Authors: Deutsch N et al.
Source: Anesthesia & Analgesia. February 2026. Volume 142(2):232–244. DOI: 10.1213/ANE.0000000000007440
Summary:
The demand for pediatric cardiac anesthesiologists in the United States continues to rise as survival among patients with congenital heart disease improves, yet workforce growth has failed to keep pace. In this national survey-based analysis, the Pediatric Anesthesia Leadership Council and the Congenital Cardiac Anesthesia Society evaluated the current state of pediatric cardiac anesthesiology staffing, work environment, training, compensation, and career development.
Across multiple stakeholder groups—including faculty anesthesiologists, division chiefs, fellowship directors, and recent fellowship graduates—response rates were high, lending strength to the findings. Nearly one-third of practicing pediatric cardiac anesthesiologists reported considering leaving the subspecialty for a less stressful field. Despite widespread involvement in academic activities, more than one-third of faculty reported receiving no protected nonclinical time, fewer than half reported formal mentorship, and fewer than half had received sponsorship for leadership roles, research, or national speaking opportunities.
Workforce projections revealed substantial anticipated hiring needs, with 129 positions expected over the next five years and nearly 200 over the next decade. Respondents rated hiring difficulty as very high, reflecting a shrinking pipeline of trainees relative to demand. Although fellowship numbers have increased modestly, growth has not been sufficient to address projected staffing gaps, raising concern for the sustainability of pediatric cardiac anesthesia services nationwide.
The authors conclude that without meaningful improvements in recruitment, retention, academic support, mentorship, and professional development, staffing shortages in pediatric cardiac anesthesiology are likely to worsen, potentially compromising access to high-quality perioperative care for children with congenital heart disease.
What You Should Know:
• Nearly one-third of pediatric cardiac anesthesiologists are considering leaving the subspecialty.
• Protected academic time, mentorship, and sponsorship for career advancement are inconsistent and often lacking.
• Hiring demand far exceeds the current trainee pipeline, with severe challenges anticipated over the next decade.
• Workforce instability may threaten future access to specialized pediatric cardiac anesthesia care.
Key Points:
• This national survey highlights critical workforce strain in pediatric cardiac anesthesiology.
• Burnout, insufficient support, and limited career development are major contributors to attrition risk.
• Anticipated hiring needs significantly outpace fellowship training output.
• Strategic efforts to recruit, retain, and support pediatric cardiac anesthesiologists are urgently needed.
Thank you to Anesthesia & Analgesia for publishing this important workforce analysis addressing a growing threat to the sustainability of pediatric cardiac anesthesiology in the United States.