Recent Graduates Experience Difficulty in Finding Positions Despite Apparent Need for More Pediatric Cardiologists in Canada.

There have been reports that pediatric cardiology is an increasingly competitive field and that it has become difficult for recent graduates to find employment. In Canada, empirical observations are consistent with these findings, but this has not been formally evaluated. The aim of this study was to survey pediatric cardiologists (PCs) on their perception of the current workforce in Canada. A survey was sent to PCs and trainee members of the Canadian Pediatric Cardiology Association in November 2017. Eligible nonmembers of the Canadian Pediatric Cardiology Association were also contacted with the help of Canadian program directors and division chiefs. A total of 68 of 83 PCs completed the survey (82%). The proportion of respondents reporting difficulties in finding a stable position in pediatric cardiology was 83% for those finishing training after 2014 compared with 33% between 2010 and 2014. There was a concomitant increase in the duration of additional subspecialization, which more than doubled after 2014. This contrasted with most PCs (57%) and division chiefs (86%) reporting being understaffed, and with a higher number of anticipated openings compared with available trainees. Division chiefs reporting being understaffed mostly attributed this to government regulations or institutional budgetary constraints. We observed a discrepancy between a perceived need for additional PCs and a reported increasing difficulty in finding employment by recent graduates. This coincided with an increasing number of additional subspecialization years by recent graduates. Institutional and government restrictions may contribute to this situation.

Des études ont montré que la cardiologie pédiatrique est un domaine de plus en plus concurrentiel. Conséquemment, les diplômés actuels ont du mal à trouver de l'emploi. Au Canada, des observations empiriques sont cohérentes avec ces conclusions, mais aucune évaluation formelle n'a été réalisée. L'objectif de la présente étude était de mener une enquête auprès des cardiologues pédiatres (CP) sur leur perception de la main-d'œuvre actuelle au Canada. En novembre 2017, nous avons envoyé un sondage aux CP et aux résidents membres de l'Association canadienne de cardiologie pédiatrique. Nous sommes également entrés en contact avec les non-membres admissibles de l'Association canadienne de cardiologie pédiatrique par l'intermédiaire des directeurs de programmes et des chefs de division. Soixante-huit des quatre-vingt-trois CP ont rempli l'enquête (82 %). Le pourcentage des répondants qui ont rapporté avoir des difficultés à trouver un poste stable en cardiologie pédiatrique était de 83 % chez ceux ayant terminé leur formation après 2014, alors que le pourcentage était de 33 % chez ceux ayant terminé leur formation entre 2010 et 2014. La durée des formations en surspécialité a augmenté de manière concomitante et a plus que doublé après 2014. Ces données entraient en contradiction avec les commentaires de la plupart des CP (57 %) et des chefs de division (86 %) qui, disaient manquer de personnel et avoir un nombre anticipé plus de postes vacants plus élevés que le nombre de résidents disponibles. Les chefs de division qui rapportaient manquer de personnel attribuaient principalement cela à des contraintes gouvernementales ou budgétaires. Nous avons observé des contradictions entre les besoins perçus pour des CP additionnels et la difficulté croissante que rapportent les diplômés actuels à trouver de l'emploi. Ceci coïncide avec un nombre croissant d'années supplémentaires de formation en surspécialisation. Des contraintes institutionnelles ou gouvernementales contribuent possiblement à cette situation.

Rationale and Design of the FREQUENCY Study: The Fetal Cardiac Registry of Québec to Improve Resource Utilization in Fetal Cardiology.

OBJECTIVE: Prenatal detection of congenital heart diseases (CHD) decreases morbidity and cost. To improve detections rates, most physicians refer pregnant women with high-risk pregnancies to fetal cardiologists even when there is no suspicion of CHD at the second trimester screening. This paper presents the rationale and detailed method of the Fetal Cardiac Registry of Québec to Improve Resource Utilization in Fetal Cardiology (FREQUENCY) study. The overall objective is to assess the impact of second trimester ultrasound screening (U/S) and referral pattern in fetal cardiology on detection rates, health care costs, and resource utilization, as well as perinatal morbidity and mortality. METHODS: This multicentre retrospective population-based cohort study will link fetal echocardiography data from all centres performing fetal echocardiography in Québec with administrative health care data. This data linking will allow the determination of a true denominator (all women in Québec who underwent second trimester U/S) with complete follow-up of up to 2 years for offspring. This protocol meets Canadian Task Force Classification II-2. RESULTS: The study investigators have collected and cleaned fetal echocardiography data for 24 259 eligible pregnancies referred to fetal cardiology. These data will be matched to approximately 860 000 pregnancies between 2007 and 2015. CONCLUSION: The results of the FREQUENCY study will shed light on the impact of the current prenatal CHD screening strategy in Canada.