A novel approach for the accurate prediction of thoracic surgery workforce requirements in Canada.
OBJECTIVE
To develop a microsimulation model of thoracic surgery workforce supply and demand to forecast future labor requirements.


METHODS
The Canadian Community Health Survey and Canadian Census data were used to develop a microsimulation model. The demand component simulated the incidence of lung cancer; the supply component simulated the number of practicing thoracic surgeons. The full model predicted the rate of operable lung cancers per surgeon according to varying numbers of graduates per year.


RESULTS
From 2011 to 2030, the Canadian national population will increase by 10 million. The lung cancer incidence rates will increase until 2030, then plateau and decline. The rate will vary by region (12.5% in Western Canada, 37.2% in Eastern Canada) and will be less pronounced in major cities (10.3%). Minor fluctuations in the yearly thoracic surgery graduation rates (range, 4-8) will dramatically affect the future number of practicing surgeons (range, 116-215). The rate of operable lung cancer varies from 35.0 to 64.9 cases per surgeon annually. Training 8 surgeons annually would maintain the current rate of operable lung cancer cases per surgeon per year (range, 32-36). However, this increased rate of training will outpace the lung cancer incidence after 2030.


CONCLUSIONS
At the current rate of training, the incidence of operable lung cancer will increase until 2030 and then plateau and decline. The increase will outstrip the supply of thoracic surgeons, but the decline after 2030 will translate into an excess future supply. Minor increases in the rate of training in response to short-term needs could be problematic in the longer term. Unregulated workforce changes should, therefore, be approached with care.
Division of General Surgery, Department of Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada. Electronic address: janetpatriciaedwards@gmail.com.
Janet P
JP
Edwards
Division of General Surgery, Department of Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Indraneel
I
Datta
Department of Civil Engineering, University of Calgary Schulich School of Engineering, Calgary, Alberta, Canada.
John Douglas
JD
Hunt
HBA Specto Incorporated, Calgary, Alberta, Canada.
Kevin
K
Stefan
Division of General Surgery, Department of Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Chad G
CG
Ball
Division of General Surgery, Department of Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Elijah
E
Dixon
Division of Thoracic Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Sean C
SC
Grondin
D002170:Canada / Q000453:epidemiology; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000639:trends; D005544:Forecasting; D006280:Health Workforce / Q000639:trends*; D006801:Humans; D015994:Incidence; D007396:Internship and Residency / Q000639:trends; D008175:Lung Neoplasms / Q000453:epidemiology / Q000601:surgery*; D008962:Models, Theoretical; D010820:Physicians / Q000600:supply & distribution* / Q000639:trends*; D013903:Thoracic Surgery / Q000193:education / Q000639:trends*; D019616:Thoracic Surgical Procedures / Q000193:education / Q000639:trends*; D013997:Time Factors