Pediatric Anesthesiology Fellowship Positions: Is There a Mismatch?

Cladis, Franklyn P.; Lockman, Justin L.; Lupa, M. Concetta; Chatterjee, Debnath; Lim, Doyle; Hernandez, Michael R.; Yanofsky, Samuel D; Waldrop, William B.

doi:10.1213/ane.0000000000004431

Cited by 10 publications

(10 citation statements)

References 5 publications

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“…The best pre–COVID-19 data suggested that we were overtraining pediatric anesthesiologists and that trainees would outpace retirees by 2035. 20,21,30,31 Our findings that approximately 15% of pediatric anesthesiologists will likely retire earlier than planned and that 12% may retire later than planned challenges these previous workforce projections. Change in retirement planning was associated with number of years in practice, with those in mid-to-late career being the most affected.…”

Section: Discussionmentioning

confidence: 65%

The effects of COVID-19 on pediatric anesthesiologists: A survey of the members of the Society for Pediatric Anesthesia

Margolis

Strupp

Beacham

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has affected the personal and professional lives of all health care workers. Anesthesiologists frequently perform virusaerosolizing procedures (eg, intubation and extubation) that place them at increased risk of infection. We sought to determine how the initial COVID-19 outbreak affected members of the Society for Pediatric Anesthesia (SPA) on both personal and professional levels. Specifically, we examined the potential effects of gender and age on personal stress, burnout, sleep deprivation, anxiety, depression, assessed job satisfaction, and explored financial impact. METHODS: After receiving approval from the SPA Committees for Research and Quality and Safety and the Colorado Multiple Institutional Review Board, we e-mailed a questionnaire to all 3245 SPA members. The survey included 22 questions related to well-being and 13 questions related to effects of COVID-19 on current and future practice, finances, retirement planning, academic time and productivity, and clinical and home responsibilities. To address low initial response rates and quantify nonresponse bias, we sent a shortened follow-up survey to a randomly selected subsample (n = 100) of SPA members who did not respond to the initial survey. Response differences between the 2 cohorts were determined. RESULTS: A total of 561 (17%) members responded to the initial questionnaire. Because of COVID-19, 21.7% of respondents said they would change their clinical responsibilities, and 10.6% would decrease their professional working time. Women were more likely than men to anticipate a future COVID-19-related job change (odds ratio [OR] = 1.92, 95% confidence interval [CI], 1.12-2.63; P = .011), perhaps because of increased home responsibilities (OR = 2.63, 95% CI, 1.74-4.00; P < .001). Additionally, 14.2% of respondents planned to retire early, and 11.9% planned to retire later. Women and non-White respondents had higher likelihoods of burnout on univariate analysis (OR = 1.75, 95% CI, 1.06-2.94, P = .026 and OR = 1.82, 95% CI, 1.08-3.04, P = .017, respectively), and 25.1% of all respondents felt socially isolated. In addition, both changes in retirement planning and future occupational planning were strongly associated with total job satisfaction scores (both P < .001). CONCLUSIONS: The COVID-19 pandemic has affected the personal and professional lives of pediatric anesthesiologists, albeit not equally, as women and non-Whites have been disproportionately impacted. The pandemic has significantly affected personal finances, home responsibilities, and retirement planning; reduced clinical and academic practice time and responsibilities; and increased feelings of social isolation, stress, burnout, and depression/ anxiety.

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Section: Discussionmentioning

confidence: 65%

The effects of COVID-19 on pediatric anesthesiologists: A survey of the members of the Society for Pediatric Anesthesia

Margolis

Strupp

Beacham

et al. 2021

Anesthesia &Amp; Analgesia

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“…At the time the Task Force was commissioned, there was a concerning trend in unfilled pediatric anesthesiology fellowship positions. Cladis et al 22 highlighted how this mismatch between the total number of fellowship positions and matched candidates has progressively worsened since 2015 and impairs selectivity in the application process, especially if programs and their directors are encouraged to fill positions. Early in the Task Force work, there was discussion about whether recommendations should include changes to the number of pediatric anesthesiology fellowship programs/positions.…”

Section: Discussionmentioning

confidence: 99%

A Consensus-Driven Approach to Redesigning Graduate Medical Education: The Pediatric Anesthesiology Delphi Study

Ambardekar

Eriksen

Ferschl

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: Pediatric anesthesiology fellowship education has necessarily evolved since Accreditation Council for Graduate Medical Education (ACGME) accreditation in 1997. Advancements in perioperative and surgical practices, emerging roles in leadership, increasing mandates by accreditation and certification bodies, and progression toward competency-based education—among other things—have created pressure to enrich the current pediatric anesthesiology training system. The Society for Pediatric Anesthesia (SPA) formed a Task Force for Pediatric Anesthesiology Graduate Medical Education that included key leaders and subject matter experts from the society. A key element of the Task Force’s charge was to identify curricular and evaluative enhancements for the fellowship program of the future. METHODS: The Task Force executed a nationally representative, stakeholder-based Delphi process centered around a fundamental theme: “What makes a pediatric anesthesiologist?” to build consensus among a demographically varied and broad group of anesthesiologists within the pediatric anesthesiology community. A total of 37 demographically and geographically varied pediatric anesthesiologists participated in iterative rounds of open- and close-ended survey work between August 2020 and July 2021 to build consensus on the current state, known deficiencies, anticipated needs, and strategies for enhancing national educational offerings and program requirements. RESULTS: Participation was robust, and consensus was almost completely achieved by round 2. This work generated a compelling Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis that suggests more strengths and opportunities in the current Pediatric Anesthesiology Graduate Medical Education program than weaknesses or threats. Stakeholders agreed that while fellows matriculate with some clinical knowledge and procedural gaps, a few clinical gaps exist upon graduation. Stakeholders agreed on 8 nonclinical domains and specific fundamental and foundational knowledge or skills that should be taught to all pediatric anesthesiology fellows regardless of career plans. These domains include (1) patient safety, (2) quality improvement, (3) communication skills, (4) supervision skills, (5) leadership, (6) medical education, (7) research basics, and (8) practice management. They also agreed that a new case log system should be created to better reflect modern pediatric anesthesia practice. Stakeholders further identified the need for the development of standardized and validated formative and summative assessment tools as part of a competency-based system. Finally, stakeholders noted that significant departmental, institutional, and national organizational support will be necessary to implement the specific recommendations. CONCLUSIONS: A Delphi process achieved robust consensus in assessing current training and recommending future directions for pediatric anesthesiology graduate medical education.

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“…During this time, there was a concomitant decrease in pediatric cases at general hospitals and increase at pediatric hospitals. This change has been partly driven by the increase in pediatric anesthesiologists, as noted by the expansion of pediatric anesthesia fellowship programs in hospitals dedicated to pediatric care 47 . The increase in the number of specialty trained anesthesiologists will further encourage patients to have their ambulatory procedures managed at non-hospital locations where this high-level care can be delivered.…”

Section: Introductionmentioning

confidence: 99%

Pushing the Envelope

Young

Pollard

Shapiro

2021

Advances in Anesthesia

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Synopsis In 2018, over 23 million ambulatory surgeries were performed in the US, representing the continued trajectory of procedures moving from hospitals towards ambulatory facilities. The primary incentives are improved costs, convenience, and patient satisfaction. Careful evaluation of patients, procedures, costs, and outcomes is required to be successful. Due to the COVID-19 pandemic, surgeons and anesthesiologists must now pay attention to local, state, and federal guidelines developed to manage COVID-19: screening, testing, and PPE. A few positives have resulted from COVID-19: improved and more consistent facility hygiene, consistent mask usage, and social distancing. The rise of telemedicine in pre-anesthesia screening has facilitated Case flow, reducing same-day surgery cancellations while saving the everyone time and money.

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Pediatric Anesthesiology Fellowship Positions: Is There a Mismatch?

Cited by 10 publications

References 5 publications

The effects of COVID-19 on pediatric anesthesiologists: A survey of the members of the Society for Pediatric Anesthesia

The effects of COVID-19 on pediatric anesthesiologists: A survey of the members of the Society for Pediatric Anesthesia

A Consensus-Driven Approach to Redesigning Graduate Medical Education: The Pediatric Anesthesiology Delphi Study

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