American Academy of Pediatrics Technical Report

The effective and efficient delivery of children’s health care depends on the pediatrician workforce. The number, composition, and distribution of pediatricians necessary to deliver this care have been the subject of long-standing policy and professional debate. This technical report reviews current characteristics and recent trends in the pediatric workforce and couples the workforce to a conceptual model of improvement in children’s health and well-being. Important recent changes in the workforce include (1) the growth in the number of pediatricians in relation to the child population, (2) increased numbers of female pediatricians and their attainment of majority gender status in the specialty, (3) the persistence of a large number of international medical graduates entering training programs, (4) a lack of ethnic and racial diversity in pediatricians compared with children, and (5) the persistence of marked regional variation in pediatrician supply. Supply models projecting the pediatric workforce are reviewed and generally indicate that the number of pediatricians per child will increase by 50% over the next 20 years. The differing methods of assessing workforce requirements are presented and critiqued. The report finds that the pediatric workforce is undergoing fundamental changes that will have important effects on the professional lives of pediatricians and children’s health care delivery. Pediatrics 2005; 116:e156–e173. URL: www.pediatrics.org/cgi/doi/10.1542/ peds.2005-0874; child health workforce, diversity, family medicine, female pediatricians, geographic distribution, health manpower, internal medicine-pediatrics, international medical graduates, nonphysician clinicians, physician workforce, pediatrics, pediatric medical subspecialists, pediatric surgical specialists. ABBREVIATIONS. AAP, American Academy of Pediatrics; FOPE II, Future of Pediatric Education II; ABP, American Board of Pediatrics; AMA, American Medical Association; GME, graduate medical education; IMG, international medical graduate; medpeds, internal medicine-pediatrics; FTE, full-time equivalent; HMO, health maintenance organization; GMENAC, Graduate Medical Education National Advisory Committee; GDP, gross domestic product.