Assessing the Pediatric Dermatology Workforce

The Society for Pediatric Dermatology (SPD) was established in 1975 and currently has more than 1,500 members worldwide. It is the only national organization in the US dedicated to pediatric dermatology, a relatively young subspecialty. Although the number of board-certified pediatric dermatologists is growing, demand continues to outpace the number of available physicians and wait times for appointments with pediatric dermatologists can be long. Jennifer Schoch, MD, FAAD, SPD Workforce Committee Chair, offers a look at the current workforce status and shares the SPD’s strategies for recruiting and addressing ongoing shortages. The SPD Workforce Committee is responsible for developing short-term approaches and long-term strategies to address the pediatric dermatology workforce shortage.

PD: What is the status of the pediatric dermatology workforce?

Jennifer Schoch, MD: Though the pediatric dermatology workforce has experienced growth, there remain only a few hundred board-certified pediatric dermatologists in the entire country (317 as of 2020). This translates to about four pediatric dermatologists per million children (compared to four general dermatologists per 100,000 people). With an average of 10 to 20 pediatric dermatology fellows training each year, the supply of new board-certified pediatric dermatologists is not significantly outpacing retirement, leading to slow growth of the subspecialty.

PD: What progress has been made and what initiatives are targeting the future?

Dr. Schoch: Admittedly, though many strategies have been trialed, the progress is slow. Programs to combine pediatric internship, dermatology residency, and pediatric dermatology fellowship were mostly unsuccessful in increasing the number of trainees committing to the career. Future initiatives are focusing on early exposure to the subspecialty of pediatric dermatology in medical school (and even pre-med!).

PD: What are some of the main impediments for entry into pediatric specialization?

Dr. Schoch: One of the unique challenges for recruiting into pediatric dermatology is that it is such a specialized field. There is often limited, if any, exposure to pediatric dermatology before medical students commit to a residency. So, most students who match into dermatology are not going into dermatology with interest in pediatric specialization. Another significant challenge is the pay gap between pediatric and adult subspecialties. Improving pay for pediatric dermatologists (to be more in line with other fellowship-trained dermatologic subspecialties) would likely help improve the workforce shortage.

PD: We are seeing more new chemical entities approved in dermatology. Is there any correlation between innovation and interest in the field?

Dr. Schoch: This is a great question and one that I don’t know the answer to (yet!). Personally, the increase in treatment options for pediatric skin disease has improved my job satisfaction, so I could see this helping with recruitment.

PD: Are there efforts within pediatric dermatology to increase representation?

Dr. Schoch: Absolutely. One specific example is the Society for Pediatric Dermatology’s URiM (Underrepresented in Medicine) Mentorship Award, which is a program designed to expose URiM students to pediatric dermatology. Early mentorship has been cited as the most important factor in the decision to pursue a career in pediatric dermatology.

PD: Could you summarize the benefits of a robust pediatric dermatology workforce as well as the risks associated with the ongoing shortage?

Dr. Schoch: The biggest problem with the workforce shortage right now is access to care. In my practice, the wait time to the next new pediatric dermatology appointment ranges from 4-8 months. Though we try to triage, this sometimes results in patients waiting too long for problems that should have been treated urgently. Ideally, this number should be closer to 2-3 weeks. A more robust pediatric dermatology workforce would benefit patients by allowing prompt access to care. Additionally, we need more pediatric dermatologists in residency training programs so that residents who go into general dermatology feel well-equipped to treat common pediatric skin conditions.

Editor’s Note: The opinions expressed here are Dr. Schoch’s own. Data mentioned are from Wright T, Update on the Pediatric Dermatology Workforce Shortage. Cutis. 2021;108(5):237-8.