The urology work force in Ontario for the 21st century: feast or famine?

To address the issues of work-force planning and modelling in the 21st century for the specialty of urology in the Province of Ontario.

Data (from 1991 to 1995) regarding urology physician resources were gathered from Health Canada, the Royal College of Physicians and Surgeons of Canada, the Ontario Physician Human Resources Data Centre, the Canadian Post-M.D. Education Registry, the System for Health Area Resource Planning (SHARP) database, the Canadian Institute for Health Information and the National Physician Database. Specifically, the age and gender breakdown of currently active Ontario urologists, measures of urologist clinical activity (from Ontario Hospital Insurance Plan billings and questionnaires), inputs into and exits from the active urologist population were gathered, and estimates of future needs for urologist services, based on current population and demographic models, were made. A model to predict the balance between future needs for urology services and future supply of urologists was then created and validated against data drawn from the SHARP database.

The model revealed that there will be a significant shortage of urologists in Ontario in the immediate and long-term future; by the year 2010 there will be a shortfall of 101 urologists in Ontario, or 51% of the total needed.

Enlarging the urology training programs in Ontario would help to minimize the estimated shortfall. Systematic modelling of physician work-force needs for the future is necessary for the optimal allocation of health care resources. The methodology of the urology work-force model is generalizable to physician work-force planning for other specialty groups on a provincial or national basis.