Elsevier

The Journal of Pediatrics

Volume 157, Issue 5, November 2010, Pages 844-847.e1
The Journal of Pediatrics

Original Article
Variability of the Pediatric Subspecialty Workforce in Canada

https://doi.org/10.1016/j.jpeds.2010.05.015Get rights and content

Objective

To assess the regional variability of the pediatric subspecialty workforce in the academic health science centers in Canada, because effective and efficient delivery of specialized pediatric health care depends on the pediatrician workforce.

Study design

This was an analysis of the pediatric subspecialty workforce database of the Pediatric Chairs of Canada for the surveys obtained between 2003/04 and 2005/06.

Results

In 2003/2004, 960 pediatrician specialists who spent a majority of their time supporting clinical, educational, research, and administrative activities within the 16 Canadian medical schools were reported. In 2004/05, this figure was 1044, and in 2005/06, it was 1140. The growth was due predominantly to increases in physician workforce in the fields of emergency medicine, respiratory medicine, and neonatology. The average academic pediatric workforce, excluding general pediatricians, increased from 12.86/100 000 child population in 2003/04 to 13.99 in 2004/05 and 15.27 in 2005/06. Substantial regional variability exists, with 4-fold differences in academic pediatrician workforce among the low-supply provinces (Saskatchewan, British Columbia, and Ontario) and high-supply provinces for both total workforce and subspecialists.

Conclusions

The substantial variability in the supply of pediatric subspecialists across Canada requires additional analysis to determine any relationship to child health outcomes.

Section snippets

Methods

In the autumn of 2004, 2005, and 2006, Canadian medical schools reported the number of physicians working in their departments who were credentialed as a pediatrician or pediatric subspecialist by either the Royal College of Physicians and Surgeons of Canada or the Medical College of Québec, using consensus definitions of academic faculty.4 In brief, a physician had to have a status of at least 50% time spent in the academic institution. No adjustment was made for the full-time equivalent (FTE)

Results

There were 960 pediatric subspecialists in 2003/04, 1044 in 2004/05, and 1140 in 2005/06. Consistent with provincial population distribution, ON had the largest number of physicians, followed by PQ, AB, and British Columbia (BC).

Since 2003, when 1109 pediatric academic physicians were reported (with general pediatricians included in that particular count),4 the pediatric academic workforce has grown moderately, to 1316 academic pediatricians in 2005/06 (including general pediatricians; data not

Discussion

Overall, our data illustrate great variability in the distribution of specialized pediatricians in Canada. Compared with the distribution of the general population, Canadian physicians are more highly concentrated in urban areas; this is particularly so for specialists. Fewer than 16% of family physicians and only 2.4% of specialists are located in rural and small town Canada (using the Statistics Canada definition of rural), where 21.1% of the overall population resided in 2004.8 Importantly,

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    • This database was established through the Paediatric Chairs of Canada and funded by its members. There was no specific funding for the analysis. The authors declare no conflicts of interest.

    ∗

    List of Paediatric Chairs of Canada is available at www.jpeds.com (Appendix).

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