Back to Basics: A Curriculum to Address the Pediatric Cardiac Anesthesia Workforce Crisis

Abstract

The field of pediatric cardiac anesthesia faces a critical workforce shortage. Survival of children with congenital heart disease (CHD) has improved dramatically, increasing both lifetime procedural demand and case complexity. At the same time, the supply of fellowship-trained pediatric cardiac anesthesiologists is shrinking due to an aging workforce, declining fellowship recruitment, financial disincentives, and concerns about work-life balance and professional culture. The resulting mismatch between demand and supply threatens access to care and risks moral injury and attrition within the specialty. At our institution, workforce pressures necessitated the redistribution of some CHD care to general pediatric anesthesiologists through the Special Cardiac Care Anesthesia (SCCA) model. As this team expanded, members themselves recognized a pressing need for structured education in congenital cardiac physiology and anesthetic implications. In response, the Cardiac Basics curriculum was developed to provide accessible, foundational cardiac content for anesthesiologists, fellows, advanced practice providers, and intensivists. The program was designed with three goals: (1) to provide essential cardiac knowledge, (2) to deliver material in a format accessible to diverse learners, and (3) to foster a psychologically safe environment where all participants could ask questions and engage openly. The curriculum uses weekly topic guides, brief interactive didactic sessions, and case-based reinforcement. It has been well received, with strong participation across learner groups and overwhelmingly positive feedback highlighting clarity, brevity, and clinical applicability. Educational innovations such as Cardiac Basics represent a pragmatic and scalable strategy to address the pediatric cardiac anesthesia workforce crisis. By equipping a broader group of providers with the skills to care safely for selected CHD patients, such curricula can serve as a critical "force multiplier" while longer term solutions-fellowship recruitment, pipeline repair, and cultural change-are pursued.