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Bridging the Gap: Aligning Aspirations with Workforce Reality in Pediatric Endocrinology

Bridging the Gap: Aligning Aspirations with Workforce Reality in Pediatric Endocrinology 1024 683 Pam Georgiana

Recent survey reveals a mismatch in career expectations and realities, calling for enhanced mentorship and policy reform.

Pediatric endocrinology, like many pediatric subspecialities, is struggling to sustain an adequate workforce.

When Leena Nahata, MD, served on the Research Affairs Committee of the Pediatric Endocrine Society in 2024, a topic of interest for the upcoming annual conference was understanding the career goals and expectations of current pediatric endocrinology fellows.

Studio portrait of Dr. Leena Nahata

Leena Nahata, MD

“We on the committee had noticed a decreasing interest in research among fellows. So, we wanted to better understand what the current cohort envisions for their future careers,” says Dr. Nahata.

Dr. Nahata is the founding medical director of the Fertility and Reproductive Health Program at Nationwide Children’s Hospital, principal investigator in the Center for Biobehavioral Health at the Abigail Wexner Research Institute at Nationwide Children’s, and professor of Clinical Pediatrics at The Ohio State University College of Medicine.

The committee conducted a cross-sectional survey study of pediatric endocrinology fellows from the United States and Canada. One hundred twenty-seven fellows completed the survey — nearly a 50% response rate. The results were recently published in The Journal of Pediatrics.

Expectation vs. Reality in Patient Care Time

Among notable insights from the study was the mismatch between respondents’ ideal and actual time spent on patient care. Fellows reported that, on average, they envisioned dedicating 61% of their post-fellowship work time to patient care. However, third- and fourth-year fellows reported accepting job offers with 75% of their time dedicated to patient care.

“This gap suggests that young specialists may quickly discover that clinical obligations supersede time they had hoped to dedicate to research, education and quality improvement. This trend has important implications for career satisfaction, retention and future interest in the field,” explains Dr. Nahata.

Research: Few Aspirations, Fewer Opportunities

Equally concerning, only 13% of fellows envisioned spending at least half of their time on research, and 6% of those with job offers had positions with a strong research focus.

“Who will advance the field if we are not cultivating a new generation of physician-scientists?” Dr. Nahata asks.

Early-career roles are often focused on revenue-generating clinical work. Consequently, many talented junior faculty may lack the necessary time and resources to secure funding and become successful physician-scientists.

Implications for the Future of Pediatric Endocrinology

The study also highlights broader workforce considerations. Nearly one-quarter of respondents noted that visa considerations influenced their job opportunities. We also know that numerous pediatric endocrinology fellowship positions remain unfilled. This creates a dual crisis: a clinical workforce shortage and a dwindling pipeline of pediatric physician-scientists.

Dr. Nahata advocates for enhanced exposure to pediatric subspecialties, research and structured mentorship during medical training. Advocating for improved compensation for these subspecialties and increasing strategies to make research careers sustainable (such as federal loan repayment and targeted early-career funding) could also help bridge the gap.

“For pediatric endocrinology — and potentially other pediatric subspecialties — the message is clear: we must better prepare our fellows for their future careers and also develop future physician-scientists,” Dr. Nahata concludes.

This article appeared in the Spring/Summer 2025 issue. Download the full issue.

Reference:

Nahata L, Srinivasan S, Roche CI, Leavens KF, Kim MS, Levenson A, Topor LS, Singer K, McCormack S. Measuring up: Do pediatric endocrinology fellows’ career expectations align with workforce reality? J Pediatr. 2024;275:114321.

About the author

Pam Georgiana is a brand marketing professional and writer located in Bexley, Ohio. She believes that words bind us together as humans and that the best stories remind us of our humanity. She specialized in telling engaging stories for healthcare, B2B services, and nonprofits using classic storytelling techniques. Pam has earned an MBA in Marketing from Capital University in Columbus, Ohio.

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