Background/Purpose: Many countries face a shortage of rheumatologists. Based on an accepted benchmark of 1 specialist per 50,000 people as the number needed for effective patient care1, recent figures show severe shortages in the U.S.2and Canada.3This qualitative environmental scan was designed to identify what faculty, administrators and learners associated with Canadian postgraduate rheumatology programs identify as appropriate means and messages that programs could use to attract future trainees.
Methods: Individual-level data from program faculty (F), administrators and learners (L) across Canada (n = 103) were collected via an online survey (n=78) and interviews (n = 25). Data were subjected to Thematic Framework Analysis to identify commonalities across sites to determine ways to address the rheumatology manpower shortage. Quotes are provided as examples.
Results:
Participants: There were 103 respondents from nine programs including learners (medical students, junior residents (PGY1-3) rheumatology residents (PGY4-6) or new graduates); program and division directors and their assistants; and faculty in academic centres or community practices. Two-thirds of the survey respondents were female.
Ways to Increase Interest in Rheumatology: The need for rheumatologists was widely recognized. Respondents advocated targeting both undergraduates (“People who influenced me were [role models] I had as a medical student” [F]) and junior residents in Internal Medicine. Proposed methods included increasing exposure to rheumatology in undergraduate programs through formal lectures and courses, clinical skills and other hands-on training sessions, faculty available to shadow or mentor learners and postgraduate weekend information and training sessions, mandatory rotation for Internal Medicine residents, internships and career counseling.
Messaging to Promote Rheumatology: Messages to brand rheumatology as an attractive specialty included the intellectual challenge (“This field fascinates me” [L]; “novel immunotherapies make it very exciting” [F]), stimulating workday (“nice mix of procedural and cerebral work” [L]), positive relationships with colleagues and patients (“According to a recent survey we are the happiest specialists” [F]), alleviating suffering (“We know how to treat arthritis now” [L]), good quality of life and excellent job prospects (“the health care system needs you” [F]).
Conclusion:
We found consensus on the need to inform potential trainees about rheumatology early in their education through a variety of messages and methods. Because of the shortage of rheumatologists it is important to increase awareness and information about the field by selectively using limited resources. The next step would be to collaboratively develop, test and evaluate tools designed to help increase the number of future rheumatologists, which will be applicable in many locales.
References: 1Karolinska Institutet/i3 Innovus. (2009) (http://www.comparatorreports.se/RA%20 Barrier%20Report_FINAL_050110.pdf); 2Deal et al. (2007). Arthritis & Rheumatism 56(3):722-729; : 32012 CMA Masterfile (www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/ 02SpecAge.pdf
Disclosure:
A. Cividino,
None;
V. Bakowsky,
None;
S. Barr,
None;
L. Bessette,
None;
N. Khalidi,
None;
C. A. Pineau,
None;
J. E. Pope,
None;
D. Robinson,
None;
K. Shojania,
None;
E. Yacyshyn,
None;
L. Lohfeld,
None;
D. Crawshaw,
None.
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