The future of the pediatric workforce has been the subject of significant dialogue in the pediatric community and generated much discussion in the academic literature. There are significant concerns regarding the ability of pediatricians to meet the growing demands of our pediatric population. Over the past 5 years, there has been a decline in the percentage of doctor of osteopathic medicine students who pursue a career in pediatrics but an equally important increase in the number of pediatric positions that are filled by doctor of osteopathic medicine students and international medical graduates. Although there has been an increase in the number of pediatric positions offered in the National Resident Matching Program, the last 4 years have seen a significant increase in the number of unfilled pediatric positions. A number of pediatric subspecialties struggle to fill their training positions, and those with low match rates may have 20% to 40% fewer applicants than positions. The pediatric vision for the future must include a commitment to a comprehensive strategic planning process with the many organizations involved across the multiple stages of the educational continuum. It is time to elucidate and address the questions raised by the workforce data. Developing solutions to these questions will require a careful planning process and a thoughtful analysis of the pediatric workforce data. Establishing this as an important priority will require a major collaborative effort between pediatric academic and professional organizations, but the future benefit to the nation’s children will be significant.
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RE: Subspecialty Pediatric Docs
Thank you for your observation regarding the presence of nurse practitioners in the community and their potential role in the pediatric subspecialty workforce. There are many excellent systems that utilize advanced practice providers, including nurse practitioners, as integral parts of the health care team. Whether the pediatric nurse practitioner workforce will continue to add depth to the pediatric workforce has been the subject of a recent review suggesting that we may soon experience a critical shortage of pediatric nurse practitioners.(1) This is an important topic that must continue to be addressed by leaders in our nurse practitioner training programs. I also appreciate your suggestion to provide alternative training opportunities for the practicing pediatrician and this is certainly worthy of further discussion. As suggested by Turner and colleagues there may be an important role for programs such as MOCA-Peds to enhance the education of practicing pediatricians.(2) Preliminary results from the MOCA-Peds pilot highlight the impact on self-reported learning and the attainment of knowledge that led to an important number of changes in the clinical practice of pediatricians who participated in the pilot. Might this be an opportunity for us to design programs such as MOCA-Peds to further enhance the skills of the busy pediatric clinician? As we carefully consider strategies to support the pediatric workforce we should also recognize the important role of lifelong learning in augmenting the knowledge and skills of those practitioners who are entrusted to meet the current and future needs of the children we serve.
1. Gigli KH, Beauchesne MA, Dirks MS, Peck JL. White Paper: Critical Shortage of Pediatric Nurse Practitioners Predicted. J Pediatr Health Care. 2019 May-Jun;33(3):347-355
2. Turner AL, Olmsted M, Smith AC, Dounoucos V, Bradford A, Althouse L, Leslie LK. Pediatrician Perspectives on Learning and Practice Change in the MOCA-Peds 2017 Pilot. Pediatrics. 2019 Dec;144(6):e20192305