Christopher Theriault ¹ Tracy Burns ² Kenneth Goldschneider ^3,4 Anjali Koka ⁵ Deirdre Logan ⁵ Steven J. Weisman ^6,7 Robert T. Wilder ⁸ Robert B. Windsor ^10,9 William T. Zempsky ^1,11*

• ¹ Connecticut Children's Medical Center, Hartford, United States
• ² Children’s National Hospital, Washington D.C., District of Columbia, United States
• ³ Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
• ⁴ College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States
• ⁵ Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States
• ⁶ Children's Hospital of Wisconsin, Milwaukee, Wisconsin, United States
• ⁷ Medical College of Wisconsin, Milwaukee, Wisconsin, United States
• ⁸ Children’s Center, Mayo Clinic, Rochester, Minnesota, United States
• ⁹ Prisma Health Children's Hospital, Greenville, Illinois, United States
• ¹⁰ School of Medicine Columbia, University of South Carolina, Columbia, South Carolina, United States
• ¹¹ School of Medicine, University of Connecticut, Farmington, Connecticut, United States

Introduction: Many youth with pain lack access to pediatric pain expertise. There is a critical shortage of pediatric pain physicians, due partly to a paucity of training programs in Pediatric Pain Medicine. Pain fellowships are Anesthesiology-based and there is no pathway to fellowship training or Pain Medicine board certification for pediatricians. This workforce assessment sought to examine the current state of Pediatric Pain Medicine in the United States and future interest in pursuing Pain Medicine among pediatricians. Methods: A multidisciplinary working group of Pain Medicine clinicians designed three surveys to examine pediatric comprehensive pain programs in the US, practice patterns of pediatricians and their motivations and opinions regarding Pain Medicine board certification, and current residents' exposure to and interest in Pediatric Pain Medicine.Results: Wait times for initial evaluations are two months or longer for two-thirds of responding centers, and barriers to increase staff size and resources were reported, including an inadequate number of trained or available physicians. Pediatricians expressed interest in earning board certification in Pain Medicine, given the opportunity. Additionally, there is interest among pediatric residents in pursuing Pediatric Pain Medicine, and qualitative data highlight information residents perceived needing in order to pursue a career in the field.Discussion: Results demonstrate the need for increased training opportunities in pediatric pain medicine. A formal pathway to Pain Medicine for Pediatricians should be developed to increase the potential workforce and to address the lack of trained pediatric pain specialists, thereby improving access to care for youth with pain.