Medical schools fail to produce enough pediatric specialists while one in six doctors can’t find a job: study

Tom Blackwell | Jan 6, 2013 7:49 PM ET
More from Tom Blackwell | @tomblackwellNP

Getty/Thinkstock. Twice the number of pediatric neurologists were being taught as needed, for instance, yet half as many neonatologists — the doctors who treat premature and sick newborns — are being trained as hospitals are expected to require.

 

Medical schools across Canada are training far too many doctors for some pediatric specialities — but failing to produce enough in other key areas of child health care, concludes a new study that starkly illustrates the surprising disconnect between physician education and real-world demands.
The findings are symptomatic of an “astonishing” problem that has left many freshly minted doctors unemployed, even as patients continue to face long wait lists in some areas, says an official with the national body that oversees specialty accreditation.

The authors of the new study, including heads of university pediatric departments, compared the number of medical graduates training in various pediatric sub-specialties with the projected demand in those areas. There was a close match in just one of 16 sub-specialites.

Twice the number of pediatric neurologists were being taught as needed, for instance, yet half as many neonatologists — the doctors who treat premature and sick newborns — are being trained as hospitals are expected to require.

While cautioning that the results were based on projections of demand and are not definitive, the researchers call it the first attempt to gauge how well pediatric training programs respond to what the system needs.

The findings raise the question of whether medical graduates should be encouraged to choose specialties based on projected needs, rather than “personal passion for a particular area,” they say.
University administrators “have a social and moral responsibility to guide the future deployment of pediatricians based on the precise health care needs of this vulnerable population,” the paper, just published in the journal Pediatrics and Child Health. “It is neither ethically or fiscally responsible to train individuals without knowledge of workforce requirements.”

Their conclusions emerge as many newly graduated Canadian physicians continue to face what would have seemed like an unheard-of problem just a few years ago — the prospect of not being able to find a job.

Getty/ThinkstockThe findings raise the question of whether medical graduates should be encouraged to choose specialties based on projected needs, rather than “personal passion for a particular area,” researchers say.

 

Surveys by the Royal College of Physicians and Surgeons indicate that one in six doctors just finished their residencies — training periods of two to five years following medical school — cannot find a position, said Danielle Fréchette, head of the college’s health policy department. While some physicians — like family doctors and psychiatrists — can simply hang out a shingle and start billing medicare, surgeons and others who work with expensive equipment and support staff usually must find a position with a hospital or health region.

Research by the college — which certifies specialists in Canada — indicates there is unemployment or underemployment in 13 specialties, including cardiac surgery, neurosurgery, plastic surgery, orthopedic surgery, otolaryngology, urology, gastroenterology, adult neurology, dermatology, general surgery, ophthalmology, pediatric infectious diseases and radiation oncology.

The reasons are complex, but in at least two specialties — cardiac surgery and neurosurgery — the number of trainees has not been reduced in tandem with the shrinking demand for the specialists, said Ms. Fréchette. Yet she notes that waiting lists continue to be a problem; although there is reputed to be a glut of orthopedic surgeons, she has been forced to “waddle about” for a year waiting to get a hip replacement.

“I just find it absolutely astonishing that, with the information technology potential, we can’t do a better job,” said Ms. Fréchette. “That’s because we don’t have a commitment, a concerted commitment to try to get this done right.”

The Royal college is planning a summit meeting next year to address the problems and find ways to better match residency positions with projected demand, said Ms. Fréchette. The key is to have a national program to monitor health human resources, and cooperation between those who train and those who employ physicians, she said.

The pediatric training study looked at the number of students in various pediatric sub-specialities as of 2009-10, then projected the need for their services based in part on the number of doctors retiring over the ensuing five years at 16 academic hospitals across Canada.

The researchers, including pediatrics professors at the Laval, Queen’s and Western Ontario medical schools, admitted the study had a number of limitations, including the fact it did not adjust for changes in population, or pediatricians being trained in other countries.

National Post

tblackwell@nationalpost.com