Physician resources and postgraduate training in canadian academic rheumatology centers: a 5-year prospective study.
OBJECTIVE
To describe the trends in physician resources, changes in activity profiles, and the output of the postgraduate training programs in Canadian academic rheumatology centers from 1998-2002.


METHODS
In 1998, the Canadian Council of Academic Rheumatologists (CCAR) established a prospective database to monitor physician resources, activity profiles, and recruitment within 15 academic rheumatology units in Canada. Information was also collected on residents pursuing subspeciality training in rheumatology.


RESULTS
Over the 5 year period there was an increase in the number of rheumatologists from 157 to 168. The majority of this increase (91%) was attributable to changes in full-time staff. The mean age of rheumatologists increased from 47.9 to 48.9 years over the same period and the ratio of male to female rheumatologists decreased incrementally from 2.5:1 to 1.9:1. The overall allocation of time for clinical care (54-53%), teaching (17-16%), research (21-23%), and administration (7%) remained stable over time. Unfilled staff positions varied between 18-25 per year and were spread between 9-12 centers. The number of trainees in adult and pediatric rheumatology fell incrementally from 38 to 22 over the first 4 years of the study, with an increase to 30 in 2002. The majority of trainees were located at 2 centers and the number of active training programs varied between 6 and 12 per year. Funding for clinical fellowship training was provided by government (27-51%), the Arthritis Society (21-33%), and alternative sources (23-40%).


CONCLUSIONS
These results indicate that rheumatology physician resources within Canadian academic units are inadequate to fulfill responsibilities in the delivery of clinical service and academic programs. Enrollment in rheumatology training programs is falling and is insufficient to meet the present and future needs for patients with rheumatic diseases in Canada.
Hanly
John G
JG
Canadian Council of Academic Rheumatologists and Dalhousie University, Halifax, Canada.
D000046:Academic Medical Centers; D002170:Canada; D016208:Databases, Factual; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D011446:Prospective Studies; D012219:Rheumatology / Q000193:education*; D000078329:Workforce