Only 42% of US board-certified ACHD physicians practice full-time, highlighting a significant provider gap despite widespread concern about workforce shortages.
A survey of US ACHD board-certified physicians reveals that only 42% practice full-time in the specialty, highlighting a critical workforce shortage and a need for alternative training pathways.
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Abstract Background Adults with congenital heart disease (ACHD) are a rapidly growing population of patients with multisystemic issues that stem beyond the heart and require expert, specialized care. Two-year Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowships began in the US in 2015. Despite this, there remains a critical shortage of trained physicians, with further widening gaps in care projected. Purpose To evaluate the demographics of current US ACHD board-certified providers, their job satisfaction and opinions regarding potential solutions to the workforce crisis. Methods A 26-question cross-sectional survey was created using Qualtrics and distributed to US ACHD board-certified physicians via the Adult Congenital Heart Association (ACHA) listserv. Data analysis was performed using Jamovi version 2.5. Pre-specified sub-groups of interest included career stage (early: 0-7 years, middle: 8-14 years, senior: ≥15 years), training background (internal medicine, pediatrics, combined), and additional specializations (advanced imaging, interventional cardiology, electrophysiology, heart failure/transplant and research). Results 473 ACHD physicians received the survey and 119 (25%) responded, with full survey completion in 104 (22%). 15% of respondents were early career, 17% middle and 67% senior. Most respondents (67%) had not completed an ACGME-accredited ACHD fellowship, with 33% board certified in pediatric cardiology, 32% in adult cardiology and 34% dual certified. Only 42% practiced ACHD full-time. Nearly all (95%) respondents were concerned about workforce shortages and 87% planned to board recertify. Given the opportunity to go back in time, early-career physicians were less likely to choose ACHD as a specialty again and fewer planned to recertify. Suggestions for future training varied significantly based on whether providers had undergone ACGME-accredited training (p=0.02). More non-ACGME-trained respondents preferred 12-month fellowships (41% vs. 34%) or personalized training lengths (21% vs. 8%). Few preferred the current 24-month model (8% vs. 18%) or proposed 2+2 training models (30% vs. 40%). Conclusion Only 42% of responding board-certified ACHD physicians in the US practice full-time in their specialty. This suggests that even greater gaps in care access likely exist for this complicated patient population. Most ACHD providers are satisfied, plan to recertify, but worry about future physician shortages. And many favor consideration of alternate training pathways to help expand the provider population.
Clark et al. (Sat,) reported a other. Only 42% of US board-certified ACHD physicians practice full-time, highlighting a significant provider gap despite widespread concern about workforce shortages.