Furthermore, the REF Blue Ribbon Panel, which was convened to review and evaluate the REF’s portfolio, states that the award “has been very successful and has contributed to increased numbers of rheumatology trainees,” and indicates that it was “clear there are a variety of needs with respect to amount, duration, and flexibility for the ‘ideal’ award that varies widely between programs.” The Blue Ribbon Panel also recommends that the REF “consider modifications of the award that will increase the diversity of the rheumatology workforce and decrease the number of unfunded rheumatology training slots.”
The REF continues to work closely with the ACR Committee on Workforce and Training to determine the best way to support rheumatology training programs. This committee—which includes representatives from adult and pediatric rheumatology and other health professionals—interacts regularly with training program directors, providing a broad range of input essential to any ongoing needs assessment.
From 2002 to 2008, the number of first-year training slots increased from 177 to 189, only a paltry growth rate given our projected workforce needs. Today, programs are filling most of their available slots. Therefore, the number of graduates is likely to remain static over the next few years unless divisions are able to expand their fellowship programs. In a recent comprehensive study of academic rheumatology programs in the United States led by the ACR Committee on Workforce and Training, fellowship program directors identified availability of trainee salary support as the major barrier to accepting additional trainees. Thus, expansion will require additional funds that are difficult to obtain in the cash-strapped academic environment.
The REF also recognizes the scarcity of underrepresented minorities in the field of rheumatology. The most recent Workforce Survey commissioned by the ACR revealed that only 1–4% of rheumatologists are underrepresented minorities. How can the REF use the Rheumatology Fellowship Training Award to increase the diversity of the rheumatology workforce? This is yet another question we need to answer.
The ACR REF/Amgen/Pfizer Rheumatology Fellowship Training Award holds a prominent place in the history of the REF. Although it is only a partial solution to our workforce needs, this award nevertheless represents a vital tool in the overall strategy to address the burgeoning demand for rheumatologists. The REF stands firm in its commitment to this award, a rallying point for “ensuring the future of rheumatology.”
Dr. St.Clair is president of the ACR REF and interim chief of the division of rheumatology and immunology at Duke University in Durham, N.C. Contact him at [email protected].
