Survey of Board-Certified Adult Congenital Heart Disease Providers Assessing Workforce Gaps

Adults with congenital heart disease (ACHD) are a rapidly growing population of patients with multisystemic issues that stem beyond the heart and require expert, specialized care. There is a critical shortage of adult congenital heart disease (ACHD)-trained physicians, with widening gaps in care projected. We designed a 26-question cross-sectional survey that was distributed via the Adult Congenital Heart Association to United States-based American Board of Internal Medicine ACHD certified physicians between December 2023 and March 2024, with a goal of evaluating their demography and opinions regarding workforce issues, gauging opinion regarding potential solutions. One hundred nineteen of 473 ACHD physicians (25%) responded, with complete responses to all questions by 104 (22%). Most respondents (67%) had not completed an ACHD-specific fellowship. Two-thirds were board-certified in pediatric cardiology, 32% in adult cardiovascular disease, and 34% were dual certified. Only 42% reported practicing ACHD as their “full-time” field. Nearly all (95%) were concerned about workforce shortages, and 87% planned to board recertify. Early-career physicians were less likely than their seniors to choose ACHD again or express a plan to recertify. While most favored revising current training pathways, the preferred pathway differed by training experience. In conclusion, less than half of currently boarded ACHD physician practice in their specialty full-time, suggesting even greater gaps in access to care for this complicated patient population.