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Luis Miguel Dos Santos Endicott College, Woosong University, Daejeon, South KoreaCorrespondence: Luis Miguel Dos Santos 196-5 Jayang Dong, Daejeon, 34514, South KoreaTel +82 10-3066-7818Email luismigueldossantos@yahoo.comPurpose: This study aims to understand the motivations of academic voyage and post-graduation career decisions of occupational therapy international students in Australia. The following two research questions guided this study: why do international students choose to study in Australia instead of ones in their own countries? And why do international students choose to study occupational therapy program(s) in Australia instead of ones in their own countries?Patients and Methods: A qualitative design with phenomenology was employed to recruit 20 participants for the data collection procedures, including interview sessions, focus group activity, and member checking interview. The participants were studying one of the accredited occupational therapy programs in Australia as international students.Results: Six themes were yielded. All participants expressed that due to the excellent education, reasonable tuition fees and living standard, and the positive career opportunities, almost all expressed their positive experiences of their Australian voyage as international students and tended to stay in Australia after they gained the registration career development. More importantly, the notions of contribution to Australian communities are captured as many considered Australia as an important place in their lives.Conclusion: University leaders may wish to take action in upgrading their international students’ services, particularly career development services. Government agencies may take this study as a blueprint for upgrading the current regulations for international students, particularly in establishing a targeted immigration visa for recent graduates who want to establish their own businesses or invest in Australia.Keywords: medical education, medical staff shortage, medical student, occupational therapy education, social cognitive career theory, social cognitive career and motivation theory, workforce shortage

OBJECTIVE Using the framework of Social Cognitive Career Theory, this study aimed to ascertain attitudes and perceptions of geropsychology career paths, given the present notable geriatric workforce shortage. METHODS An online survey was developed iteratively and disseminated through various modalities (i.e., internet, email, word-of-mouth). Participants included 28 predoctoral and 76 professional geropsychologists (N = 107; age M = 39.18, SD = 12.05). The sample was largely female (72%), non-Hispanic White (89%), and has or was working towards their PhD (82%). RESULTS Results delineate attractive and unattractive aspects of common career options (academic, clinical Veterans Affairs [VA], clinical non-VA), and assessed the hypothetical proclivity and feasibility of switching between academic and clinically focused careers. The results found gender (women vs. men) and career stages (predoctoral vs. professional) to be significant contributors to career perceptions. CONCLUSIONS The present study advances past literature by unveiling potential avenues to ameliorate this workforce shortage within both clinical and academic fields in geropsychology.

Continuing education directed at building providers' skills and knowledge in geriatrics represents a practical approach to addressing the geriatric mental health (MH) care workforce shortage. To inform the development of professional training curricula, we surveyed MH providers (N = 65) at a Veterans Affairs medical center on working with older persons with dementia (PwD) and informal caregivers. Providers rated service provision to PwD and caregivers as highly important but endorsed modest self-efficacy. Half of respondents were minimally confident in managing risk of harm to self or others in a PwD. Respondents believed PwD can benefit from MH treatments, yet identified several barriers to providing care, including inadequate time and staffing resources. Interest in geriatric training topics was high. Findings demonstrate that MH providers at this site value care provision to PwD and caregivers, and desire additional training to serve this population. System-level barriers to MH care for PwD should also be identified and addressed.

Singapore, a young nation like many developed countries, faced a shortage of nurses. Attempts to resolve the workforce shortage through the employment of foreign nurses started in the mid-1980s. Over the years, workforce recruitment from traditional sources nearby, namely Malaysia and Philippines, has expanded to include nurses from countries such as People Republic of China, India, and Myanmar. Attempts have also been made to train, recruit, and retain local nurses such as improving working conditions and remunerations, raising the profile of nursing, improving career recognition and progression, and encouraging nonpracticing nurses back to the workforce. However, the institutions' and the government's attempts to ameliorate the nursing shortage were met with limited success. Even with the recruitment of foreign nurses, the shortage of workforce persists. The shortage is compounded by the three major health-care challenges confronting Singapore: (1) rapid growth in population; (2) rapid aging of the population; and (3) increasing burden of chronic diseases. As the population continues to grow and as more of the population ages, as life expectancy increases and the burden of chronic diseases increases, not only will the demand for nurses continue, but the intensity and the nursing care they require will also increase. This article describes the challenges confronting the practice of nursing in Singapore and their implications. Although these challenges are daunting, they offer nursing the unprecedented opportunities to shape health-care delivery systems and increase nursing influences everywhere across settings and along the delivery continuum.

Behavioral health workforce shortages to provide quality care services for children, adolescents, and transitional age youth are well established. This paper highlights the workforce shortage and t...

The workforce shortage in construction is well known, and demand for construction managers is projected to grow over the next 10 years. These challenges are exacerbated for trade contractors. This ...

Providing optimal end-stage kidney disease (ESKD) management requires an adequately trained and sufficiently staffed workforce, including doctors, nurses, and patient care technicians (PCTs). The growing need for ESKD services for a surging population of dialysis-dependent patients has made obvious a workforce crisis affecting nephrology. For a multitude of reasons, the physician workforce supply available to provide dialysis care has failed to expand commensurate with patients need in recent years. Of most importance, fewer US trainees are choosing to enter nephrology, and fewer international medical graduates are available to fill training program rosters. Equally important but less frequently cited are occupational shortages of trained dialysis nurses and PCTs. This article brings attention to this complex workforce shortage and addresses the limited information available regarding how it might constitute a barrier to optimal dialysis care.

Given the workforce shortage of adequately trained behavioral health professionals, schools of social work are ideally positioned to teach empirically supported treatments for preventing and reduci...

The objective of this article is to analyze the governance of migration of health professionals in Switzerland. Owing to a lack of health workers, the growing needs of healthcare, and the limited number of recent graduates, the Swiss health institutions are dependent upon international healthcare professionals. After an analysis of the need for healthcare professionals, this article examines the laws regulating the migration flows, before considering the challenges related to the governance of international migration and recruitment of health professionals in Switzerland. This article confirms Switzerland’s longstanding health workforce shortage, its chronic dependence upon the health professionals from EU neighboring countries, and its difficulty to achieve self-sufficiency against the backdrop of increasing health and demographic challenges, a need to maintain its welfare state, and to strengthen its international competitiveness by attracting talents, and the threat caused by rising restrictionist and anti-migrant political rhetoric, thereby resulting in difficult compromises regarding its migration policy outcomes.

At a time when U.S. policymakers are demonstrating their commitment to CTE established to address particular workforce shortage areas, this mixed methods evaluation study sought to understand the key features and outcomes of an existing healthcare education program (HEP) founded with this intent. Findings demonstrated that the HEP incorporates several unique features that should be considered by other programs including hands-on work using hospital equipment, workplace observations, and a strong emphasis on career decision-making efficacy. Evidence showed that students who continue in a Career and Technical Education (CTE) program for more than one year may exhibit somewhat higher rates of college enrollment.

The authors propose that, through innovative and mutually beneficial partnerships between medical schools and local Emergency Medical Services (EMS) agencies, medical students can help mitigate EMS shortages in areas across the country. These partnerships, which we have seen very early signs of in some places, would create channels by which medical students get their emergency medical technician certifications in the summer before matriculating and volunteer with the agency’s ambulance service, either as an extracurricular clinical experience (which are very popular among medical students) or as a way to fulfill clinical or service requirements or earn elective credit. In the attached piece, the authors (1) establish, using data, that a key factor contributing to current and impending EMS shortages is a lack of certified personnel, and (2) propose why and how medical students could provide a novel source of additional volunteers for understaffed public ambulance services, explore some of the benefits and limitations of this proposal, and provide a road-map for how to form partnerships between medical schools and local EMS agencies.

The expansion of genetic and genomic testing across medical specialties and the changing workforce demographics of certified genetic counselors (CGCs) have led to concerns of a workforce shortage. We assessed the number of genetic counselors working in the Southern United States&mdash, a rural and medically underserved region&mdash, using various online and professional resources. We identified 683 practicing genetic counselors across the Southern U.S. and 160 specializing in prenatal genetics. CGCs were concentrated in urban areas, counties with a CGC had a significantly higher proportion of minority residents and median household income than counties without a CGC. There is an average of 2.97 prenatal CGCs per 5000 high-risk births in the South. Alternative delivery models are needed to increase access to counseling services in the Southern U.S., particularly for low income households and those of high risk pregnancies. Increased provider education and patient educational materials can help facilitate informed decision-making in prenatal settings as genetic technologies gain a stronger foothold and bring value to medical practice.

Given the current professional behavioral health workforce shortage, nursing professional development practitioners require educational resources to fully support registered nurses across settings in responding to patients with behavioral health symptoms. Mental Health First Aid is an 8-hour training to help nonprofessional bystanders assess a mental health crisis, provide initial help, and connect to supports and self-help resources in the local community. Mental Health First Aid was acceptable and useful to 60 RNs and can be supplemented with additional content.

The importance of interprofessional education (IPE) in continuing medical education and professional development has long been recognised by health organisations and academic societies, benefiting not only patient outcomes and interprofessional relationships but also overall health systems and workforce shortage. We report on the outcomes of an Australian IPE activity on medication-overuse headache (MOH) with general practitioners (GPs) and community pharmacists as learners. The design of the activity, which followed the predisposing–enabling–reinforcing instructional framework by Green and Kreuter, aimed to: (1) improve knowledge and foster a willingness in GPs and pharmacists to work collaboratively to enhance the prevention, diagnosis and management of MOH; and (2) address their educational gap by demonstrating the utility of a blended learning IPE strategy on MOH. Integrated into the activity was an assessment of its effectiveness and impact to instil change in the participants’ knowledge of MOH, attitude and willingness to treat, and clinical practice behaviours of GPs and pharmacists to work together. The learners gained knowledge and confidence in diagnosing and managing MOH and in their ability to educate patients. The IPE approach suited the activity and was valued by the participating GPs and pharmacists, who seldom experience such learning formats. However, for educational providers in Australia, developing and deploying an independent medical education (IME) programme can be challenging. Providers of IMEs need to be aware of the potential pitfalls when competing with pharmaceutical-company-sponsored and delivered programmes.

There is a pressing workforce shortage and leadership scarcity in palliative care to adequately meet the demands of individuals with serious illness and their families. To address this gap, the Cambia Health Foundation launched its Sojourns Scholars Leadership Program in 2014, an initiative designed to identify, cultivate, and advance the next generation of palliative care leaders. This report intends to summarize the second cohort of Sojourns Scholars' projects and their reflection on their leadership needs.This report summarizes the second cohort of sojourns scholars' project and their reflection on leadership needs.After providing a written reflection on their own projects, the second cohort participated in a group interview (fireside chat) to elicit their perspectives on barriers and facilitators in providing palliative care, issues facing leadership in palliative care in the United States, and lessons from personal and professional growth as leaders in palliative care. They analyzed the transcript of the group interview using qualitative content analysis methodology.Three themes emerged from descriptions of the scholars' project experience: challenges in palliative care practice, leadership strategies in palliative care, and three lessons learned to be a leader were identified. Challenges included perceptions of palliative care, payment and policy, and workforce development. Educating and collaborating with other clinicians and influencing policy change are important strategies used to advance palliative care. Time management, leading team effort, and inspiring others are important skills that promote effectiveness as a leader.Emerging leaders have a unique view of conceptualizing contemporary palliative care and shaping the future.Providing comprehensive, coordinated care that is high quality, patient and family centered, and readily available depends on strong leadership in palliative care. The Cambia Scholars Program represents a unique opportunity.

Background Multiple studies have documented a significant decrease in the general surgery workforce in the United States, both rural and urban, for the past 3 decades. This 11-year study evaluates the Texas general surgery workforce at both the state and local level in 2002 and 2012. Methods Data were obtained from the Texas Medical Board, the United States Census Bureau/Texas State Library and Archives Commission, and the Texas Department of State Health Services for 2002 and 2012. A benchmark target of 7 general surgeons per 100,000 population was used. Results During the study period, the Texas population increased 21%, and actively practicing physicians increased 44%. All surgical specialists increased by 26%. General surgeons increased 4%; however, the number of general surgeons per 100,000 population decreased 14% (from 6.7 to 5.8/10 5 ). Using the total Texas population for 2012, an additional 329 general surgeons are needed by benchmark standards. However, when analyzed by individual county population, 449 additional general surgeons are needed in the individual counties. These effects were greater in the nonmetropolitan areas of Texas where per capita general surgeons decreased by 21%. Conclusions The absolute increase in Texas general surgeons over the past decade has not kept pace with an increase in the Texas population. The general surgery workforce deficit based on the Texas state population underestimates the local workforce shortage, particularly in the nonmetropolitan areas of Texas.

Globally, there has been attention given to addressing the workforce shortage in nursing. One strategy to respond to this has resulted in renewed emphasis on the development of career and education pathways for students in the final years of high school. An evaluation of the School Based New Apprenticeship (SBNA) initiative in nursing in a regional Area Health Service in New South Wales (NSW) was undertaken. The evaluation revealed the experiences of the students who participated in the Programme were largely positive. However, there are a number of ambiguities that should be addressed in order to better enable SBNA Programmes to achieve broader goals within changing education and health contexts. These relate primarily to the need to clarify the intent of the Programme and the activities of health and education personnel in order to meet the shared desire among stakeholders to provide a quality learning and employment experience for students.

As part of an effort to address shortages in the cancer workforce, C-Change developed competency standards and logic model-driven implementation tools for strengthening the cancer knowledge and skills of non-oncology health professionals. These standards and tools were applied by four diverse grant programs to yield gains in the management of pain and palliative care, thereby improving the quality of care for individuals experiencing or recovering from cancer treatment. The results from the four grant sites and tools used to achieve them are described in this article.

This article describes a community-based mentoring program, Partners in Nursing (PIN), which was developed as a collaborative effort to address the nursing workforce shortage. While the primary goal was to increase retention rates of new nurse graduates, the program also produced secondary benefits of professional development and outreach opportunities. Furthermore, through the creation of PIN, local resources were identified to support new graduates and cultivate leadership potential. While the program was deemed effective, continued research is needed to quantify the benefits of such programs so that similar initiatives can be successfully replicated.

Background The Australian Medical Association is strongly opposed to the nurse practitioner (NP) role with concerns that NPs may become doctor substitutes without the requisite training and education that the medical role demands. Despite this, NPs have been heralded by some as a potential solution to the access block, workforce shortage and increased demand affecting emergency departments (EDs). Aims The purpose of this study was to determine the perception of NPs by medical staff working in Australian EDs. Methods Semi-structured telephone interviews were conducted with closed and open-ended questions. Participants were drawn from a representative stratified sample of two city, two metropolitan and two provincial hospitals of each State/Territory. Results A total of 95 doctors from 35 EDs participated in this study including 36 Departmental Directors; 36% of participating Directors indicated having an NP on staff. Doctors were strongly opposed to the statement that NPs could replace either nurses or other prevocational doctors; 71 interviewees commented on the role of NPs in the ED. Thematic analyses revealed polarised views held by doctors. Eight major themes were identified, the most common being that there is a lack of clarity of the NP role definition, their scope of practice and differentiation from the medical role. Conclusion Although ED NPs represent a highly skilled professional group their role is poorly understood by ED doctors. Opposition to the NP role is a significant barrier to the introduction of great numbers of ED NPs as a strategy to overcome the medical workforce shortage. Electronic supplementary material The online version of this article (doi:10.1007/s12245-010-0214-8) contains supplementary material, which is available to authorized users.

Background The specialty of emergency medicine (EM) continues to experience a significant workforce shortage in the face of increasing demand for emergency care. Summary In July 2009, representatives of the leading EM organizations met in Dallas for the Future of Emergency Medicine Summit. Attendees at the Future of Emergency Medicine Summit agreed on the following: 1) Emergency medical care is an essential community service that should be available to all; 2) An insufficient emergency physician workforce also represents a potential threat to patient safety; 3) Accreditation Council for Graduate Medical Education/American Osteopathic Association (AOA)-accredited EM residency training and American Board of Medical Specialties/AOA EM board certification is the recognized standard for physician providers currently entering a career in emergency care; 4) Physician supply shortages in all fields contribute to—and will continue to contribute to—a situation in which providers with other levels of training may be a necessary part of the workforce for the foreseeable future; 5) A maldistribution of EM residency-trained physicians persists, with few pursuing practice in small hospital or rural settings; 6) Assuring that the public receives high quality emergency care while continuing to produce highly skilled EM specialists through EM training programs is the challenge for EM's future; 7) It is important that all providers of emergency care receive continuing postgraduate education.

Previous studies indicate declining interest in child and adolescent psychiatry (CAP) as a career choice during psychiatry residency training. Programs have developed integrated training in psychiatry and CAP as a means to address the workforce shortage in CAP, but little is known about the number or nature of these training tracks.A survey was conducted among all program directors of Accreditation Council for Graduate Medical Education (ACGME) accredited CAP residency training programs in the United States. Those reporting integrated training with their affiliated psychiatry training programs were contacted for in-depth interview. Integrated research programs were not included in this survey.Of the 115 ACGME accredited CAP programs at the time of the survey, 93 responded and 33 of those indicated having some form of integrated training in psychiatry and CAP. Only seven programs identified residents in integrated training in the first year of residency.There is no consensus regarding a definition of integrated psychiatry and CAP training. Even though integrated training may provide opportunities for recruitment and retention of child and adolescent psychiatrists, few programs currently offer fully integrated training. This article describes several potential models for integrated training tracks, identifying factors to consider when developing such pathways.

Background Globally, the nursing profession faces shortages, high turnover, and inequitable distribution. These problems are particularly acute in South East Asia. The present paper describes the design and initial findings of the Thai Nurse Cohort Study (TNCS). Methods The TNCS is a longitudinal prospective cohort study comprising multiple age cohorts, initiated in 2009 and expected to run until 2027. Cohorts comprise registered nurses (RN) holding professional licenses granted by the Thailand Nursing and Midwifery Council. Follow-up is at 3-year intervals, with new (younger) TNCS cohorts introduced and older, no-longer eligible members checked out. This maintains the cohort size as representative of the Thai RN population. The first survey round (2009) used a self-administered mailed questionnaire. The second round (2012) provided follow-up of the initial cohort and formed the baseline survey of new entries. Results The sampling frame for the first round was 142,699 licensed RN; 50,200 age-stratified participants were randomly selected and mailed the questionnaire, and 18,198 questionnaires were returned owing to incorrect addresses. Of the remaining 32,002 participants, 18,756 (58.6 %) responded (average age 43.7 ± 9.8 years). About 15.4 % (equivalent to 20,000 of the current RN population), reported an intention to leave their nursing career. The second round achieved a follow-up rate of 60.2 %. This round included 3020 participants randomly selected from 6402 new RN (response rate, 38.3 %; mean age 23.1 ± 3.5 years). In this round, 11.2 % reported they intended to leave nursing in the next 2 years. Conclusions These two survey rounds have highlighted that Thailand is facing critical nurse shortages. A high rate of nurses expressed an intention to leave the profession; the capacity to replace these potential losses is much lower.

Addressing the geropsychology workforce shortage requires ongoing training of psychologists to develop geropsychology competencies, as well as expanding the number of geropsychology supervisors to train them. This study surveyed graduates of geropsychology doctoral and postdoctoral training programs regarding their current geropsychology practice and supervision activities and perceptions of their own training preparation for these activities. One hundred psychologists (87 who had completed all formal training and 13 current postdoctoral fellows) responded to an online survey. Of those who had completed geropsychology training, 82% reported currently engaging in clinical care, and 55% reported providing supervision; more than half of clinical and supervision activities focused on older adults. Participants reported generally strong quality of training to prepare them for providing geropsychology services; areas of more uneven preparation included family and group interventions and select consultation activities. Participants reported quite variable preparation for general supervision practice, and desire for more training and practice in supervisory roles. Geropsychology training programs may use feedback from graduates for ongoing program development, and professional geropsychology may wish to consider forums for enhancing geropsychology supervision skills.

• General practice is well placed to become a major setting for medical student education over the next decade. • New models of clinical education are required, to take account of changes in the patient population, disease profile and management strategies. • While there has been an increase in general practice-based and other community-based education, there is the potential for further expansion. Evidence for the positive role of general practitioners and general practice in medical education is growing, including the benefits of prevocational training in general practice. • If GPs are to assume a major role in community-based education of medical students, there will need to be changes in funding structures and supporting resources, particularly at this time of increasing medical student numbers and workforce shortage and maldistribution.

Recent dramatic decreases in US medical graduate and International Medical Graduate interest in nephrology as a career suggest that delivery of care to the vulnerable population of dialysis patients in the United States could be negatively affected in coming years. Demographic shifts and changes to national health policy are also likely to exacerbate challenges to provide adequate care to people on dialysis or at risk of end-stage renal disease. Training an adequate number of nephrologists is imperative and will require both reconfiguring current approaches to training and certain aspects of care delivery as well as highlighting bright spots of innovation within the field of nephrology.

Population shifts among surgeons and the general populous will contribute to a predicted general surgeon shortage by 2020. The Public Policy and Advocacy Committee of the Society for Surgery of the Alimentary Tract designed and conducted a survey to assess perceptions and possible solutions from important stakeholders: practicing surgeons of the society, general surgery residents, and medical students. Responses from 1,208 participants: 658 practicing surgeons, 183 general surgery residents, and 367 medical students, were analyzed. There was a strong perception of a current and future surgeon shortage. The majority of surgeons (59.3 %) and residents (64.5 %) perceived a current general surgeon shortage, while 28.6 % of medical students responded the same. When asked of a perceived general surgery shortage in 20 years, 82.4, 81.4, and 51 % said “yes”, respectively. There were generational differences in responses to contributors and solutions for the impending shortage. Surgeons placed a high value on improving reimbursement, tort reform, and surgeon burnout, while residents held a strong interest in a national loan forgiveness program and improving lifestyle barriers. Our survey offers insight into possible solutions to ward off a surgeon shortage that should be addressed with programmatic changes in residency training and by reform of the national health care system.

Objectives: To determine if the frequency of physician visits on Fridays varied over the course of 1997 to 2010, and if it varied by geographical region. Methods: Data from the National Ambulatory Medical Care Survey (NAMCS) of the National Center for Health Statistics were analyzed to examine the frequency of office visits with physicians on Friday from 1997 to 2010, and the same data were also stratified by geographical location. Results: Fewer office visits occurred on Fridays compared to other weekdays, and the percentage of total visits that occurred on Fridays decreased over time (p = 0.04). Comparing between the different geographical regions, the South had the lowest rate of Friday visits and the West had the highest rate. The Northeast (p = 0.003) and South (p < 0.0001) had significantly lower rates than the West. Conclusion: Although patients and physicians alike are disappointed in the amount of time physicians and patients spend face to face, physicians are currently not utilizing eve...

Introduction: This study assessed the role of women as fractional full-time equivalent (FTE) rural academics in the context of significant workforce shortage and increasing academic demand. Methods: The design was a cross-sectional cohort study conducted from June 2002 to June 2012. All Rural Clinical School teaching sites in Western Australia were included, numbering from 3 (at inception in 2002) to 13 in 2012. Participants were all clinicians employed as academic staff of The University of Western Australia since its inception. Teaching staff employed elsewhere were not included. Main outcome measures were the proportion of women employed in the Rural Clinical School and work characteristics including appointment fraction, duration and site leadership. Results: Relative to the workforce at large, female academics were disproportionately employed in the Rural Clinical School with a relative risk of 1.28 (CI 1.0-1.64), �²=2.0 p= 0.46. Their likelihood of being Australian trained was 1.62 (CI 1.3-2.0), �²=19.3, p= 0.000 relative to the rural female GP workforce. Their FTE ( t= 1.0 p= 0.295), time of tenure ( t= 1.19, p= 0.24) and site leadership was indistinguishable from male Rural Clinical School academics. Conclusion: Female doctors who are willing to take on part-time work are supporting the rural medical teaching workforce.

Objectives To target pediatric dermatologists directly in order to evaluate their current demographics and the most important motivating factors that influenced their career choice. Pediatric dermatology is one of the pediatric subspecialties with an inadequate supply to meet current patient needs. Study design A survey was designed to evaluate the training pathway, employment status, participation in teaching, and clinical practice characteristics of pediatric dermatologists. The survey was administered to attendants of the 2010 Society for Pediatric Dermatology annual meeting. Any remaining board certified pediatric dermatologists who had not previously responded were queried via Survey Monkey. Results There was a 71% response rate. The majority chose a career in pediatric dermatology early, often prior to starting a dermatology residency. The vast majority of respondents noted mentorship as the most important influence on their decision to pursue a career in pediatric dermatology. The most common obstacles cited by respondents were financial hardship and resistance of some dermatology programs to accept applicants previously trained in pediatrics. Conclusions Our survey provides evidence to support the importance of early exposure to the field and, most importantly, to committed pediatric dermatologists who can serve as mentors. This information may be helpful in approaching solutions to the workforce shortage in the field of pediatric dermatology.

Background Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. Methods A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Results Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P < 0.05). Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4–3.4), followed by Urgent care (9.0 weeks; IQR = 2.1–12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4–16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks). Interpretation Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

The shortage of nursing faculty has contributed greatly to the nursing workforce shortage, with many schools turning away qualified applicants because there are not enough faculty to teach. Despite the faculty shortage, schools are required to admit more students to alleviate the nursing shortage. Clinical groups in which preceptors are responsible for student learning extend faculty resources.Purpose.To determine the effectiveness of an alternative clinical experience (preceptorship).Methods.quasi-experimental, randomized, longitudinal design. Students were randomized to either the traditional or precepted clinical group. The clinical experience was a total of 12 weeks. Groups were compared according to several variables including second semester exam scores, HESI scores, and quality and timeliness of clinical paperwork.Sample.Over a two-year period, seventy-one undergraduate nursing students in the second semester medical-surgical nursing course participated. 36 were randomized to the experimental group. The preceptors were baccalaureate-prepared nurses who have been practicing for at least one year.Setting.Two hospitals located in the Texas Medical Center.Statistical Analysis.Descriptive statistics and independentt-test.Results.There was no difference between the groups on the variables of interest.Conclusion.Students in the precepted clinical group perform as well as those in a traditional clinical group.

Background: An orthopaedic workforce shortage has been projected. The purpose of this study is to analyze the supply side of this shortage by ascertaining the career plans of current orthopaedic residents, comparing these plans with the career patterns of practicing orthopaedists, and identifying career-plan differences according to sex. Methods: An online, self-administered survey was e-mailed to U.S. orthopaedic residents in postgraduate year three or higher, querying them about their fellowship specialty choice and their career plans. Results: A total of 498 residents completed the online survey; 430 respondents (86%) were male, sixty-three (13%) were female, and five (1%) did not provide information regarding sex. Ninety-one percent of the residents were planning to enroll in a fellowship, with some respondents indicating more than one subspecialty choice: 28% intended to choose sports; 21%, arthroplasty; 14%, hand surgery, 12%, trauma; 8%, pediatrics; 8%, shoulder and elbow surgery; 8%, spine surgery; 6%, foot and ankle surgery; and 2%, oncology. With regard to the top career priorities of residents in selecting a fellowship specialty, 40% indicated intellectual priorities; 36%, educational; 21%, lifestyle; and 4%, economic. Significantly more women than men were planning on pursuing a pediatric fellowship (24% versus 6%, respectively, p < 0.05) and significantly fewer were planning on pursuing a sports fellowship (11% versus 31%, respectively, p < 0.05). Significantly more women than men planned on a subspecialty-only practice (62% versus 34%, respectively, p < 0.05). The projected retirement age of sixty-four years for current residents is roughly equal to that of the previous generation. There was no difference between men and women with regard to leadership and research aspirations, projected retirement age, and projected workdays per week. However, significantly more women than men (65% versus 47%, respectively) planned on reducing their work hours or changing to part-time status at some time during their careers. There is a higher percentage of female residents (13%) than female practicing orthopaedists (4%) in the United States. Conclusions: We should continue efforts to collect workforce data and be proactive to avert or minimize the effect of impending orthopaedic workforce shortages on our patients. Given the trend toward an increasing proportion of female orthopaedists and the higher likelihood that they will reduce their work hours during portions of their career, policymakers should consider training more orthopaedists to ensure patient access to timely, quality orthopaedic care.

e17559 Background: There is an oncologist workforce shortage. Medical sub-specialty training experiences influence residents’ career choices. We hypothesized that an inpatient ward rotation may inc...

It is widely recognized that the United States is going to experience a serious shortage of physicians in the coming years unless the number of physicians completing residency training and entering practice is greatly increased. Members of the academic medicine community have approached this issue by calling on Congress to eliminate the cap that currently limits the number of residency positions that Medicare will support. Simply eliminating the cap, however, will not ensure an adequate supply of physicians. In this commentary the author argues that decreasing the length of training required in core clinical specialties will be required to effectively address the workforce shortage by allowing more residents to be trained in core specialties without greatly increasing the number of training programs and the aggregate amount that Medicare currently spends on graduate medical education.

As optical technologies become increasingly important to a variety of industries, the demand for optical engineers, researchers, and technicians continues to grow. Workforce shortages are raising salaries and threatening to slow the growth of exploding markets. Although the slowdown of the telecom industry has reduced the pressure in the near term, optical technologies are as critical today as they were two years ago and the demand for trained workforce will continue to grow. Statistics in the U.S. indicate that we will fail to meet the demands of industry unless the make up of the technical workforce undergoes dramatic changes through the increased participation of segments of the population that are currently under-represented. In an effort to address this challenge, SPIE's Women in Optics (WiO) has developed a variety of programs to attract and retain women in optics- related careers.

The chronic workforce shortage in child and adolescent psychiatry (CAP) remains a germane issue that has been difficult to deal with effectively. Collaboration between medical schools without sufficient CAP resources and those with enough to share may help improve interest in the field.This lecture series piloted a collaborative effort between CAP residents from a Midwest academic center and student-led interest groups from two osteopathic medical schools. CAP residents led nine interactive lectures with medical students on relevant topics, using video-teleconferencing. Baseline and follow-up surveys were used to assess attitudes and responses to the lecture series. RESULTS A group of 175 students completed the baseline survey; 43 students completed the follow-up survey; 21 of 43 (48%) reported that the lectures would positively influence their career choice toward CAP.Interactive lectures via video teleconferencing demonstrated potential to improve medical students' exposure to CAP, and they were well received in this initial pilot study.

The healthcare workforce shortage is a global phenomenon, especially in the ICU. Use of a register nurse-unlicenced assistive personal model is an undeniable reality that fills the void created. Model Team is a structured training program for healthcare assistants to expand their role, facilitating them to perform nursing tasks that require nursing skill and knowledge. The purpose of the study is to investigate whether the Model Team approach could reduce bedside nursing activities.

It will take more than 30 years for some African countries to reach their recommended numbers of doctors on the basis of current training levels, according to new research. Even if attrition rates within their health organisations were limited to premature deaths and other involuntary losses, current workforce training means it would take 36 years for numbers of doctors, nurses, and midwives to reach the World Health Organization’s target of 2.28 professionals per 1000 population, according to a study based on 12 countries in sub-Saharan Africa ( Bulletin of the World Health Organization ; doi:10.2471/BLT.08.051599). And some of the countries, say the authors, will never reach it. “Our results suggest that the health workforce shortage in …