The market for pediatric surgeons: A survey of recent graduates

Purpose: The aim of this study was to identify the demand for pediatric sur geons as perceived and experienced by recent graduates of North American tr aining programs. Methods:A survey questionnaire was mailed to every pediatric surgeon who ha d completed a certified training program in the United States or Canada bet ween 1992 and 1997; 84% of the 165 responded. The data were then analyzed u sing univariate and bivariate statistics and content analysis. Results: The number trained has risen since 1992 from 21 to 35 per year, ex ceeding previous definitions of need. However, recently trained pediatric s urgeons found positions, and their first-year incomes had risen oven the 6- year period. In contrast, just 54% found first positions in the type of hos pital desired, and the percent working in a children's hospital dropped fro m 65% in 1992 to 32% in 1997; 34% cover between four and ten hospitals. The majority of those in practice for more than 2 years expressed the percepti on of a decline in market demand with just 30% of those 1996 to 1997 gradua tes perceiving a strong market. The clinical scope of practice was less tha n that for which they were trained. Three specified complex cases were mana ged by fewer than 30% of recent graduates during practice despite more than 60% having had fellowship experience. The scope of practice, as measured b y variables of index procedures, was strongly associated with hospital type (children's or general) and by practice region. Although satisfaction with practice is lower for each successive class, 96% of the graduates were sat isfied with their training programs, and 98% believed they had been well pr epared, although 46% indicated they desired some additional training. Sixty -one percent believed the role of pediatric surgeons will change over the n ext 5 years. Conclusions: The market demand was strong as measured by employment and inc ome. This was in contrast to the striking recent changes in the market for new pediatric surgeons, including a migration of practice from children's t o general hospitals, a reduced scope of practice, a more negative perceptio n of the pediatric surgery market, and concerns for narrowing of the specia lty. J Pediatr Surg 34:931-939. Copyright (C) 1999 by W.B. Saunders Company .