The Division of Workforce and Medical Education Policy guides the Academy in the advocacy and development of public policy related to the health care workforce and the education of physicians. The Division collaborates with federal agencies, regulatory authorities, and other health care organizations engaged in policy development to address the following topics: medical education funding, the regulation of the physician workforce through federal legislation and appropriations, the scope of practice of non-physicians, the diversity of the physician and patient populations, physician retirement patterns, and physician reentry into practice.
The Division also staffs the Committee on Pediatric Workforce (COPW), which formulates AAP workforce policy, and the Committee on Pediatric Education (COPE), which serves as a think tank of content experts on educational issues from medical school through continuing medical education. Descriptions of other Division-led initiatives can be found below.
The AAP Workforce Survey of Medical Subspecialty and Surgical Specialty Sections and Councils
The Division of Workforce and Medical Education Policy launched the AAP Workforce Survey of Medical Subspecialty and Surgical Specialty Sections. These surveys are intended to fill large gaps in knowledge related to the pediatric medical subspecialty/pediatric surgical specialty workforce, and will greatly enhance the Academy’s advocacy efforts at many levels and in many venues. View the list of the Sections and Councils that have signed on to participate.
Match Day 2013
On March 15, 2013, medical school graduates were
matched to their residency programs through the National Resident
Matching Program. View a PowerPoint outlining how Pediatrics performed in the match and read an AAP News article of this year’s Match results.
Demographics of Women in Medicine
provides current and comparative date for women physicians and women pediatricians.
AAP Supports Expansion of Pediatric Subspecialty and Surgical Specialty Workforce ("Health Care Workforce Loan Repayment Programs")
The AAP has taken a strong, proactive stand in advocating for full funding of Section 775 of the Public Health Service Act. This program provides loan repayments for pediatric medical specialists and pediatric surgical specialists and for child and adolescent mental and behavioral health professionals. The AAP Pediatric Workforce Policy Statement states: “Many hospital regions in the United States lack pediatric medical subspecialists and surgical specialists, and primary care pediatricians report difficulty obtaining pediatric medical subspecialty and surgical specialty care for their patients. The shortage of mental health subspecialists (eg, child psychiatrists, developmental/ behavioral pediatric specialists) is especially critical, because it is estimated that approximately 21% of children in the United States meet criteria for a mental health disorder. In letters (April 2013, August 2013) supporting this legislation, it has been noted that, “. . . reauthorizing the pediatric subspecialty and pediatric mental health specialist loan repayment program is an important step in encouraging students to choose careers in pediatric subspecialties and pediatric mental health care.”
Pediatric Subspecialty Workforce Shortage Presentation
The National Governors Association Center for Best Practices requested AAP participation in a Webinar covering issues in the pediatrician workforce. The Divisions of Workforce and Medical Education Policy and State Government Affairs, took the lead in preparing an extensive PowerPoint presentation regarding shortages in the pediatric subspecialty workforce and an overview of the pediatric workforce, which was delivered by Mary Ellen Rimsza, MD, FAAP, current chair of the COPW. The presentation addressed subspecialty workforce shortages, the reasons behind the shortages, and successful strategies that states have used to address them. Health policy staff in governors' offices nationwide attended the Webinar and archives were sent to AAP chapters for further dissemination. An outline of advocacy opportunities is also available for those interested in helping policy makers understand that the supply of pediatric subspecialists and surgical specialists is inadequate to meet the health needs of children.
Physician Reentry into the Workforce
Frequently Asked Questions
Many physicians, particularly women, leave practice and then wish to reenter the physician workforce after an extended period of time away from clinical medicine. The reasons range from childbearing and caring for elderly relatives to taking a position in administration or management. When a physician wishes to return to practice, what kind of retraining is needed? How is the person's clinical competence evaluated? What role in the workforce should the individual pursue? How should licensure and credentialing issues be addressed? The Academy, in collaboration with 20 other medical organizations, is exploring these and many other important questions. To learn more, visit the Physician Reentry Web site.
The Division also maintains responses to pediatrics and workforce-related frequently asked questions.
- The Accreditation Council for Graduate Medical Education (ACGME) solicited comments regarding proposed changes to the common program requirements. The Division solicited input regarding these proposed changes from all AAP Committees, Councils, and Sections. Ten groups responded to this request. It is clear from the range of responses that the language used by the ACGME is open to wide interpretation. Additionally, and of particular concern, many groups were anxious that the ACGME might be overstepping its boundaries by instituting changes that, in effect, judge individuals rather than programs. The overall response is mixed at best, and the majority of respondents are uncomfortable with the changes as written. Read the official AAP response for more information.
- The ACGME solicited comments regarding proposed changes to the pediatric residency program requirements. The Division solicited input regarding these proposed changes from all AAP Committees, Councils, and Sections. Nineteen AAP groups provided feedback. Overall, the majority of the comments were specific in nature to each individual group. There were, however, two themes that transcended these individualized recommendations: (1) a concern that many programs are not large enough to allow residents to develop recommended procedural competencies, and (2) anxiety that the new requirements will not provide trainees with a solid foundation in general pediatrics. Read the official AAP response (the letter to the ACGME; the combined response from all Committees, Councils, and Sections; and the SOMSRFT response) for more information.
- On June 30, 2011, the U.S. Government Accountability Office (GAO) released a report called "MEDICAID AND CHIP: Most Physicians Serve Covered Children but Have Difficulty Referring Them for Specialty Care.”
This report was mandated by the Children’s Health Insurance Program
Reauthorization Act of 2009 (CHIPRA), which contained a provision for a
study to be conducted by the GAO regarding children’s access to primary
care and specialty services under Medicaid and CHIP. The Academy has
considerable interest in pediatric workforce issues and the provision of
care to pediatric patients covered by Medicaid and CHIP, and was
therefore concerned about the survey instrument that was used to gather
data for this report. The GAO report discusses: the extent to which physicians are enrolled as Medicaid and CHIP providers and serving children in these programs; the extent to which physicians are accepting these and other children as new patients; and the extent to which physicians experience difficulty referring
children in Medicaid and CHIP for specialty care, as compared to
privately insured children. Staff prepared a companion brief that should be reviewed prior to reading the GAO report.
- This AAP Response to the Accreditation Council for Graduate Medical Education (ACGME) Proposed Duty Hours Revision is based on a solicitation for feedback that was sent to all AAP Committees, Councils, and Sections. These responses form the basis of the 19-page document, including the key findings, AAP positions, and an appendix with each group’s individual response or perspectives.
- In December 2008, the Institute of Medicine (IOM) issued a report on resident duty hours entitled, "Resident Duty Hours: Enhancing Sleep, Supervision, and Safety". This report contains a number of recommendations calling for revisions to the resident duty hours limitations set by the ACGME in 2003. These recommendations have served as the impetus for thought-provoking conversations around patient safety and the quality of the educational environment.
For more information and resources on workforce and educational policy issues, please visit the Web pages for the Committee on Pediatric Workforce and the Committee on Pediatric Education.
Holly J. Mulvey, MA
Division of Workforce and Medical Education Policy
Carrie Radabaugh, MPP
Senior Health Policy Analyst
Division of Workforce and Medical Education Policy