5 Challenges of Hiring Pediatricians and How to Overcome Them

Hiring and recruiting pediatricians is about finding skilled, compassionate doctors who parents can trust with their child’s health.

Yet, the process is riddled with challenges, from a shrinking talent pool to high turnover rates. If healthcare facilities don’t adapt, they risk delays in care and increased stress on existing staff.

So, how can hospitals and clinics attract and retain top pediatric talent?

Let’s break down the obstacles and the strategies that can help overcome them.

Current State of Pediatrician Recruitment

Pediatrician recruitment in the United States has reached a critical juncture, with healthcare organizations reporting increasing difficulty in filling positions. In the 2024 residency Match, only about 92% of pediatric residency positions were filled—a drop from 97% the year before—according to an AAMC News analysis.

“What we saw this year in the Match® was a wake-up call, but it certainly wasn’t news to us. Over the past four to five years, the number of people matching in pediatrics has been virtually the same, whereas many other fields have grown.” - Jesse Hackell, MD, Chair, The American Academy of Pediatrics Committee on Pediatric Workforce

Most unfilled slots were later taken through the Supplemental Offer and Acceptance Program. This decline is part of a broader, downward trend: the number of U.S. medical school seniors matching into pediatrics in 2022 was 10% lower than in 2017, based on National Resident Matching Program data.

Such trends raise red flags because children comprise a substantial portion of the population, yet pediatricians make up only a small slice of the physician workforce. The U.S. Bureau of Labor Statistics projects just 1% growth in pediatrician employment through 2031—well below the average for physicians—according to a National Library of Medicine report. Although the total number of general pediatricians grew from around 53,600 in 2010 to 56,800 in 2020, much of that growth was confined to urban areas, based on a JAMA Netw Open study.

Rural communities, meanwhile, have seen minimal increases—or even decreases—in pediatrician density. Completely rural counties now have fewer than one pediatrician per 10,000 children, and only 5% of pediatricians practice in those areas, despite roughly 14% of U.S. children living there. As a pediatric residency director told the AAMC, “It’s about cultivating a workforce that meets the needs of our nation’s youth.”

Factors Contributing to Pediatrician Recruitment Issues

Several interconnected factors contribute to ongoing challenges in pediatrician recruitment. Financial disparities, career satisfaction perceptions, and concerns around work-life balance significantly influence medical graduates' decisions, often steering them away from pediatrics and toward more lucrative or lifestyle-friendly specialties. Understanding these dynamics is essential for addressing shortages and strengthening the pediatric workforce.

1. Financial Incentives and Compensation Disparities

One of the most significant hurdles in recruiting pediatricians is the financial reality of pediatric practice. General pediatricians average about $260,000 per year, while many other specialties earn $350,000 or more, and high-paying fields can exceed $500,000. These figures have been noted by AAMC News. Meanwhile, the median medical school debt for new physicians stands around $200,000, which pushes many graduates to choose higher-paying specialties. A cross-sectional study in the Journal of Pediatrics found that heavier debt was associated with trainees veering away from primary care fields such as pediatrics.

“Sometimes I will ask a student interested in a specific specialty, such as infectious disease, if they’ve considered pediatrics, and their immediate reaction is to tell me about their financial situation, debt status, family, etc. But I wasn’t asking about their financial situation. That is exactly where we’ve left students.” - Sallie Permar, MD, PhD, Professor of Pediatrics and Chair of the Department of Pediatrics at Weill Cornell Medicine

Much of the compensation gap is rooted in lower reimbursement rates. More than half of U.S. children receive insurance via Medicaid or CHIP, which typically reimburses at about two-thirds the rate of Medicare—and Medicare itself pays less than private insurers, as noted in the AAMC analysis. Private pediatric practices seeing mostly Medicaid-insured patients often find it difficult to break even. Pediatricians also spend substantial time on preventive care and counseling, which are less lucrative than procedures. This financial disadvantage deters many from entering the field, especially new graduates facing high debt.

2. Perceptions of Career Satisfaction

Beyond money, the perceptions of prestige and satisfaction in pediatrics can be mixed. A cultural bias in medical education often glamorizes procedural specialties while viewing primary care fields like pediatrics as having lower prestige, a point discussed by Dr. Poitevien in a Cornell post. The reality, however, is that 84% of pediatricians report high career satisfaction, and around 9 in 10 find their work personally rewarding, according to surveys from the American Academy of Pediatrics. Yet burnout remains a concern. Studies have shown that over 60% of pediatricians experience at least one burnout dimension—figures cited in a McKinsey analysis.

Contributors to burnout include administrative overload and the emotional toll of working with sick children and anxious families.

3. Work-Life Balance and Job Expectations

Many early-career physicians worry that pediatrics may not allow a favorable work-life balance. Night and weekend calls, complex family needs, and significant administrative work can lead to long hours. Surveys of pediatric residents have indicated that 71% are satisfied with their work-life balance, compared to 83% satisfied with their overall careers—a gap that suggests balancing personal responsibilities remains a challenge (as noted in PubMed research). Because about 65.6% of pediatricians are women, according to AAMC data, there is also a higher demand for flexible or part-time schedules. Excessive workload can hasten burnout, making it harder to retain those who do choose pediatrics.

Effects of Declining Interest in Pediatrics

The declining interest in pediatrics has far-reaching consequences that ripple throughout child healthcare systems. Pediatrician shortages not only affect the availability and quality of pediatric services but also place additional strain on healthcare professionals and families, particularly those in underserved regions. Addressing these impacts is crucial to ensuring sustainable, accessible healthcare for children.

4. Impact on Child Healthcare Services

A shrinking pediatric workforce reduces access to care for children, lengthens wait times, and constrains specialized services. Pediatric subspecialty shortages are especially concerning. In 2022, fellowship programs in pediatric endocrinology, nephrology, infectious disease, and developmental pediatrics filled 70% or fewer of their available slots, based on research in The Journal of Pediatrics. Fewer subspecialty trainees now mean even tighter shortages in a few years, driving longer delays for appointments and potentially compromising timely treatment for serious conditions. One AAMC News report highlighted a child waiting four months to see a pediatric neurologist, a delay that can be life-altering in critical cases.

Even for general pediatrics, rural and underserved areas face acute shortages. Only about 5% of pediatricians practice in rural counties, though close to 14% of U.S. children live there. Rural families might rely on urgent care centers or adult-focused physicians instead, limiting comprehensive preventive care for children. Some children’s hospitals, especially those in smaller communities, have had to reduce services or close units due to insufficient staffing. Hospitals also report persistent vacancies in neurologic, behavioral, and mental health specialties for children, as summarized by the Children’s Hospital Association.

The dearth of child mental-health professionals intersects with the pediatrician shortage because pediatricians are typically on the front line for issues such as anxiety, ADHD, and depression in youth.

5. Consequences for Pediatricians and Families

Shortages also hurt current pediatricians, who must take heavier workloads to fill gaps, fueling a burnout cycle. Surveys show that nearly one-third of pediatric faculty have considered retiring early or leaving clinical practice, citing workload as a major factor. For families, fewer pediatricians mean diminished continuity of care—parents may see multiple providers or wait long periods for appointments, fragmenting healthcare for children. Rural children are especially disadvantaged, as many must travel to distant cities for specialized treatment.

Healthcare organizations also feel the strain. Overreliance on nurse practitioners (NPs) or physician assistants (PAs) can help alleviate workload but is not a full substitute for board-certified pediatricians, particularly in complex cases. Dr. Poitevien cautioned in a Cornell interview that children facing advanced or rare diseases still require highly specialized pediatric expertise. If the pediatric workforce pipeline continues to decline, it will undermine childhood preventive care and potentially increase healthcare costs long-term, as unaddressed issues in children can become more serious adult conditions.

Effective Pediatrician Recruitment Strategies

While the challenges are significant, there are concrete, proactive steps that hospitals, clinics, and healthcare systems can take to attract and retain pediatricians. Below are three broad areas of focus.

Highlight the Impactful Nature of Pediatrics

One of pediatrics’ greatest strengths is its profound impact on children’s lives. Recruiters should emphasize this sense of mission to inspire potential candidates. Many enter pediatrics out of a desire to improve the future for children; showcasing stories that demonstrate this impact can resonate powerfully with medical graduates.

Patient stories and success cases: Sharing anecdotes about children who have thrived thanks to timely pediatric interventions demonstrates the field’s importance. Below is a great example:

Long-term influence on public health: Pediatricians tackle everything from newborn screening and immunizations to adolescent mental health, often reducing the future burden of disease. In fact, achievements in pediatric research over the past few decades have dramatically improved child health outcomes, underscoring how early interventions can shape a lifetime.

Advocacy and community leadership: Pediatricians frequently lead local health efforts, from vaccination drives to policy advocacy. For students who want to address societal issues, pediatrics offers a direct path—pediatricians often become community leaders.

Recruitment materials that feature personal testimonials—such as a pediatrician who has cared for multiple generations of the same family—convey the emotional rewards and vital role pediatricians play. Highlighting pediatric research breakthroughs also appeals to those seeking innovative, cutting-edge opportunities. By framing pediatrics as both compassionate and forward-looking, organizations can counter the perception that it lacks prestige.

Address Financial Concerns

No matter how altruistic a trainee might be, finances matter. Pediatricians earn an average of about $260,000 per year, significantly less than many other physician specialists, according to AAMC data. Meanwhile, newly graduated doctors often face around $200,000 in medical school debt, based on an AAMC report. To offset lower earning potential, healthcare organizations should offer:

Competitive compensation packages: Even modest salary boosts or sign-on bonuses can make pediatrics more financially attractive.
Loan repayment or forgiveness: Assisting with large medical school debts can be a game-changer for new pediatricians. Employers might provide a set annual loan payment or a lump-sum reduction after a certain tenure.
Scholarships and stipends: Partnerships with medical education programs can provide scholarships to students committed to pediatrics. Residency programs can offer housing stipends or other perks that lighten the financial load.
Retention bonuses: Offering financial incentives at three- or five-year milestones encourages longer stays and helps organizations recoup their recruitment investment.

On a systemic level, stronger advocacy for higher Medicaid reimbursement is crucial. Pediatric services often rely on Medicaid, which pays significantly less than Medicare or private insurance—typically about two-thirds the rate of Medicare, according to the AAMC. Raising these rates would help practices pay pediatricians more competitively. Programs like the Children’s Hospital Graduate Medical Education (CHGME) program can also expand pediatric residency slots. By making systemic shifts—while also offering immediate incentives—health systems can reduce the financial deterrents for aspiring pediatricians.

Promote Work-Life Balance

Work-life balance is a priority for the new generation of physicians, including many who weigh the demands of pediatric practice against personal considerations. Surveys indicate that about 71% of recent pediatric residency graduates are satisfied with their work-life balance, while 83% are satisfied with their overall careers, according to PubMed research. Additionally, around 65.6% of pediatricians are women, based on AAMC data, which often heightens the need for flexible scheduling. Advertising family-friendly policies can make pediatrics more appealing.

Flexible scheduling: Allow pediatricians to help design their own schedules, compress work weeks, or swap on-call days. Shift-based hospitalist models can reduce after-hours burdens.
Adequate support staff: Scribes, nurses, and allied health professionals (NPs, PAs) can share administrative tasks, reducing burnout from electronic health record documentation and paperwork.
Protected personal time: Encourage pediatricians to use vacation time and arrange coverage so they truly can step away from work. Some children’s hospitals have on-site childcare, an especially attractive feature in a field with many working parents.
Wellness culture: Mentorship programs, peer-support groups, and reduced after-hours charting can bolster physician well-being. Organizations should show tangible commitment, for instance, by highlighting a measurable reduction in after-hours workload.

Publicizing these efforts in recruitment materials is essential. Candidates often ask current pediatricians about their real experiences. If an institution’s staff feel genuinely supported, that reputation spreads and becomes a key selling point for new hires.

Targeted Interventions for Recruitment

In addition to broad strategies, more focused interventions can strengthen the pediatric pipeline.

Mentorship Programs for Medical Students

Early, positive exposure to pediatrics can tip a student’s decision toward the field. Hospitals and academic pediatric departments can:

Create pediatric interest groups at local medical schools. Faculty and community pediatricians serve as mentors, hosting career panels or shadowing opportunities.
Pair medical students with pediatric residents in a near-peer mentorship model. Hearing firsthand why current residents chose pediatrics can spark lasting interest.
Offer summer internships or research experiences in pediatrics. Students who get hands-on exposure are more likely to find the specialty rewarding and choose it.

For example, The American Society of Pediatric Hematology/Oncology (ASPHO) exemplifies this approach through its Early Career Mentoring Program, which pairs medical students and trainees with seasoned professionals in clinical, research, and educational paths, thus supporting informed career decisions and fostering excellent patient care. Watch the video below for more details:

Studies show that mentorship strongly influences specialty choice—one survey revealed a close association between students’ interaction with mentors and selecting that mentor’s field. Providing structured, enthusiastic mentorship throughout medical school and early residency can help sustain a student’s interest and counter negative stereotypes.

Community Outreach and Engagement

Another way to build the pediatric workforce is to reach potential future doctors before they even apply to medical school while also raising the profile of pediatrics among the public.

Partner with local schools to host “Meet the Pediatrician” sessions or career fairs that demystify the profession for high school or college students.
Public health campaigns led by pediatricians (e.g., vaccination drives or free children’s health screenings) can elevate the visibility of pediatrics. Watching pediatricians in action may inspire youth to follow in their footsteps.
Target underserved or rural communities, which often produce physicians inclined to return home and serve those areas. Pipeline programs that identify and support such students early can help address regional shortages.

An inspiring example is The Oliver Patch Project, a community initiative providing personalized denim jackets adorned with patches for young cancer patients. This kind of visible community involvement highlights the compassionate role pediatricians play and can motivate young people considering healthcare careers. Check out the video below to learn more:

By engaging the community, pediatricians show that theirs is a specialty dedicated to advocacy, leadership, and grassroots health improvement—a message that resonates strongly with socially minded students. Initiatives like the Community Pediatrics Training Initiative (CPTI) have demonstrated that when pediatric residents work on community-based projects, they often feel more connected to the mission and remain in the field, according to research on CPTI outcomes.

Collaborations With Medical Schools

Close collaboration between hospitals and medical schools ensures that future physicians receive robust pediatric exposure and that more residency slots are available.

Enriched pediatric curriculum: Many programs incorporate pediatric cases and simulations throughout the four-year medical school experience rather than relegating pediatrics to a short rotation. National Academies reports have called for rethinking how students encounter pediatrics early in their training.
Combined or early-acceptance programs: A medical school might guarantee early acceptance into its pediatric residency for students who commit to pediatrics by their third year, potentially including scholarships.
Align training with local workforce needs: If a region needs more general pediatricians or specific subspecialists, residency and fellowship programs can expand or tailor their offerings. Fellowship incentives—like extra stipends—can attract residents to subspecialties with severe shortages.

The University of Minnesota’s Department of Pediatrics demonstrates effective collaboration with a structured mentorship plan that includes research and promotion mentors, professional development resources, and community-building activities tailored to local workforce needs.

By working together, educational institutions and healthcare organizations can “grow their own” pediatric workforce. Providing consistent mentorship, curricular support, and local job opportunities makes pediatrics a more seamless pathway. Approximately half of pediatric residency entrants decide on pediatrics before even starting medical school, according to AAMC survey data. Ensuring strong pediatric exposure for the other half can tip more students toward the field.