Match Day and the Future of Pediatric Care

The room is full but quiet. Hands grip sealed envelopes. And in an instant, everything changes.

On Match Day, the dreams of thousands of medical students take shape as they rip open those envelopes and learn where they will go for residency training. It’s a moment filled with relief, pride, and joy after years of study.

For those going into pediatrics, that third Friday every March is the beginning of a commitment to care for children. Each envelope represents the future of a pediatrician or subspecialist who will one day diagnose a rare condition, support a family through uncertainty, and help children heal and grow.

But celebration also comes with urgency as children’s hospitals continue to experience significant workforce shortages.

The reality

Across pediatric health care, workforce challenges are growing, partly because kids need more specialized care.

While children make up 23% of the population, only 8.1% of medical residents initially matched pediatric residency programs in 2025, dropping from 8.8% in 2021.

The demand for specialized pediatric expertise continues to outpace the supply of clinicians trained to provide it. Vacancies in neurology, developmental-behavioral medicine, child and adolescent psychiatry, and genetics are almost unchanged from shortages identified in 2017.

These workforce shortages stem from a variety of factors:

• Lower pay: Reimbursement for pediatric providers is historically low, in part because close to half of children are covered by Medicaid. Lower pay, coupled with other financial disincentives such as educational debt, influences decisions about specialty choice.
• Training: Pediatric subspecialists must have additional training to treat children with serious, complex, or chronic conditions across all ages and stages of physical and emotional development.
• Scholarship and loan forgiveness programs: Many federal scholarship and loan forgiveness programs are adult-care-focused and do not meet the needs of the pediatric workforce.
• Condition-specific needs: Pediatric workforce shortages have been intensified by the ongoing youth mental health crisis and seasonal respiratory illness surges.

And although Match Day helps launch careers in health care, the path from being matched to independent practice takes years of training and sustained support.

Between undergraduate education, medical school, residency, and fellowships, a doctor might spend up to 14 years learning how to care for a specific type of patient or illness. The needs can be even more specific when it comes to pediatrics.

Pediatric providers are trained to deliver compassionate, comprehensive, and developmentally appropriate care to children of all ages, stages of development, backgrounds, and needs. They also need to know how to help patients’ family members who may need emotional support.

This level of expertise cannot be replaced, which is why pediatric workforce shortages threaten access to timely, high-quality care for kids nationwide.

The impact

When pediatric subspecialists are hard to access, families have fewer options. They may travel farther, wait longer, or face more stress as they navigate uncertainty.

Vacancy rates turn into delays, and delays impact child health outcomes. Gaps in specialty care can lead to missed interventions, unmanaged symptoms, worsened conditions, avoidable emergency visits, and escalating family strain.

In a new workforce report, children’s hospitals reported vacancies of 12 months and longer for some pediatric subspecialists. On average, children were waiting close to 21 weeks for medical genetics appointments, more than 21 weeks for developmental-behavioral visits, and 14 weeks to see a pediatric neurologist.

These bottlenecks ripple throughout the whole system. When one area is short-staffed, it can increase pressure on emergency and inpatient settings and affect the path to stability for patients and families.

How we recruit, support, and retain pediatric providers influences whether families continue waiting or finally receive the care their children need.

The future

Match Day gives us a glimpse of tomorrow’s pediatric workforce. It’s a pivotal time not just for medical students, but for the countless children and families who will rely on their care.

These future physicians will celebrate their milestones: taking the first steps after injury, ringing a bell after treatment, and going home after a long hospital stay. They’ll also learn what it’s like when the system is strained by tight schedules, fewer appointments, and growing waitlists.

That’s why Match Day should inspire us not just to celebrate, but to act.

We must strengthen the pediatric workforce now so kids can get the specialized care they need when they need it.

Read CHA’s workforce blueprint to learn more about pediatric workforce challenges and what policymakers can do to alleviate them.