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Assessment of physician training and prediction of workforce needs in paediatric cardiac intensive care in the United States

Published online by Cambridge University Press:  20 December 2021

Robin V. Horak Open the ORCID record for Robin V. Horak [Opens in a new window] ,
Bradley S. Marino ,
David K. Werho Open the ORCID record for David K. Werho [Opens in a new window] ,
Leslie A. Rhodes ,
John M. Costello ,
Antonio G. Cabrera ,
David S. Cooper ,
Shasha Bai ,
Sarah Tabbutt  and
Isabelle Rao
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Robin V. Horak*
Affiliation:
Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Anesthesia Critical Care, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Bradley S. Marino
Affiliation:
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
David K. Werho
Affiliation:
Department of Pediatrics, University of California San Diego School of Medicine, Rady Children’s Hospital, San Diego, CA, USA
Leslie A. Rhodes
Affiliation:
Department of Pediatrics, University of Alabama at Birmingham, Children’s Hospital of Alabama, Birmingham, AL, USA
John M. Costello
Affiliation:
Department of Pediatrics, Medical University of South Carolina College of Medicine, MUSC Shawn Jenkins Children’s Hospital, Charleston, SC, USA
Antonio G. Cabrera
Affiliation:
Department of Pediatrics, University of Utah College of Medicine, The Heart Center, Primary Children’s Hospital, Salt Lake City, UT, USA
David S. Cooper
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Shasha Bai
Affiliation:
Biostatistics Resource at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
Sarah Tabbutt
Affiliation:
Department of Pediatrics, University of California San Francisco School of Medicine, Benioff Children’s Hospital, San Francisco, CA, USA
Isabelle Rao
Affiliation:
Department of Management Science and Engineering, Stanford University, Stanford, CA, USA
David Scheinker
Affiliation:
Department of Management Science and Engineering, Stanford University, Stanford, CA, USA
Andrew Y. Shin
Affiliation:
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
Catherine D. Krawczeski
Affiliation:
Department of Pediatrics, The Ohio State University College of Medicine, The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA
*
Author for correspondence: R. Horak, MD, Department of Anesthesiology, Critical Care Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd. MS #3, Los Angeles, CA 90027, USA. Tel: 323-361-8202; Fax: 323-361-1001. Email: rhorak@chla.usc.edu
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Abstract

Objective:

To assess the training and the future workforce needs of paediatric cardiac critical care faculty.

Design:

REDCap surveys were sent May−August 2019 to medical directors and faculty at the 120 US centres participating in the Society of Thoracic Surgeons Congenital Heart Surgery Database. Faculty and directors were asked about personal training pathway and planned employment changes. Directors were additionally asked for current faculty numbers, expected job openings, presence of training programmes, and numbers of trainees. Predictive modelling of the workforce was performed using respondents’ data. Patient volume was projected from US Census data and compared to projected provider availability.

Measurements and main results:

Sixty-six per cent (79/120) of directors and 62% (294/477) of contacted faculty responded. Most respondents had training that incorporated critical care medicine with the majority completing training beyond categorical fellowship. Younger respondents and those in dedicated cardiac ICUs were more significantly likely to have advanced training or dual fellowships in cardiology and critical care medicine. An estimated 49–63 faculty enter the workforce annually from various training pathways. Based on modelling, these faculty will likely fill current and projected open positions over the next 5 years.

Conclusions:

Paediatric cardiac critical care training has evolved, such that the majority of faculty now have dual fellowship or advanced training. The projected number of incoming faculty will likely fill open positions within the next 5 years. Institutions with existing or anticipated training programmes should be cognisant of these data and prepare graduates for an increasingly competitive market.

Keywords

Paediatric cardiac intensive careattending physiciancongenital heart diseasefellowshipsworkforce predictionsICUpaediatric
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 11 , November 2022 , pp. 1748 - 1753
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Horak, RV, Alexander, PM, Amirnovin, R, et al. Pediatric cardiac intensive care distribution, service delivery, and staffing in the United States in 2018. Pediatr Crit Care Med 2020; 21: 797–803.CrossRefGoogle ScholarPubMed
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Horak, R, Bai, S, Marino, B, et al. Workforce demographics and unit structure in pediatric cardiac critical care in the United States. Crit Care Med 2021 Dec 3; 1–5. [Epub ahead of print].Google ScholarPubMed
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