Yet, currently, one-third of American children must travel greater than 40 miles to receive care from many types of pediatric specialists, including those who do what I do in pediatric emergency medicine. In some parts of the country, children have to wait more than three months to get an appointment to see the right pediatric specialist to treat them. The nation’s current supply of pediatric specialists is simply inadequate to take care of the growing needs of children, and the staggering loan repayment burden these physicians face disheartens rather than incentivizes more providers from entering the field.
The next phase of medical training, which includes residency and fellowships for those going into subspecialties, does not make it any easier to pay off this substantial debt. Residency salary averages in 2010 were $48,460, and fellowship salaries are not much more than that—far less than our adult counterparts. This combined training may add up to an additional 4-7 years post medical school graduation.
But pediatricians like me, who choose careers in a subspecialty, do not do so for the salary: we pursue pediatric medicine because we love children. We recognize their resiliency, their potential, their vulnerability and their reliance on our care to grow and thrive. Still, these numbers are hard to swallow, and make it difficult to encourage medical students to pursue the subspecialties we so desperately need to adequately care for our children.
President Obama recognizes the role pediatric subspecialists play in caring for some of our nation’s most vulnerable children: in his Fiscal Year 2013 budget proposal, the president requested $5 million for a loan repayment program contained in Section 5203 of the Affordable Care Act. If fully funded, the program would forgive up to $35,000 in loan forgiveness up to three years for pediatric specialists and surgical specialists who choose to practice in underserved areas.
We need this type of investment if we are to provide the best possible care for our children. I urge Congress to honor the president’s request for this critical program as they consider ways to fund the federal government through the next fiscal year.
Sylvia Owusu-Ansah, MD, MPH, pediatric emergency medicine fellow, Washington, DC. She is also a member of the American Academy of Pediatrics