Are we training too many fellows?

The debate is on: are we training too many fellows for pediatric critical care medicine? Discussions at the recent fellowship directors meeting at the SCCM and on the PICU list seem to indicate we are. But where is the data? Is there a good model of the predicted supply vs. demand? Thanks to David Jardine in Seattle, there is now. His message from the PICU list, announcing his model, and its availability by ftp over the Internet, appears below.

Simply clicking on the file name below should take you to the proper directory, and then clicking on the file name should allow you retrieve the file to your disk. (Note: On my Mac with Netscape 1.1 or 2.01, I have to "option-click" on the file name to download it: your mileage may vary!) Kudos to David for putting some mathematics behind the rhetoric.

  fellows.xls

At the fellowship directors meeting at the SCCM, I presented a model that represented the supply of PICU physicians through the middle of the next century. This model suggests that it is quite probable that we will have an excess of PICU physicians in the future.

I thought some of you might be interested in working with the model in the privacy of your own office, so I have made it available via FTP. You can make your own estimates of the variables and see what happens! The model, which is in the form of a Microsoft Excel (version 5.0) spreadsheet, allows you to change the variables which affect PICU physician supply and demand. You can instantly see what effect these changes _MAY_ have on the number of PICU physicians in the future. PLEASE NOTE THE EMPHASIS ON THE WORD "MAY"; THIS IS ONLY A MODEL, although I have done as much as I am able to produce an accurate model. To keep the model intact, I have locked all the cells except for the variables. You can view the formulae in the locked cells, but cannot change them.

The model is available on an FTP server at the University of Washington. To get a copy, perform an anonymous FTP to "ftp.u.washington.edu". The model is located in the directory "/pub/user-supported/picu". The name of the model is " fellows.xls" (pretty catchy, eh). Before you transfer the model, be sure to set the type to "binary", otherwise the Excel file will not transfer intact. The file will work on IBM compatible or Macintosh computers. If you wish to use the file on a Macintosh computer, you must first open Microsoft Excel, then choose the "Open" command (under the "File" menu) to open the file.

If all this is Greek to you, please do not ask me to explain; get your local computer maven to help.

I would like to hear your comments about the model (both positive and negative). You can post comments to this group, or preferably, direct them to me.