(Press-News.org) With children across the U.S. facing long wait times for medical care due to a shortage of pediatricians, UC San Francisco has launched a medical education program designed to strengthen the pediatric workforce and improve childhood health outcomes.
The Pediatric Specialized Training and Advancement to Residency Track (Peds-START) is the only program of its kind in the West and provides early mentorship, individualized training, and a pathway into the UCSF pediatric residency program.
Nationwide, there are just 82 pediatricians per 100,000 children, compared with 348 adult physicians per 100,000 adults, according to national workforce data. The pediatrician shortage contributes to delayed diagnoses and treatment and is linked to the United States’ poor performance on childhood health measures relative to other high-income countries.
“Children are waiting weeks or months for the care they need,” said Michele Long, MD, a pediatric hospitalist at UCSF Benioff Children’s Hospitals and director of Peds-START. “We need to remove barriers that discourage talented students from choosing pediatrics and support them early in their training.”
The U.S. ranks behind dozens of peer nations in childhood health outcomes, including survival from birth defects, which claim nearly 6,000 children ages four and under each year. Experts say insufficient access to pediatric care is a contributing factor.
A new pathway into pediatrics
Peds-START, launched in January 2025, enrolls medical students early in their education, pairing them with pediatric mentors, offering pediatrics-focused clinical experiences, and providing a pathway into UCSF’s pediatric residency program upon graduation.
The program was inspired by the success of a prior pilot program that produced almost two dozen practicing pediatricians and pediatric subspecialists.
“Medical students face intense pressure related to specialty choice, residency placement, and educational debt,” Long said. “By offering structured support and a clear pathway, Peds-START allows students to focus on becoming excellent pediatricians.”
Workforce impact and lived experience
Kathleen Wallace, MD, a UCSF alumna of the prior pilot program that inspired Peds-START, is a practicing pediatrician in San Francisco and said the program helped her commit to pediatrics and to serving patients in her community.
“The mentorship and early clinical exposure were essential,” Wallace said. “It gave me the confidence to pursue pediatrics and tailor my education to serve children who reflect the communities I grew up in.”
Long said her own experiences struggling to secure timely pediatric subspecialty care for her hospitalized patients highlighted the urgency of workforce expansion.
“Families were waiting six months or longer for follow-up appointments,” she said. “That delay can have real consequences for children’s health.”
Policy drives the shortage
While California fares slightly better than the national average — with 86 pediatricians per 100,000 children — shortages are severe in rural and less-populated states. Idaho has the fewest pediatricians per capita in the nation.
According to Janet Coffman, PhD, MPP, MA, a researcher at UCSF’s Institute for Health Policy Studies, the shortage is mainly driven by federal and state policy decisions.
“It is important to remember that policy created the physician and pediatrician shortage, and policy can solve the shortage,” Coffman said.
She cited limited federal funding for pediatric residency positions, lower reimbursement rates for pediatric care, and caps on federally supported graduate medical education slots. Although children represent 22% of the U.S. population, fewer than 10% of residency positions are in pediatrics.
Coffman and other experts say solutions must include expanded federal graduate medical education funding for pediatrics, increased support for children’s hospitals, removal of residency caps, improved Medicaid reimbursement for pediatric care, and better loan-forgiveness programs.
“Programs like Peds-START are essential,” Coffman said. “But without systemic policy change, the pediatrician shortage will persist — and children will continue to pay the price.”
About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF’s primary academic medical center, includes among the nation's top specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at https://ucsf.edu or see our Fact Sheet.
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