National Academic Paediatric Workforce Database
In Canada, health care and education are primarily a Provincial responsibility; however, some Federal funding encourages support of the principles and standards of a national health care system.
Over the last several decades, new technology, new pharmaceuticals, advances in health care, changing expectations, altered patterns of health care delivery, growing gaps in the availability service providers, the demographics of an aging population and an increasingly competitive funding environment have challenged health practitioners, health care administrators, educators and academic health centers.
Collaboration to facilitate benchmarking, innovation, efficiency, effectiveness, patient safety, rationalization of health care delivery and human resource planning has become increasingly essential.
In 1993, the 16 Chairs of Pediatrics in Canada initiated an annual survey of pediatric specialists and sub-specialists who practiced within their Medical Schools and compiled the first nation-wide population-based academic pediatric workforce database.
Over the last decade, the Paediatric Chairs of Canada (PCC) improved the accuracy of the survey data by developing standardized physician career activity profiles (Clinician Specialist/Teacher, Clinician Educator, Clinician Scientist/Investigator, Clinician Administrator) and reporting criteria.
To obtain a clear picture of the geographic distribution, subspecialty mix and actual roles of physicians, data are reported as both a raw number of physicians in clinical educational, research or administrative roles in each discipline and as the number of subspecialty practitioners for the actual population < 18 years of age at each academic center, within each Province and nationally.
PCC also collect data on the number of pediatric clerkship, resident and subspecialty traineeships by discipline at each of the 16 academic health centers and are beginning to relate that to our projected workforce needs and strategies to better match supply and demand.
Lastly, PCC is collecting common utilization indicators that provide a benchmark for physician productivity and an accountability measure to justify a) the expansion of pediatric resident and subspecialty pediatric training programs and b) the physician resources that the academic pediatric centers require.
Of approximately 2500 pediatricians in Canada, a total of 1,109 (510 female) spend a majority of their time supporting the clinical, educational, research and administrative activity within the 16 Canadian Medical Schools. With rare exception, this includes all of the pediatric sub specialists.
The majority (69%, n = 768) of pediatricians appointed to academic departments of Pediatrics function as Clinician Specialist/Teachers. Of the remainder, Clinician Scientists/Investigators made up a further 17% (n = 185) of academic department members.
Clinician Educators in Canada have frequently obtained Masters or doctorate level training in education and have major educational development and research roles in addition to traditional bedside teaching activities. This emerging group of academic pediatricians account for 8% (n = 85) of the total pediatric workforce.
Clinical Administrators were less than 5% (n = 52) of the workforce. Non-pediatric sub specialists who spent the majority of their time consulting in pediatrics represented only 2% (n = 20) of the total.
The majority of Canada's academic pediatricians are actively engaged in the delivery of specialized child health care and the clinical supervision of undergraduate and post graduate medical trainees. Overall, the data indicate a relative paucity of academic researchers and educators.