Growth and changes in the pediatric medical subspecialty workforce pipeline

Abstract

Background To inform discussions of pediatric subspecialty workforce adequacy and characterize its pipeline, we examined trends in first-year fellows in the 14 American Board of Pediatrics (ABP)-certified pediatric medical subspecialties, 2001–2018. Methods Data were obtained from the ABP Certification Management System. We determined, within each subspecialty, the annual number of first-year fellows. We assessed for changes in the population using variables available throughout the study period (gender, medical school location, program region, and program size). We fit linear trendlines and calculated χ 2 statistics. Results The number of first-year pediatric medical subspecialty fellows increased from 751 in 2001 to 1445 in 2018. Fields with the growth of 3 or more fellows per year were Cardiology, Critical Care, Emergency Medicine, Gastroenterology, Neonatology, and Hematology Oncology ( P value <0.05 for all). The number of fellows entering Adolescent Medicine, Child Abuse, Infectious Disease, and Nephrology increased at a rate of 0.5 fellows or fewer per year. Female American Medical Graduates represented the largest and growing proportions of several subspecialties. Distribution of programs by region and size were relatively consistent over time, but varied across subspecialties. Conclusions The number of pediatricians entering medical subspecialty fellowship training is uneven and patterns of growth differ between subspecialties. Impact The number of individuals entering fellowship training has increased between 2001 and 2018. Growth in the number of first-year fellows is uneven. Fields with the greatest growth: Critical Care, Emergency Medicine, and Neonatology. Fields with limited growth: Adolescent Medicine, Child Abuse, Infectious Disease, and Nephrology. Concerns about the pediatric medical subspecialty workforce are not explained by the number of individuals entering the fellowship.

Addressing Social Determinants of Health and Mitigating Health Disparities Across the Lifespan in Congenital Heart Disease: A Scientific Statement From the American Heart Association

“…There are no complete data on diversity among pediatric cardiology professional subspecialties, because even recent articles on the workforce pipeline in pediatrics address proportions of women and men in the pediatric subspecialty workforce, but not URMs. 78 There also are no general population data available on the race and ethnicity of the pediatric or patients with congenital HD populations. Multiple studies show differential outcomes for patients with congenital HD from different racial and ethnic groups, but these are based on specific procedures or administrative data, and do not reflect the whole population.…”

Moving the Needle Toward Fair Compensation in Pediatric Nephrology

“…Pediatric nephrology training remains one of the most stagnant professions of all the pediatric subspecialty workforce, with one of the highest unfilled training position rates amongst all specialties. Data from the American Board of Pediatrics Interactive Workforce database indicate that the pediatric nephrology trainee pipeline only increased on average by 0.5 or less trainees per year from 2001 to 2018 ( 3 ), which is in stark contrast to the fields of cardiology, neonatology, critical care medicine, and hematology-oncology who are experiencing rapid growth, and many more applicants than positions exist. The training program fill rates for pediatric nephrology have ranged from 41.5 to 73.9% over the past 5 years ( 4 ), with FY21 match data showing substantial improvement over prior years, although it is too early to determine if this is an anomaly due the COVID-19 pandemic or a true trendline.…”

Essentials of Neonatal–Perinatal Medicine Fellowship: careers in Neonatal–Perinatal Medicine

“…Neonatology has had the most growth of any pediatric subspecialty over the past 20 years [18]. The number of NPM fellowship programs and first-year fellowship positions increased between 2016 and 2020, but fellowship applications decreased by 17% between 2015 and 2019 [19].…”

“…Although the number of practicing neonatologists has increased, the average age rose from 53.7 to 57 years between 2008 and 2015 [17], suggesting an aging workforce. Over the last 20 years, female American medical graduates drove the growth in the field [18]. Women now represent 75% of NPM fellows.…”