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What is the Future of Pediatric Neurology in Canada? Resident and Faculty Perceptions of Training and Workforce Issues

  • Asif Doja (a1), Chantalle Clarkin (a1), Sharon Whiting (a1) and Mahendranath Moharir (a2)

Abstract

Background: Pediatric neurology trainee numbers have grown considerably in Canada; recent research, however, has shown that the number of pediatric neurology graduates is outpacing the need for future pediatric neurologists. The purpose of this study was to seek the opinion of pediatric neurology program directors and trainees regarding possible solutions for this issue. Methods: Two focus groups were convened during the Canadian Neurological Sciences Federation annual congress in June 2012; one consisted of current and former program directors, and the other of current pediatric neurology trainees. Groups were asked for their perceptions regarding child neurology manpower issues in Canada as well as possible solutions. Focus groups were audio-recorded and transcribed for analysis. Theme-based qualitative analysis was used to analyze the transcripts. Results: Major themes emerging from both focus groups included the emphasis on community pediatric neurology as a viable option for trainees, including the need for community mentors; recognizing the needs of underserviced areas; and establishing academic positions for community preceptors. The need for career mentoring and support structures during residency training was another major theme which arose. Program directors and trainees also gave examples of ways to reduce the current oversupply of trainees in Canada, including limiting the number of trainees entering programs, as well as creating a long-term vision of child neurology in Canada. Conclusions: A nationwide dialogue to discuss the supply and demand of manpower in academic and community pediatric neurology is essential. Career guidance options for pediatric neurology trainees across the country merit further strengthening.

Quel est l’avenir de la neurologie pédiatrique au Canada ? Perceptions des médecins résidents et du corps professoral en ce qui regarde les enjeux liés à la formation et aux effectifs. Contexte: Le nombre de stagiaires en neurologie pédiatrique a considérablement augmenté au Canada. Toutefois, une étude récente a montré que le nombre de finissants ayant été formés dans ce domaine dépasse les besoins en futurs neurologues pédiatriques. L’objectif de cette étude a donc consisté à solliciter l’avis des directeurs de programmes en neurologie pédiatrique et des stagiaires, ainsi que leurs pistes de solution, face à cette situation. Méthodes: Deux groupes de discussion (focus groups) ont été constitués à l’occasion du congrès annuel de la Fédération canadienne des sciences neurologiques tenu en juin 2012. Un de ces groupes regroupait d’anciens et d’actuels directeurs de programmes en neurologie pédiatrique tandis que l’autre regroupait de jeunes médecins alors stagiaires en neurologie pédiatrique. On a demandé aux participants de faire part de leurs impressions concernant les enjeux qui touchent la relève au Canada et à exprimer des pistes de solution. Ces groupes de discussion ont fait l’objet d’un enregistrement audio et ont été transcrits aux fins d’analyse. Les transcriptions ont ensuite été analysées thématiquement de façon qualitative. Résultats: Parmi les principaux thèmes ayant émergé, on peut citer l’accent mis sur la neurologie pédiatrique communautaire comme option valable pour les stagiaires, ce qui sous-tend le besoin de mentors communautaires. Il a aussi été question de reconnaître les besoins des régions insuffisamment desservies et de créer des postes universitaires de précepteurs communautaires. Les besoins en mentorat professionnel et en structures de soutien durant le programme de formation en résidence a été un autre thème important évoqué. Les directeurs de programmes et les stagiaires ont aussi fourni des exemples de mesures qui permettraient de réduire l’excédent actuel de stagiaires au Canada, notamment en limitant le nombre de personnes candidates et en forgeant une vision à long terme de la neurologie pédiatrique au Canada. Conclusions: Un dialogue à l’échelle nationale pour discuter de l’offre et de la demande en ce qui concerne les effectifs en neurologie pédiatrique demeure essentiel, et ce, tant à l’université que sur le plan communautaire. L’orientation professionnelle des stagiaires en neurologie pédiatrique au pays mérite aussi d’être davantage consolidée.

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Copyright

Corresponding author

Correspondence to: Asif Doja, Assistant Professor, Division of Neurology, Children’s Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, Ontario, K1H 8L1. Email: adoja@cheo.on.ca

References

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1. Keene, DL, Humphreys, P. Inventory of pediatric neurology “manpower” in Canada. Can J Neurol Sci. 2005;32(3):306-310.
2. Doja, A. Pediatric neurology training in Canada: current status and future directions. Can J Neurol Sci. 2012;39:369-377.
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6. Royal College of Physicians and Surgeons of Canada. Proposed Document. General standards applicable to all residency programs: B standards. 2011 [cited 2014 Nov 11]. Available from: http://www.royalcollege.ca/portal/page/portal/rc/common/documents/accreditation/accreditation_blue_book_b_standards_e.pdf.
7. Doja, A, Orr, SL, McMillan, HJ, Kirton, A, Brna, P, Esser, M, et al. Canadian Paediatric Neurology Workforce Survey and Consensus Statement. Can J Neurol Sci. Epub 2016 Jan 20. doi:10.1017/cjn.2015.360.

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