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Shortage of Pediatric Specialists, Rising number of Chronically Ill Kids Prompts AAP Call to Revamp Training Funds

A shortage of pediatric medical specialists combined with growing numbers of children with chronic health problems and special medical needs prompted the nation’s largest group of pediatricians to call for revamping the way graduate medical education (GME) is funded.

A newly updated American Academy of Pediatrics (AAP) policy statement in the April 2016 issue of Pediatrics, “Financing Graduate Medical Education to Meet the Needs of Children and the Future Pediatrician Workforce” (published online March 28), notes that although U.S. medical schools have increased their enrollment to address physician workforce shortages, there hasn’t been an equal number of federally funded training positions added for new medical graduates. In addition, only three years of residency training are fully funded, while additional years of subspecialty fellowship training and other programs that train more specialized caregivers are funded at 50 percent.

Pediatric training programs face additional challenges because while most teaching hospitals receive the bulk of their GME funds through Medicare, pediatric residency programs based in children’s hospitals rely on less secure funding from the Health Resources and Services Administration (HRSA) that must be re-allocated each year.

Among the recommendations in the updated policy statement, the AAP urges that GME training for all pediatricians, including pediatric medical subspecialists and pediatric surgical specialists, be fully funded.  It also recommends increasing pediatric GME positions, stabilizing funding for children’s hospital residencies and expanding the sources of GME funding to include all those who benefit from a well-trained pediatrician workforce. Government, hospitals, healthcare systems, health maintenance organizations, the pharmaceutical industry, private and public insurers, medical device and equipment companies, health information technology companies and others, it says, should contribute funding to GME training without being able to influence the curriculum or training requirements.

Authors of the report said GME training is a “public good” that is essential to having pediatricians who practice the highest quality, patient-centered care that’s accessible to all children.

“The need to fix our nation’s graduate medical education funding system has reached a critical point,” said William B. Moskowitz, MD, FAAP, chair of the AAP Committee on Pediatric Workforce and one of the policy statement’s authors. “It has to be structured so that it can produce a physician workforce that meets the evolving health needs of the country, and especially its children.”


The American Academy of Pediatrics is an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds.

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