Concerns regarding the pediatric workforce: what are we missing?

Concerns about the adequacy of the pediatric physician workforce have intensified in recent years, yet many proposed solutions may not address some of the most critical underlying issues. This manuscript challenges prevailing assumptions-particularly the emphasis on financial compensation as a primary deterrent to entering pediatrics-and recommends a broader, evidence-based exploration of factors influencing specialty and subspecialty choice. While economic disparities between pediatricians and adult care providers are real and must be addressed, other influences may play a significant role in specialty selection among medical students and subspecialties among pediatric residents. There is a need to go beyond the study of those who chose pediatrics and turn instead to those who specifically did not choose pediatrics (and by extension chose other specialties). To grow the specialty, we need to find out what, precisely, would have made pediatrics, or one of the pediatric subspecialties, more attractive to them. We must also begin to grapple with the growing gender imbalance in the specialty and its impact on workforce adequacy. IMPACT: It is more helpful to look at longer term trends than focusing on yearly fluctuations in match rates. It may be helpful to learn from those who did not choose pediatrics what influenced that decision. There may be modifiable and non-modifiable inherent aspects to pediatrics which make it less attractive to some medical students. From a workforce perspective, there is a need to address the gender imbalance in pediatrics. There is a need to set workforce goals, not only to find problems.