scholarly journals Canadian Pediatric Gastroenterology Workforce: Current Status, Concerns and Future Projections

2007 ◽  
Vol 21 (10) ◽  
pp. 653-664 ◽  
Author(s):  
Véronique Morinville ◽  
Éric Drouin ◽  
Dominique Lévesque ◽  
Victor M Espinosa ◽  
Kevan Jacobson

BACKGROUND: There is concern that the Canadian pediatric gastroenterology workforce is inadequate to meet health care demands of the pediatric population. The Canadian Association of Gastroenterology Pediatric Committee performed a survey to determine characteristics and future plans of the Canadian pediatric gastroenterology workforce and trainees.METHODS: Estimates of total and pediatric populations were obtained from the 2001 Census of Population, Statistics Canada (with estimates to July 1, 2005). Data on Canadian pediatric gastroenterologists, including clinical full-time equivalents, sex, work interests, opinions on workforce adequacy, retirement plans, fellowship training programs and future employment plans of fellows, were gathered through e-mail surveys and telephone correspondence in 2005 and 2006.RESULTS: Canada had an estimated population of 32,270,507 in 2005 (6,967,853 people aged zero to 17 years). The pediatric gastroenterology workforce was estimated at 9.2 specialists per million children. Women accounted for 50% of the workforce. Physician to pediatric population ratios varied, with Alberta demonstrating the highest and Saskatchewan the lowest ratios (1:69,404 versus 1:240,950, respectively). Between 1998 and 2005, Canadian pediatric gastroenterology fellowship programs trained 65 fellows (65% international trainees). Twenty-two fellows (34%) entered the Canadian workforce.CONCLUSIONS: The survey highlights the variable and overall low numbers of pediatric gastroenterologists across Canada, an increasingly female workforce, a greater percentage of part-time physicians and a small cohort of Canadian trainees. In conjunction with high projected retirement rates, greater demands on the work-force and desires to partake in nonclinical activities, there is concern for an increasing shortage of pediatric gastroenterologists in Canada in future years.

Neurology ◽  
2020 ◽  
Vol 94 (11) ◽  
pp. 495-500 ◽  
Author(s):  
Ahmed Z. Obeidat ◽  
Yasir N. Jassam ◽  
Le H. Hua ◽  
Gary Cutter ◽  
Corey C. Ford ◽  
...  

ObjectiveTo investigate the current status of postgraduate training in neuroimmunology and multiple sclerosis (NI/MS) in the United States.MethodsWe developed a questionnaire to collect information on fellowship training focus, duration of training, number of fellows, funding application process, rotations, visa sponsorship, and an open-ended question about challenges facing training in NI/MS. We identified target programs and sent the questionnaires electronically to fellowship program directors.ResultsWe identified and sent the questionnaire to 69 NI/MS fellowship programs. We successfully obtained data from 64 programs. Most programs were small, matriculating 1–2 fellows per year, and incorporated both NI and MS training into the curriculum. Most programs were flexible in their duration, typically lasting 1–2 years, and offered opportunities for research during training. Only 56% reported the ability to sponsor nonimmigrant visas. Most institutions reported having some internal funding, although the availability of these funds varied from year to year. Several program directors identified funding availability and the current absence of national subspecialty certification as major challenges facing NI/MS training.ConclusionOur study is the first to describe the current status of NI/MS training in the United States. We found many similarities across programs. We anticipate that these data will serve as a first step towards developing a standard NI/MS curriculum and help identify areas where shared resources could enhance trainee education despite differences in training environments. We identified funding availability, certification status, and nonimmigrant visa sponsorship as potential barriers to future growth in the field.


2014 ◽  
Vol 28 (2) ◽  
pp. 89-93 ◽  
Author(s):  
Jennifer G Stretton ◽  
Barbara K Currie ◽  
Usha K Chauhan

BACKGROUND/OBJECTIVE: Inflammatory bowel disease (IBD) is a chronic relapsing illness primarily including Crohn disease and ulcerative colitis. The disease course often fluctuates over time, and requires maintenance therapy and acute interventions to target disease flares. IBD management requires a multidisciplinary approach, with care from physicians, nurses, dieticians, social workers and psychologists. Because nurses play a pivotal role in managing chronic disease, the aim of the present study was to assess and determine how many nurses work primarily with IBD patients in Canada.METHODS: A 29-question survey was developed using an Internet-based survey tool (www.surveymonkey.com) to investigate nursing demographics, IBD nursing roles and nursing services provided across Canada. Distribution included the Canadian Society of Gastroenterology Nurses and Associates, the Canadian Association of Gastroenterology, Progress (AbbVie Corporation, USA) and BioAdvance (Janssen Inc, USA) coordinators (via e-mail), and online availability for 15 weeks.RESULTS: Of 275 survey respondents, 98.2% were female nurses, with 68.7% employed in full-time positions. Among them, 42.5% were between 51 and 60 years of age, and 32.4% were between 41 and 50 years of age. In addition, 53.8% were diploma-prepared registered nurses, 35.3% were Baccalaureate-prepared nurses and 4.4% were Masters-prepared nurses. Almost one-half (44% [n=121]) were employed in Ontario, followed by 19.6% (n=54) in Alberta and 9.1% (n=25) in British Columbia. All provinces were represented with the exception of Nunavut and the Northwest Territories. Forty-three per cent (n=119) of nurses identified as working in endoscopy units. Of the 90% who responded as working with IBD patients, only 30% (n=79) had a primary role in IBD care. Among these 79 nurses with a primary role in IBD care, 79.7% worked with the adult population, 10.1% with the pediatric population, and 10.1% worked with both adult and pediatric patients. Their major service was an outpatient setting (67.1%).CONCLUSIONS: Survey results showed that only a small percentage of Canadian gastroenterology nurses provide clinical IBD care. Many have multiple roles and responsibilities, and provide a variety of services. The exact depth of care and service is unclear and further study is needed.


Author(s):  
Sonali Basu ◽  
Robin Horak ◽  
Murray M. Pollack

AbstractOur objective was to associate characteristics of pediatric critical care medicine (PCCM) fellowship training programs with career outcomes of PCCM physicians, including research publication productivity and employment characteristics. This is a descriptive study using publicly available data from 2557 PCCM physicians from the National Provider Index registry. We analyzed data on a systematic sample of 690 PCCM physicians representing 62 fellowship programs. There was substantial diversity in the characteristics of fellowship training programs in terms of fellowship size, intensive care unit (ICU) bed numbers, age of program, location, research rank of affiliated medical school, and academic metrics based on publication productivity of their graduates standardized over time. The clinical and academic attributes of fellowship training programs were associated with publication success and characteristics of their graduates' employment hospital. Programs with greater publication rate per graduate had more ICU beds and were associated with higher ranked medical schools. At the physician level, training program attributes including larger size, older program, and higher academic metrics were associated with graduates with greater publication productivity. There were varied characteristics of current employment hospitals, with graduates from larger, more academic fellowship training programs more likely to work in larger pediatric intensive care units (24 [interquartile range, IQR: 16–35] vs. 19 [IQR: 12–24] beds; p < 0.001), freestanding children's hospitals (52.6 vs. 26.3%; p < 0.001), hospitals with fellowship programs (57.3 vs. 40.3%; p = 0.01), and higher affiliated medical school research ranks (35.5 [IQR: 14–72] vs. 62 [IQR: 32, unranked]; p < 0.001). Large programs with higher academic metrics train physicians with greater publication success (H index 3 [IQR: 1–7] vs. 2 [IQR: 0–6]; p < 0.001) and greater likelihood of working in large academic centers. These associations may guide prospective trainees as they choose training programs that may foster their career values.


Author(s):  
Josh Krushell

Though much literature has been produced on the topic of academic restructuring, those works concerned  with the Canadian context have mainly focused on issues of corporate­university linkages, the role of state coordination of public universities, and the disparity between funding and student enrollment. Very little work has been done in documenting or analysing the role of adjunct faculty, who now make up nearly half  the university faculty, in Canadian universities. Statistics Canada has only once collected data on part­time faculty, and only one current analysis of this data has been conducted (Omiecinski, 2003). The Canadian  Association of University Teachers, furthermore, only publishes data concerning full­time faculty  members. The implications of an emerging division between the use of full­time and part­time faculty on  the nature of academic work and the quality of post­secondary education has been yet unexamined. Drawing on labour market segmentation theory, this study presents the multiple ways in which the work of  academic staff in Canadian post­secondary education has conformed to the principles of the flexible firm model, first observed of private business firms in the 1980s by John Atkinson. A series of semi­structured  interviews with academic faculty and administrators, as well as a collection of current secondary source data, informed the basis of this research. It was found that the changing nature of academic work in post­  secondary education is negatively affecting the quality of undergraduate education provided in Canada.


PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 265-265
Author(s):  

The following statement was adopted by the Federation of Pediatric Organizations in February, 1990. The Federation consists of the following pediatric organizations: Ambulatory Pediatric Association, American Academy of Pediatrics, American Board of Pediatrics, American Pediatric Society, Association of Medical School Pediatric Department Chairmen, Association of Pediatric Program Directors, Society for Pediatric Research. The Federation supports the concept that "the principal goal of fellowship training should be the development of future academic pediatricians." Graduates of pediatric fellowship programs usually work in academic centers with significant time set aside for research. Some fellowship-trained pediatricians, particularly neonatologists, allergists, and neurologists, may not work in hospitals or ambulatory settings that are associated closely with academic programs. Fellowship-trained pediatricians in all settings should be encouraged to continue their interest in research to add to the body of pediatric knowledge. To achieve the goal of training pediatric scientists, the following guidelines for fellowship education are recommended: 1. Upon completion of a pediatric fellowship, the trainee should be proficient in clinical care, teaching, and research. Fellowship training should prepare a pediatrician to care for children with complex illnesses within his/her area of special expertise and to serve as a consultant for the general pediatrician. In addition, the fellowship-trained pediatrician should be responsible for the education of pediatric residents and the continuing education of practicing pediatricians. For this reason, fellowship training should include interpersonal skills and pedagogical techniques. 2. Research training should begin as soon as possible; premedical students, medical students, and pediatric residents should be encouraged strongly to participate in meaningful research, and research activities should be carried out throughout fellowship training.


PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. A8-A8

In 1990, the Federation of Pediatric Organizations adopted a statement on pediatric fellowship training.1 This revised statement represents the current position of the federation regarding the purpose and objectives of fellowship training. The federation continues to support the concept that "the principal goal of fellowship training should be the development of future academic pediatricians." Within academic and teaching centers, there is a need for master clinicians, skilled teachers, and productive investigators who conduct research with varied interests. Graduates of pediatric fellowship programs should be proficient in both direct and consultative clinical care, teaching, and a selected area of research. Thereafter, differentiation of interests and activities should be expected and encouraged, but graduates of the fellowship programs in all settings should continue their involvement in research, whether collaborative or direct, to add to the body of knowledge in their area of interest. The following guidelines for fellowships are recommended: 1. Fellowship training should prepare pediatricians to care for children with complex problems within their areas of special expertise and to serve as consultants. Fellows should participate directly in the care of patients and should serve as consultants, with guidance and supervision provided by senior clinical mentors. 2. Fellowship training should include the development of skills as an educator, including presentation skills, curriculum development, and evaluation. Fellows should participate in the education of pediatric residents and the continuing education of practicing pediatricians. 3. Each fellow should have a mutually agreed on research mentor(s). It is essential for the fellow to have mentor(s) capable of fostering the trainee's career development.


2019 ◽  
Author(s):  
Xin Chen ◽  
Liang Gao ◽  
Hu Zhang ◽  
Hong Chai

As a crucial part of China’s healthcare reform, the Chinese Standardized Residency Training Program was released in mainland China in 2013. At the end of 2014, 55000 resident physicians had been trained in 8500 residency programs from 559 hospitals across the country. In 2016, the national government initiated the Chinese Subspecialty Fellowship Training Program (CSFTP) with the aim to establish an initial framework of the training by 2020. On June 12, 2017, the Chinese Medical Doctor Association, directly affiliated with the National Health and Family Planning Commission of China, officially announced the first group of hospitals for the pilot phase of CSFTP in three subspecialties, including neurosurgery, respiratory and critical care medicine, and cardiovascular disease. This paper highlights the current status and challenges of chinese residency and fellowship training system.


2021 ◽  
Vol 13 (3) ◽  
pp. 377-384
Author(s):  
Taylor Sawyer ◽  
Megan Gray ◽  
Shilpi Chabra ◽  
Lindsay C. Johnston ◽  
Melissa M. Carbajal ◽  
...  

ABSTRACT Background A vital element of the Next Accreditation System is measuring and reporting educational Milestones. Little is known about changes in Milestones levels during the transition from residency to fellowship training. Objective Evaluate the Accreditation Council for Graduate Medical Education (ACGME) Milestones' ability to provide a linear trajectory of professional development from general pediatrics residency to neonatal-perinatal medicine (NPM) fellowship training. Methods We identified 11 subcompetencies that were the same for general pediatrics residency and NPM fellowship. We then extracted the last residency Milestone level and the first fellowship Milestone level for each subcompetency from the ACGME's Accreditation Data System on 89 subjects who started fellowship training between 2014 and 2018 at 6 NPM fellowship programs. Mixed-effects models were used to examine the intra-individual changes in Milestone scores between residency and fellowship after adjusting for the effects of the individual programs. Results A total of 1905 subcompetency Milestone levels were analyzed. The average first fellowship Milestone levels were significantly lower than the last residency Milestone levels (residency, mean 3.99 [SD = 0.48] vs fellowship 2.51 [SD = 0.56]; P &lt; .001). Milestone levels decreased by an average of -1.49 (SD = 0.65) from the last residency to the first fellowship evaluation. Significant differences in Milestone levels were seen in both context-dependent subcompetencies (patient care and medical knowledge) and context-independent subcompetencies (professionalism). Conclusions Contrary to providing a linear trajectory of professional development, we found that Milestone levels were reset when trainees transitioned from general pediatrics residency to NPM fellowship.


2019 ◽  
Vol 134 (2) ◽  
pp. 172-179
Author(s):  
Magali Angeloni ◽  
Ron Bialek ◽  
Michael P. Petros ◽  
Michael C. Fagen

Objective: The objectives of this study were (1) to obtain data on the current status of public health workforce training and the use of the Training Finder Real-Time Affiliate Network (TRAIN), a public health learning management platform, in state health departments, and (2) to use the data to identify organizational features that might be affecting training and to determine barriers to and opportunities for improving training. Methods: We conducted structured interviews in 2014 with TRAIN administrators and performance improvement managers (n = 14) from 7 state health departments that were using TRAIN to determine training practices and barriers to training. We determined key organizational features of the 7 agencies, including training structure, required training, TRAIN administrators’ employment status (full time or part time), barriers to the use and tracking of core competencies in TRAIN, training needs assessment methods, leadership support of training and staff development, and agency interest in applying for Public Health Accreditation Board accreditation. Results: We identified 4 common elements among TRAIN-affiliated state health departments: (1) underuse of TRAIN as a training tool, (2) inadequate ownership of training within the organization, (3) insufficient valuation of and budgeting for training, and (4) emerging collaboration and changing perceptions about training stimulated by agency preparation for accreditation. Conclusions: Public health leaders can increase buy-in to the importance of training by giving responsibility for training to a person, centralizing training, and setting expectations for the newly responsible training leader to update training policy and require the use of TRAIN to develop, implement, evaluate, monitor, and report on agency-wide training.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Haiko Kurt Jahn ◽  
James Kwan ◽  
Gerard O’Reilly ◽  
Heike Geduld ◽  
Katherine Douglass ◽  
...  

Abstract Background The number of Global Emergency Medicine (GEM) Fellowship training programs are increasing worldwide. Despite the increasing number of GEM fellowships, there is not an agreed upon approach for assessment of GEM trainees. Main body In order to study the lack of standardized assessment in GEM fellowship training, a working group was established between the International EM Fellowship Consortium (IEMFC) and the International Federation for Emergency Medicine (IFEM). A needs assessment survey of IEMFC members and a review were undertaken to identify assessment tools currently in use by GEM fellowship programs; what relevant frameworks exist; and common elements used by programs with a wide diversity of emphases. A consensus framework was developed through iterative working group discussions. Thirty-two of 40 GEM fellowships responded (80% response). There is variability in the use and format of formal assessment between programs. Thirty programs reported training GEM fellows in the last 3 years (94%). Eighteen (56%) reported only informal assessments of trainees. Twenty-seven (84%) reported regular meetings for assessment of trainees. Eleven (34%) reported use of a structured assessment of any sort for GEM fellows and, of these, only 2 (18%) used validated instruments modified from general EM residency assessment tools. Only 3 (27%) programs reported incorporation of formal written feedback from partners in other countries. Using these results along with a review of the available assessment tools in GEM the working group developed a set of principles to guide GEM fellowship assessments along with a sample assessment for use by GEM fellowship programs seeking to create their own customized assessments. Conclusion There are currently no widely used assessment frameworks for GEM fellowship training. The working group made recommendations for developing standardized assessments aligned with competencies defined by the programs, that characterize goals and objectives of training, and document progress of trainees towards achieving those goals. Frameworks used should include perspectives of multiple stakeholders including partners in other countries where trainees conduct field work. Future work may evaluate the usability, validity and reliability of assessment frameworks in GEM fellowship training.


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