Assessment of the current Canadian rhinology workforce

Smith et al. Journal of Otolaryngology - Head and Neck Surgery (2015) 44:15 DOI 10.1186/s40463-015-0070-x ORIGINAL RESEARCH ARTICLE Open Access Assessment of the current Canadian rhinology workforce Kristine A Smith1 , Doron D Sommer2, Sean Grondin3, Brian Rotenberg4, Marc A Tewfik5, Shaun Kilty6, Erin Wright7, Arif Janjua8, John Lee9, Chris Diamond8 and Luke Rudmik1* Abstract Background: The Canadian Rhinologic workforce and future needs are not well defined. The objective of this study was to define the current demographics and practice patterns of the Canadian Rhinologic workforce. Outcomes from this study can be used to perform rhinologic workforce needs assessments. Methods: A national survey was administered to all Canadian otolaryngologists who were identified to have a clinical practice composed of >50% rhinology. Results: 42 surgeons participated in the survey (65% response rate). The mean age was 46 (SD 10.1) years and the average age of planned retirement was 66 (SD 4.0). Eighty three percent of respondents had completed a rhinology fellowship and 17% practiced exclusively rhinology. Thirty three percent hold advanced degrees. Forty two percent of surgeons felt their access to operative time was insufficient. Six percent of surgeons reported not having access to image guided surgery. Fourteen percent felt that there were too many practicing rhinologists in Canada while 17% believed there were too few practicing rhinologists. Seventeen percent have advised their residents to pursue other fields due to a perceived lack of future jobs. Overall, 66% of respondents were satisfied with their income, and 83% were satisfied with their careers. Conclusions: This study has demonstrated that there is a perceived mismatch between the current supply of Rhinology labor and the capacity to treat patients in a timely manner. Outcomes from this study will begin to improve Rhinologic workforce planning in Canada and reduce the gap between patient demand and access to high quality care. Keywords: Rhinology, Sinusitis, Rhinosinusitis, Workforce, Otolaryngology Introduction Workforce planning is a relatively new approach to identifying the supply and demand of labor [1]. The goal of workforce planning is to identify talent surpluses and shortages, and project future needs to avoid similar issues. It also facilitates matching training to societal needs. In Canada, the lack of jobs in surgical subspecialties is well known. In 2013, the Royal College of Physicians and Surgeons of Canada reported the unemployment rate of recently graduated specialists was approximately 16% [2]. More specifically, of newly graduated otolaryngologists, almost 30% were unable to find permanent employment, despite a declining otolaryngologist to population ratio [2,3]. However, even * Correspondence: 1 Division of Otolaryngology, Head and Neck Surgery, Department of Surgery; University of Calgary, Calgary, Alberta, Canada Full list of author information is available at the end of the article with this apparent ‘surplus’ of surgeons, operative and consultation wait times continue to grow [4]. Deficiencies in the appropriate matching of workforce needs combined with reduced capacity to treat patients in a timely and accessible manner significantly reduces the quality of care and may adversely affect patients’ health [4-7]. Some of these issues would likely be resolved by improving the concordance between societal health needs and labor capacity. All previous attempts to define the otolaryngology workforce have focused on the overall population of otolaryngologists, not individual subspecialties [3,8-11]. With an increasing number of residents pursing fellowship training, characterizing the subspecialist populations is paramount to create accurate workforce planning projections and improving efficient allocation of scarce health care resources [2,8]. Rhinology is a growing subspecialty © 2015 Smith et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Smith et al. Journal of Otolaryngology - Head and Neck Surgery (2015) 44:15 within otolaryngology and this population has not been previously defined. The purpose of this national survey was to describe the contemporary demographics, medical education, practice patterns, and surgeons’ attitudes towards workforce requirements and training of the current Canadian rhinologic workforce. Outcomes from this study will provide the necessary information required for physician workforce modeling and allow us to begin strategically planning for Canada’s future rhinologic needs. Page 2 of 9 Ethics, consent and permissions Institutional ethics review board approval was obtained (ID: # REB14-0970). An email containing a link to the survey and an invitation to participate in the workforce survey was sent to all the otolaryngologists identified to have large volume rhinology practices (>50% rhinology). Participation was entirely voluntary. Two reminder emails were sent, the first one week after the initial invitation and the second two weeks after the initial invitation. Submission of the completed survey was considered informed consent to participate. No identifying data was collected and all survey responses were completely anonymous. Methods Study design Outcomes This was an online survey-based study that invited participants between June and Aug 2014. The primary outcome was to define the demographics of the current rhinologist workforce in Canada. Secondary outcomes included: education, medical training, current practice patterns, scope of practice, income and job satisfaction with rhinology. Participant sample Otolaryngologists with large volume rhinology practices (at least 50% rhinology) were selected for inclusion in the study. We chose a cut off of 50% rhinology since the practice patterns of these otolaryngologists would likely have the largest impact on the overall rhinology workforce. For this study we defined “rhinology” to include all endonasal surgery and excluded the practice of managing nasal conditions which require a rhinoplasty. In order to coordinate across all the provinces and territories in Canada, a representative rhinologist was selected from each province by the principal investigator (LR). Potential participants were identified through a review of the Canadian Society of Otolaryngology – Head and Neck Surgery (CSO) database by the provincial representatives. Email addresses were obtained from the CSO registry where available and otherwise were identified from the provincial representatives. Surv (...truncated)