Winter 2020 (Volume 30, Number 4)
Report from the Human Resources Committee
By Jessica Widdifield, PhD; and Claire Barber, MD, PhD, FRCPC
Download PDF
A sustainable rheumatology workforce is essential to achieving the mission of the CRA.
This past year, the Committee has prepared a technical report on the Canadian rheumatology
workforce. Several activities were undertaken to develop this working technical report.
First, we ascertained data profiles
on the number of rheumatologists,
residents, trainees
and fellows in Canada using
national databases. The quantitative
data were derived from four
data sources, including the Canadian
Medical Association and
the Canadian Institute of Health
Information Scott’s Medical Database
for number of rheumatologists;
the Canadian Post-M.D. Education
Registry for trainee and
fellow counts; and the Canadian
Resident Matching Service data
for applicants to postgraduate
rheumatology training programs.
From these data sources, several
important rheumatology workforce
trends were identified. The
first notable trend is the growth
in the number of rheumatologists
in Canada over the past decade, though overall this fails to
meet the target benchmark of 1 rheumatologist per a population
of 75,000 (Barber et al., 2014), and rheumatologist
distribution is not equal across Canada. Another notable
trend is the continued growth in the number of female and
foreign-trained rheumatologists entering the workforce.
There is also an increasing number of available rheumatology
residency positions being offered and fewer unfilled
training positions over time. As a result of the increase in
available rheumatology residency positions, the numbers
of trainees and fellows in adult and pediatric rheumatology
training programs have significantly increased between
2000 and 2018 and, as of 2018, there were 82 residents
and 27 fellows in Canada. Twenty percent of these were visa
trainees (who are expected to return to their country of origin
after training).
Second, we further curated the evidence base (via a
scoping review) to identify Canadian rheumatology workforce
research to examine the extent, range, and nature of
research activities related to the
rheumatology workforce, and to
identify research gaps in the existing
literature. Studies evaluating
components of Canada’s
rheumatology workforce, including
the supply, demand, and medical
education aspects, have revealed
many noteworthy findings.
While the overall supply of rheumatologists
has increased, changing
workforce demographics and
other factors may be negatively
impacting the clinical capacity to
meet the demands of the increasing
volume of patients. Increasing
early exposure to rheumatology
is vital to attracting new trainees
to rheumatology. Although there
is widespread literature on the
Canadian workforce, many fundamental
questions remain unanswered,
including accurately understanding the current
full-time equivalent (FTE) supply and forecasting the future
rheumatology workforce supply needs.
Third, we conducted an environmental scan to identify
current rheumatology evidence-based clinical practice
guidelines or recommendations that specifically state the
role for rheumatologists in the care of patients with rheumatic
and musculoskeletal diseases (RMDs). Twenty-five
national and regional guidelines for RMDs were reviewed.
Eleven guidelines and two white papers contained 21 recommendations
describing the central role for rheumatologists
in the care of patients with rheumatic diseases. However,
only three Canadian guidelines explicitly stated the
role of rheumatologists in the care of RMDs.
The workforce technical report (which will be posted on
the CRA website [rheum.ca/about-us/leadership-committees/
human-resources-committee/] in early 2021) was undertaken
to inform the CRA’s Workforce Position Statements (currently
being prepared by the Committee).
Finally, the launch of the 2020 Rheumatology Workforce
and Wellness Survey was delayed until Fall 2020. This
new launch timeline has permitted the addition of questions
to better understand the impact of the pandemic on
rheumatology practices including the use of virtual care.
All rheumatologists are encouraged to complete the electronic
survey being distributed by the CRA via email to CRA
members.
References:
Barber C, Marshall D, Mosher D, et. al. Developing System-Level Performance Measures for Evaluation
of Models of Care for Inflammatory Arthritis Framework. 2014. Retrieved from www.arthritisalliance.ca/images/PDF/Final%20Background%20MOC_Nov6.pdf
Jessica Widdifield, PhD
Co-chair, CRA Human Resources Committee
Scientist,
Sunnybrook Research Institute, ICES
Assistant Professor, University of Toronto,
Institute of Health Policy, Management & Evaluation
Toronto, Ontario
Claire Barber, MD, PhD, FRCPC
Co-chair, CRA Human Resources Committee
Assistant Professor, Rheumatologist,
University of Calgary, Calgary, Alberta
|
