Recently, the Association of American Medical Colleges reported that the United States is facing a physician shortage; in fact, it has been estimated that the United States could face an estimated shortage of 37,800 and 124,000 physicians by 2034 [1]. 

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Predictably, the largest shortages are expected in primary care specialties such as family medicine, pediatrics, and geriatric medicine. In these specialties, the physician shortage range is expected to fall between 17,800 and 48,000. In stark contrast, medical specialties like cardiology, oncology, infectious diseases, and pulmonology are expected to face physician shortages in the range of 3,800 and 13,400. 

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A few demographic trends have been noted for this phenomenon. One, an aging population is driving demand for health care services. By 2034, it is predicted that there will be a 42.4% increase in patients aged 65 and older. As the population grows older, large swathes of the physician workforce are also retiring, with more than two out of every five physicians becoming 65 or older and subsequently retiring or reducing their work hours.

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In order to address this impending physician shortage in the United States, Congress has added 1,000 new Medicare-supported graduate medical education (GME) positions designed to provide health care providers for underserved communities across the nation. The Resident Physician Shortage Reduction Act of 2021 additionally adds 2,000 federally-supported medical residency positions annually for the next seven years [2]. These legislative moves are intended to improve care for rural, underserved, and uninsured communities and expand the number of licensed physicians in diverse geographic areas across the country. 

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In this context, it is important for aspiring physicians to carefully consider the medical specialty they would like to go into. Here is a brief list of in-demand five medical specialties to explore:

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1. Critical Care

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Critical care is one of 12 specialties that the AAMC projects a total shortage of 13,400 physicians by 2034. Also referred to as intensive care doctors, these physicians are charged with the task of caring for the most life-threatening cases. Interestingly, international medical graduates account for up to 40% of critical care physicians in the United States [3].  

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2. Infectious diseases 

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According to a study in the Annals of Internal Medicine, approximately 80% of U.S. counties do not have infectious disease specialists [4]. According to data from the National Resident Matching Program  ID fellowships have had a significantly lower match rate compared to other specialties, with only 82% of available positions being filled. Up to 25% of fellowship programs have had empty slots compared to almost 100% of positions for specialties like cardiology, gastroenterology, and pulmonary disease [5].  

3. Psychiatry

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The U.S. Department of Health and Human Services estimates that the current psychiatrist workforce needs to increase by 2,800 to meet the demand for psychiatric care [6]. In the aftermath of the COVID-19 pandemic, 111 million Americans are expected to live in a psychiatry shortage area, with the current shortage of psychiatrists expected to fall between 14,280 and 31,109 by 2024. The disparity in mental health providers is stark between urban and rural states across the country; in New York State, there are approximately 612 psychiatrists per 100,000 people compared to fewer than one psychiatrist per 100,000 people in Idaho. The American Academy of Child and Adolescent Psychiatry provides a comprehensive map of practicing child and adolescent psychiatrists in the country [8]. This map quantitatively demonstrates the geographic distribution of 10,597 psychiatrists for 74,077,738 children under the age of 18. 

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4. Endocrinology

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Like critical care, endocrinology is one of twelve medical specialties predicted to experience shortages in the next dozen years. By 2025, the shortage of adult endocrinologists will increase to 2,700 [8]. International medical graduates comprise 43% of the endocrinologist workforce in the United States. A key driver for increasing need for endocrinologists is the increasing prevalence of diabetes. In fact, endocrinologists rank 7th among physicians [9]. 

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5. Geriatrics 

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According to the Health Resources and Services Administration of the U.S. Department of Health and Human Services, the next few years will bring a national shortage of geriatricians, up to 26,980 geriatricians by 2025. As seen with other specialties, the degree of shortage is highly dependent on geographic location; states on the Western side of the United States are expected to have a shortage of 14,530 geriatricians compared to 2,890 geriatricians in the northeast. 

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Resources

1. https://www.aamc.org/news-insights/press-releases/aamc-report-reinforces-mounting-physician-shortage
2. https://www.aamc.org/news-insights/press-releases/aamc-endorses-resident-physician-shortage-reduction-act-2021
3. https://www.forbes.com/sites/kristenmoon/2020/05/11/will-attending-medical-school-in-the-caribbean-hurt-my-chances-of-becoming-a-us-doctor/?sh=6981b301676a
4. https://www.acpjournals.org/doi/10.7326/M20-2684
5. https://www.medpagetoday.com/special-reports/exclusives/96108
6. https://adaptivemedicalpartners.com/why-there-is-a-psychiatrist-shortage-and-what-to-do-about-it/
7. https://www.psycom.net/inside-americas-psychiatrist-shortage
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150610/#:~:text=Never%20more%20so%20than%20today,2700%20by%202025%20(4).
9. https://www.merritthawkins.com/uploadedFiles/Merritt-Hawkins-Endocrinology-White-Paper.pdf

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