263 - Trends in Pediatric Resident and Fellow Attrition, 2007-2020

Poster Number: 263
Publication Number: 263.1202

Background: Preliminary data (2023-2024) released by the Association of American Medical Colleges shows a decline in applications to pediatric residency programs and pediatric fellowships. Pediatric subspecialists play a critical role in providing advanced care to children, particularly those with complex or rare conditions, and contribute significantly to the development of cutting-edge research in pediatric medicine. It is projected that by 2032, there will be significant shortages of healthcare professionals in primary care and various specialty disciplines, including pediatrics. The attrition of pediatric residents and fellows is an essential factor in understanding the future of the pediatric subspecialty workforce, but there is limited existing research on this topic.

Objective: The primary objective of this study is to evaluate the trends in pediatric resident and fellow attrition over time period of 2007-2020.

Design/Methods: Repeat cross-sectional study of pediatric resident and fellow attrition using data from the Accreditation Council for Graduate Medical Education Databooks from 2007 to 2020. The rate of attrition and exact 95% confidence intervals were calculated for the overall group and by specialty. To assess change among the years, logistic regression was used to model the rates; p-values < 0.05 are assumed to be statistically significant.

Results: Comparing 2020 to years prior, the overall transfer rate of pediatric trainees was 10.1/1000 (p < 0.0001), the withdrawal rate was 4.7/1000 (p=0.03) and the dismissal rate was 1.9/1000 (p=0.0068). (Table 1, Figure 1, Figure 2) Additionally, the odds of not completing training in Pediatric cardiology (p=0.0086), Pediatric Critical Care (p < 0.0001), and Neonatal-Perinatal Medicine (p=0.012) have significantly decreased during the study period.

Conclusion(s): Pediatric resident and fellow attrition may negatively affect individual trainees, the future pediatric workforce, and healthcare systems’ ability to meet the needs of the pediatric population. Future research is essential to understanding the evolving trends in pediatric resident and fellow attrition.