Pediatric dermatology workforce challenge

Key Points

Editor's note:

Pediatric dermatology is a subspecialty that offers unique satisfactions, as well as specific challenges. As part of this month's "Special Report," Dermatology Times looks at recently instituted board certification and accredited, standardized fellowships that are helping to insure quality among practitioners (See story, "The little subspecialty that could"). Still, supply doesn't meet the current demand for these graduates. On another front, experts worry about the off-label use of often-powerful drugs in pediatric patients (See, "A shot in the dark").

The SPD Workforce Taskforce is currently finalizing a survey manuscript and is aiming for publication in an upcoming edition of Pediatric Dermatology, according to Kent Lindeman, SPD executive director.

Presenting and publishing the workforce survey is the first step in the subspecialty's mission to build a stronger presence, says survey author Richard Antaya, M.D., associate professor, dermatology and pediatrics, director of pediatric dermatology at Yale University, School of Medicine, New Haven, Conn., and co-chair of the SPD's Workforce Taskforce.

The survey, circulated to more than 125 dermatology programs in the United States and Canada, asks many questions, including whether there is, indeed, a shortage, and what the academic and clinical needs are in the field.

"We feel that (this survey's findings represent) the first step toward getting more pediatric dermatologists in academic centers," Dr. Antaya says. "Because once you get them there, you hit sort of a critical mass, and then they are recognized.

"If you have a program that has no pediatric dermatologists, there is no way to know about the specialty."

Shortage defined

Pediatric dermatologists struggle - uphill - to meet the needs of even academic medical centers, let alone the needs of patients, according to Amy S. Paller, M.D., endowed professor and chairman of dermatology and professor of pediatrics at Northwestern University Feinberg School of Medicine, Chicago.

"In the last few years, we have established a board in pediatric dermatology and have formalized fellowship training, but the numbers of fellows coming out every year is, on average, less than eight, and there are more than a dozen positions available, so we're not coming anywhere close to meeting that need," she says.

About 38 percent of programs surveyed by the SPD indicated that the current number of pediatric dermatology faculty at their institutions was inadequate for their training needs, according to Dr. Paller.

About 61 percent indicated that the current faculty numbers were inadequate to meet the clinical demand.

Dr. Paller, who presented the survey's findings at last year's Association of Professors of Dermatology meeting, says about 70 percent of the institutions responding to the survey had at least one pediatric dermatologist on faculty, with a total of 105 pediatric dermatologists on faculty at 57 institutions.

Seventy-six percent of such programs search more than a year for a pediatric dermatologist, according to the SPD survey.

"There are now 14 approved pediatric dermatology fellowship programs, and, currently, seven of those programs have a fellow, with eight people graduating this June. There were about 34 positions open at the time of the survey," Dr. Paller says. "So, the demand is much higher than the supply."