When young medical students envision their future careers, they are faced with a multitude of considerations. Questions about personal passions, desired work hours, and financial stability often dominate these deliberations. However, I firmly believe that the most critical factor to weigh is the patient population with which a physician will work throughout their professional journey.
As a pediatric neurosurgeon, I take immense pride in dedicating my medical career to caring for children with life-threatening or life-altering brain conditions. From brain injuries to tumors, my focus is on providing these young patients with the best chance at a good life. The experience gained during my pediatric neurosurgery fellowship solidified my passion for working with children, as I discovered that they are the best patients and that pediatric work is one of the most rewarding branches of medicine.
Yet, despite the significant rewards that come with pediatric specialties, an alarming shortage of pediatric specialists, especially in neurology and surgical fields, is a cause for deep concern. The Child Neurology Foundation reports that there is a roughly 20% deficit in the number of child neurologists in the United States compared to the national need. This shortage extends beyond neurology to other pediatric subspecialties as well, resulting in challenges for children and families to access timely healthcare.
The repercussions of this shortage are profound. Patients and their families often face long journeys to obtain specialized care, endure extensive waits for appointments, or, in some cases, go without care altogether. Consequently, they may end up receiving treatment from healthcare providers with limited training in pediatrics, which poses additional risks and complexities.
Driving Factors and Concerns
Various factors can contribute to a decline in the number of medical trainees pursuing careers in pediatrics. According to younger members of my own practice, aspiring physicians often worry about the emotional toll of treating terminally ill children. The sheer complexity of pediatric cases and the critical nature of the conditions children face can be emotionally challenging, leading some prospective physicians to opt for less emotionally demanding specialties.
Additionally, lower compensation rates compared to other specialties may deter medical students from choosing pediatric careers. Financial concerns are undoubtedly a significant factor for individuals considering long-term career paths, and the financial aspects of pediatric specialties are not always as lucrative as in other fields of medicine.
Despite these legitimate concerns, the rewards of pediatric specialties cannot be overlooked. As a member of an independent practice, I have the privilege of working solely at one of the Midwest’s leading children’s hospitals. The relationships established between healthcare providers and patients in pediatric specialties are unparalleled in the medical field.
Let me share the stories of two of my patients to illustrate the immense rewards that pediatric specialists can experience. Sarah, a mere 16 years old when she first arrived at the hospital, suffered from significant memory problems due to a cavernous malformation in her brain. Following a second bleed on the day of her scheduled surgery, her condition quickly worsened. The complex surgery to address the hemorrhage, cavernous malformation, and accompanying seizures lasted longer than anticipated. However, Sarah’s resilience and determination allowed her to make a full recovery, returning to high school and graduating. Witnessing her progress and staying in touch over the years has been immensely gratifying.
Another patient, Tyler, was a passionate 10-year-old basketball player diagnosed with a brain tumor and seizures. During the surgery to remove the tumor and provide him with the opportunity for a normal childhood, he experienced severe and almost uncontrollable bleeding. Exhaustively working to save him, I persisted with the thought, “Don’t give up. He’s not giving up. Don’t give up.” Today, Tyler remains free of tumor and seizures, pursuing basketball at a highly competitive level. These success stories highlight the tremendous impact pediatric specialists can have on a child’s life, offering them a second chance at a healthy future.
While pediatric specialties offer tremendous rewards, the field faces significant obstacles that hinder the recruitment of new physicians. The shortage of pediatric surgeons prompted the American Association of Neurological Surgeons, in collaboration with related organizations, to present a letter to Congress in March 2021. The letter sought $50 million in funding to address this shortage by supporting the recruitment and retention of clinicians dedicated to pediatric healthcare.
Although progress is being made, such as the introduction of the $15 million Pediatric Specialty Loan Repayment Program by HHS in June 2023, long-term investment is necessary to encourage more medical students to pursue pediatric specialties. Such initiatives would ensure that children have adequate access to the specialized medical care they need.
Reflecting upon my journey as a pediatric neurosurgeon, I am reminded of both the immense joys and challenges that come with this career path. It is my fervent hope that more medical students will be inspired to embark on this remarkable journey of healing, hope, and compassion. By empowering aspiring physicians to pursue pediatric neurosurgery as not only a professional choice but also a calling, we can ensure a brighter future for our youngest patients and their families.
The shortage of pediatric specialists is a critical issue that requires urgent attention. The rewards of pediatric specialties are immeasurable, from the lasting relationships established with patients to witnessing miracles of healing. By addressing the barriers and providing support for those pursuing pediatric careers, we can transform the landscape of pediatric healthcare and ensure the well-being of our most vulnerable patients.