Pediatric cardiology: The “state of the heart”!

Abstract

Althouse and Stockman provide valuable insight into workforce issues in the field of pediatric cardiology. This subspecialty is popular among trainees, ranking as the fourth most-selected subspecialty. However, a serious problem for pediatric cardiology is its aging population of practitioners; the mean age is 50 years. This with the fact that an increasing number of young trainees are seeking part-time employment presents additional challenges. Two seemingly opposing forces are at work in shaping the future of pediatric cardiology. An increasing number of trainees are interested in a private practice setting or a more clinically focused job in academic medicine (29%). The current fellowship structure, however, is tailored for the young researcher, and the third year of the training program is devoted to research in the field. Some have suggested the need for a fourth year of training for fellows to learn more specialized clinical areas and research methodology. This discourages private practice as a career. At the same time, there are fewer young research scientists entering the field—this will ultimately result in less basic science and translational research being conducted in pediatric cardiology. Althouse and Stockman do not address these issues of increasing private practice as well as specialization in clinical medicine and research within the field of pediatric cardiology, due largely to limitations of available data. One issue that is unique to pediatric cardiology is its close tie to cardiovascular surgery. Advances in the field have often combined advances in surgery and medical care. This may be one reason why there are few pediatric cardiologists in rural areas. This also raises issues about regionalization of healthcare services and the ultimate influence that may have on the projection of workforce needs. The training centers of the future must solve these dilemmas and ensure that more individuals enter private practice where the demand exists and that fellows train in more specialized clinical areas such as interventional cardiology and electrophysiology as needed. Pediatric cardiology fellowship programs must also continue to train bright young minds so that they will pursue the basic research that will keep pediatric cardiology viable. More sophisticated data will be needed to assess true workforce trends and needs for the future.