Understanding the Decline of Pediatric Endocrinology Workforce and the Path Forward

Area of Science:

• Pediatric Endocrinology
• Medical Workforce Analysis
• Healthcare Disparities

Background:

• Rising incidence of pediatric type 1 and type 2 diabetes, endocrine, and lipid disorders.
• Increasing demand for pediatric endocrinology services.
• Growing concerns about healthcare access in underserved areas.

Purpose of the Study:

• To evaluate the pediatric endocrinology and diabetes workforce shortage.
• To identify key contributing factors to the crisis.
• To propose actionable strategies for workforce revitalization.

Main Methods:

• Analysis of pediatric endocrinology fellowship trends (2015-2025): applicant numbers, position availability, and fill rates.
• Examination of systemic and structural factors impacting recruitment, retention, and provider well-being.
• Review of financial compensation, training duration, and clinical workload.

Main Results:

• Despite increased positions, fellowship applicants have declined by 4.6%, with nearly one-third of positions remaining unfilled.
• Low financial compensation, significant medical education debt, prolonged training, and high workload contribute to burnout and a widening workforce gap.
• Fewer medical students entering pediatrics exacerbates the shortage and leads to maldistribution, impacting access to care, especially in rural areas.

Conclusions:

• The pediatric endocrinology workforce is at a critical juncture, requiring urgent intervention.
• Key strategies include improving compensation, expanding loan forgiveness, and reforming reimbursement models.
• Integrating endocrinology education, recognizing nonclinical work, and expanding telemedicine are essential for revitalizing the workforce and meeting patient needs.