University of Alberta, Edmonton, Alberta, Canada.
Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
J Pediatr Surg. 2023 Jul;58(7):1351-1356. doi: 10.1016/j.jpedsurg.2023.02.044. Epub 2023 Feb 23.
Graduate and fellowship training trends for Canadian pediatric surgeons remain uncharacterized. Similarly, updated workforce planning for pediatric surgeons is required. We aimed to characterize graduate degree and fellowship trends for Canadian pediatric surgeons, with modelling to inform workforce planning.
We performed a cross sectional observational study evaluating Canadian pediatric surgeons in January 2022. Surgeon demographics collected included year of medical degree (MD) conferment, MD location, fellowship location, and graduate degree achievement. Our primary outcome was to evaluate training characteristics over time. Secondary outcomes evaluated surgeon supply and demand from 2021 to 2031. Supply was extrapolated from current Canadian pediatric surgery fellows assuming static fellowship matriculation, while retirement was estimated using a 31-, 36-, or 41-year career following MD conferral.
Of included surgeons (n = 77), 64 (83%) completed fellowship training in Canada and 46 (60%) have graduate degrees. No surgeons graduating ≤1980 hold graduate degrees, compared to 8 (100%) surgeons with MD ≥ 2011 (p < 0.001). Similarly, more surgeons with MD ≥ 2011 appear to have a Canadian MD (n = 7, 87.5%) and Canadian fellowship (n = 8, 100%). Modelling predicts that 19-49 (25%-64%) surgeons will retire between 2021 and 2031, while 37 fellows will graduate with intention to work in Canada, creating between a 12 surgeon deficit up to an 18 surgeon surplus depending on career length.
Trends in graduate degree achievement and fellowship location suggest increasing competition for Canadian pediatric surgery positions. Additionally, a substantial number of Canadian-trained fellows will need positions outside of Canada in the next decade. Overall, results support previous work demonstrating saturation of the Canadian pediatric workforce.
Level IV.
Medical Knowledge.
加拿大儿科外科医生的研究生和住院医师培训趋势仍不明确。同样，需要更新儿科外科医生的劳动力规划。我们旨在描述加拿大儿科外科医生的研究生学位和住院医师培训趋势，并进行建模以提供劳动力规划信息。
我们在 2022 年 1 月进行了一项横断面观察性研究，评估了加拿大的儿科外科医生。收集的外科医生人口统计学数据包括医学博士（MD）授予年份、MD 地点、住院医师地点和研究生学位获得情况。我们的主要结果是评估随时间变化的培训特征。次要结果评估了 2021 年至 2031 年的外科医生供应和需求。供应是从当前的加拿大儿科外科住院医师中推断出来的，假设住院医师的入学人数保持不变，而退休则是根据 MD 授予后的 31 年、36 年或 41 年的职业生涯进行估计的。
在所纳入的外科医生（n=77）中，64 名（83%）在加拿大完成了住院医师培训，46 名（60%）拥有研究生学位。与 2011 年及以后获得 MD 的 8 名（100%）外科医生相比，≤1980 年毕业的外科医生中没有拥有研究生学位的（p<0.001）。同样，越来越多的 2011 年及以后获得 MD 的外科医生似乎拥有加拿大 MD（n=7，87.5%）和加拿大住院医师培训（n=8，100%）。建模预测，2021 年至 2031 年间，19-49 名（25%-64%）外科医生将退休，而 37 名住院医师将毕业并打算在加拿大工作，这取决于职业生涯的长短，外科医生的短缺人数将达到 12 名，最多可能出现 18 名的剩余。
研究生学位获得和住院医师培训地点的趋势表明，加拿大儿科外科职位的竞争日益激烈。此外，在未来十年内，相当数量的加拿大培训的住院医师将需要在加拿大以外的地方工作。总的来说，结果支持了之前表明加拿大儿科劳动力饱和的工作。
IV 级。
美国毕业后医学教育认证委员会（ACGME）能力涵盖：医学知识。
