Kids Are Not Small Adults: Why Canada Must Invest in Pediatric Specialists Now
Featured in: Health Insight - A Mediaplanet Content Hub
Authored by: Meredith Irwin - Paediatrician-in-Chief, Department of Paediatrics, SickKids; Vice-President, Pediatric Chairs of Canada
It’s no secret that Canada’s healthcare systems face a number of complex challenges.
Chief amongst them is securing a robust, diverse workforce, trained to meet the needs of Canada’s growing and diverse population. What is less recognized are the unique challenges of preparing and recruiting the highly specialized workforce required to care for children and youth in this country.
Children are not small adults. When they require preventive care or experience illness, injury, or a limitation in their functioning, a array of highly specialized healthcare and other professionals provide expert care to maintain, improve, and promote their health and wellbeing. This workforce includes general and subspecialty pediatricians, equal in specialization and as broad in scope as the medical workforce trained to care for adults.
Healthcare organizations serving children and youth are facing unprecedented service demands. Many children’s hospitals across the country are now routinely operating at or above one hundred percent capacity. Some children in Canada now wait longer for access to time sensitive, essential care than their adult peers. While the challenges are multi-faceted, at the core of long delays is an undersized workforce. Simply put, there are not enough pediatricians – general and subspecialty – to meet the distinct needs of children and youth.
A comprehensive report from the U.S. National Academies of Science and Medicine offers insights that are relevant for Canada. The demand for pediatric subspecialty care is rising, while the number of trained providers is not. Long wait times, geographic disparities, and overwhelmed clinics are symptoms of a system under strain.
There are not enough Canadian medical graduates entering pediatrics, and even fewer are choosing additional training in many of the subspecialties, like pediatric neurology, cardiology and oncology – critical expertise for our most medically complex patients, including those requiring frequent hospitalization. The reasons are predictable: longer training paths, lower remuneration compared to adult-focused specialties, and heavy emotional burdens.
A solution lies in national coordination, grounded in robust and accessible data, paired with bold investment. The Pediatric Chairs of Canada (PCC), a national network of academic leaders responsible for training future pediatricians, recently launched a grassroots, pan-Canadian data collection initiative to assess pediatric staff and trainees—both in general pediatrics and subspecialties—within the 17 pediatric academic centres across the country. The goal is to identify potential threats to the sustainability of pediatric care and to build capacity to meet the needs of all children and youth, and their families, regardless of their postal code. These data will ensure there is a focus on the pediatric workforce within broader health workforce strategies underway.
Other helpful measures would be to ensure sufficient training allocation for pediatrics and subspecialties, reducing financial disincentives like medical education debt, and supporting retention through compensation similar to adult subspecialists. Targeted programs such as loan forgiveness, geographic recruitment incentives, and flexible training pathways, including research, can help.
Children in Canada deserve a healthy start and a bright future. Workforce challenges constrain collective efforts to right-size children’s health systems. To honour our commitment to the health and future of Canada’s children, we must act now to build and sustain the pediatric workforce.
To learn more, visit sickkids.ca