The Current State of Pediatric Cardiac Anesthesiology Staffing in the United States.

Background: The population of patients with congenital heart disease has grown, but the supply of pediatric cardiac anesthesiologists has not kept pace. The Pediatric Anesthesia Leadership Council (PALC) and the Congenital Cardiac Anesthesia Society (CCAS) formed a task force to evaluate the current state of the specialty of pediatric cardiac anesthesia, including staffing, work environment, education, compensation, and career development.

Methods: Five task force working groups developed survey questions that explored 5 different aspects of a pediatric cardiac anesthesiologist's career. Surveys were completed by CCAS member faculty volunteers, division chiefs/directors of pediatric cardiac anesthesia programs, program directors of pediatric cardiac anesthesia fellowships, and fellowship graduates from the past 10 years.

Results: Survey completion rates were 77% (n = 86) for CCAS faculty, 52% (n = 58) for pediatric cardiac anesthesiology directors/division chiefs, 91% (n = 21) for pediatric cardiac anesthesiology fellowship directors, and 53% (n = 65) for 2013-2022 pediatric cardiac anesthesia fellowship graduates. Of CCAS faculty respondents, 31.4% (n = 27) are considering leaving pediatric cardiac anesthesia for a less stressful field. While most respondents reported being involved in academic activities, 34% (n = 29) do not receive nonclinical time. Only 35.3% (n = 30) of respondents receive formal mentorship and 44.7% (n = 38) of participants have been sponsored for leadership positions, research opportunities, or speaking engagements. The total number of anticipated hires in the next 5 years is 129; that number goes up to 194 in 10 years. The challenge in hiring was graded as 8/10 with 10 being the most challenging.

Conclusions: This survey provides important data about the current state of pediatric cardiac anesthesiology and the need to address staffing and academic support. With nearly one-third of those practicing in the field considering leaving the pediatric cardiac subspecialty and with the decreasing number of fellows per year, there is a significant cause for concern for staffing, especially when the demand for practitioners in this field is increasing. In addition, even though the majority of faculty reported being involved in academic activities, many do not receive academic time for these activities and less than half receive formal mentorship or have been sponsored for leadership positions, publications, research opportunities, or speaking engagements. Further work to recruit, retain, and develop pediatric cardiac anesthesiologists is warranted.