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Physician Resources and Postgraduate Training in Canadian Academic Rheumatology Centers:
A 5-Year Prospective Study
JOHN G. HANLY, for the Canadian Council of Academic Rheumatologists
ABSTRACT.
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%). Conclusion. 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. (J Rheumatol 2004;31:1200-5) Key Indexing Terms:
CANADA
From the Canadian Council of Academic Rheumatologists and Dalhousie University, Halifax, Canada. Supported by The Arthritis Society of Canada. J.G. Hanly, MD, MRCPI, FRCPC, Professor of Medicine, Dalhousie University; Head, Division of Rheumatology and Director, Arthritis Centre of Nova Scotia, Queen Elizabeth Health Sciences Center. The Canadian Council of Academic Rheumatologists: John M. Esdaile, MD, University of British Columbia, Vancouver, BC; Anthony Russell, MD, University of Alberta, Edmonton; Liam Martin, MD, University of Calgary, Calgary, Alberta; John Sibley, MD, University of Saskatchewan, Saskatoon, Saskatchewan; Hani El-Gabalawy, MD, University of Manitoba, Winnipeg, Manitoba; Nicole Le Riche, MD, University of Western Ontario, London; Jonathan Adachi, MD, McMaster University, Hamilton; Robert Inman, MD, University of Toronto; Rayfel Schneider, MD, Pediatric Rheumatology Representative, University of Toronto; Denis Morrice, President and CEO, The Arthritis Society, Toronto; Tassos Anastassiades, MD, Queen's University, Kingston; Gunnar Kraag, MD, University of Ottawa, Ottawa, Ontario; Henri Menard, MD, McGill University; Jean-Pierre Pelletier, MD, University of Montreal, Montreal; Gilles Boire, MD, University of Sherbrooke, Sherbrooke, Quebec; John Hanly, MD, Dalhousie University, Halifax, NS; Catherine Alderdice, MD, Memorial University, St. John's, Newfoundland, Canada. Address reprint requests to Dr. J.G. Hanly, Arthritis Center of Nova Scotia, Queen Elizabeth II Health Sciences Center (Nova Scotia Rehabilitation site), 2nd Floor, 1341 Summer Street, Halifax, Canada, B3H 4K4. Submitted September 5, 2003; revision accepted December 30, 2003.
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