Establishing physician to patient ratios and predicting workforce needs for Canadian pediatric hematology-oncology programs


  • Jacqueline M. Halton MD,

    Corresponding author
    1. Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
    • Division of Hematology/Oncology, Department of Pediatrics Children's Hospital of Eastern Ontario 401 Smyth Rd Ottawa, Ontario K1H8L1, Canada.
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  • Jack Hand MD,

    1. Department of Pediatrics, Janeway Child Health Centre, St. John's, Newfoundland, Canada
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  • Patricia Byron MSN,

    1. British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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  • Douglas Strother MD,

    1. Department of Oncology and Pediatrics, University of Calgary, Calgary, Alberta, Canada
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  • Victor Blanchette FRCP,

    1. Division of Hematology/Oncology and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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  • for the C17 Council of Canadian Pediatric Hematology Oncology, Transplantation Directors

  • Conflict of interest: Nothing to declare.

  • Dr. Jack Hand died June 2012.



A Human Resources (HR) Committee of C17, the national network of Canadian academic pediatric hematology/oncology programs, obtained comprehensive data enabling analysis and planning for the physician workforce. This study establishes physician to patient ratios and predicts workforce needs for Canadian pediatric hematology/oncology programs.


Over a 10-year period, six surveys were sent to the 17 pediatric tertiary care centers treating children with cancer and blood disorders. Data were obtained on physician demographics, full time equivalent (FTE) positions, and time spent in clinical, research, education, and administrative activities. Survey results were debated at the C17 national meetings to obtain consensus on workload ratios.


Since 1999, the pediatric hematologist/oncologist workforce has increased from 71 FTE (43 oncology, 20 hematology, 8 BMT) to 109.5 FTE positions (69.7 oncology, 29.4 hematology, and 10.4 BMT). The median age of pediatric hematologists/oncologists increased from 46 years to 52 years and the male to female ratio changed from 1.8:1 to 0.9:1. The 2011 job profile showed the median time spent on activities was 60% clinical, 15% education, 15% research, and 10% administration. After assessing workload, models of care, and optimal physician FTE per program, the C17 HR Committee recommended a ratio of one oncologist per 15 newly diagnosed patients with malignancy and a ratio of one BMT physician per 15 transplants. For every 2.5 oncologists, a 1.0 hematologist is the minimum required.


Physician staffing ratios for pediatric hematology/oncology programs have been established and should be adopted across Canadian academic institutions as a standard. Pediatr Blood Cancer 2013; 60: 564–569. © 2012 Wiley Periodicals, Inc.