systemic health care challenges. It is unknown how leadership development education is currently incorporated into PHM fellowship and which topics should be included in future training. Objective: To identify fellowship directors’ perspectives on which leadership development topics are currently taught to PHM fellows and which topics should be required education during PHM fellowship training. Methods: Based on literature review and expert consensus, we developed a survey instrument for PHM fellowship directors. This instrument evaluated current leadership development training within seven domains. A 5-point Likert scale measured level of agreement for required educational content. We assessed face validity of the survey using cognitive interviewing and pilot testing. We distributed this IRB-approved survey to 42 established fellowship directors using a RedCap survey. Follow-up emails were sent to nonresponding programs. Analyses included descriptive statistics using means, standard deviations and confidence intervals. Results: Of the 42 PHM Fellowship programs, 19 (45%) fellowship directors responded. These PHM programs were established an average of 8 years ago and 63% were associated with freestanding children’s hospitals (Table 1). Fellowship directors had an average of 4 years of experience in their current role and 69% were female. Fellowship programs provide education in 45% of 44 leadership development topics included in the survey. Most programs provide education within the practice improvement domain, covering 89% of topics. However, programs only cover 61% of topics in the professionalism domain, 50% of topics in the communication domain and less than 40% of topics in leadership, healthcare systems, diversity & inclusion, and business domains (Table 2). Fellowship director agreement about required educational content (Mean Likert Score ≥ 4) was present in 4 of 7 leadership development domains and 68% of educational topics. Conclusion(s): In the first survey of PHM fellowship directors about leadership development education, we found variation in current training despite agreement by fellowship directors about what should be required content. This study serves as a foundation for future curriculum development and efforts to develop a national consensus on leadership development education for PHM fellows.