Forecasting the Workforce of Uveitis Specialists.

OBJECTIVE

The uveitis subspeciality faces workforce inadequacy in the setting of a rising burden of uveitis coupled with a decline in the number of specialists. While workforce projections exist for other ophthalmologic sub-specialties, none have modeled the future supply of uveitis specialists. The objective of our study was to characterize the current workforce and project its future supply in the United States through 2055.

DESIGN

Simulation projection study using retrospective trend data.

SUBJECTS: AUS-Registered uveitis specialists in the United States.

METHODS

We identified 224 specialists self-identifying as practicing in the U.S. using the American Uveitis Society (AUS) roster and characterized their years in practice and geographic distribution. Two Monte Carlo simulations were developed incorporating dual-training, age-specific mortality, retirement rates and fellowship match data. A fixed-entry model simulated low, status-quo, or optimistic scenarios assuming a constant annual number of new entrants, while a stochastic model incorporated annual growth and variability. Simulations were run over 100 iterations.

MAIN OUTCOME MEASURE: Projected number of practicing uveitis specialists in the United States through 2055.

RESULTS

The current workforce had a median of 12 years in practice (IQR, 7-24). Specialists were clustered in states with large metropolitan regions, while 11 states lacked any AUS-registered physicians and 32 states had fewer than 1 specialist per million residents. Five states have a high risk of workforce attrition based on average years in practice. Under the fixed entrant model, the number of uveitis specialists is expected to decline to 145 in the low scenario (-35%), increase to 268 in the status-quo (+20%), and expand to 418 in the optimistic scenario (+87%) by 2055. The stochastic projection estimated 512 uveitis specialists by 2055.

CONCLUSION

Our findings highlight the importance of sustaining the current pipeline of uveitis specialists and encouraging the development of more trainees to strengthen the workforce to allow for timely access to uveitis subspeciality care in the coming years. Future work is needed to evaluate the future uveitis workforce relative to patient demand.