Source: AAMCNEWS
Written By: Patrick Boyle, Senior Staff Writer
More women are becoming doctors, doctors of different racial backgrounds are drawn to different areas of practice, and sports medicine continues to grow fastest of all specialties, according to a new report from the AAMC.
Interest is booming in sports medicine and interventional cardiology, while fewer doctors are specializing in orthopedic surgery and radiology. The number of women doctors continues to grow and they are most apt to focus their practice on children, women, and families, while men are more likely to become surgeons.
Those are among the findings in the AAMC’s 2022 Physician Specialty Data Report, which highlights the numbers of physicians, residents, and fellows among the 48 largest specialties in 2021. For the first time since its inception in 2008, the biennial report presents data on the race and ethnicity of active physicians — showing, for example, that Asian doctors are especially likely to focus on nephrology, Hispanic doctors (regardless of race) on geriatric medicine, Black doctors on obstetrics and gynecology, and Pacific Islander, American Indian, and Alaska natives on pain management.
Here are some notable trends revealed by the 2021 data, which covers about 950,000 active physicians.
Broad specialties draw broad interest
The largest number of active physicians are in primary care specialties: internal medicine (120,342 physicians), family medicine/general practice (118,641), and pediatrics (60,305). The numbers for some other specialties:
- Emergency medicine — 46,857
- Cardiovascular disease — 22,262
- Ophthalmology — 18,948
- Urology — 10,081
- Allergy and immunology — 5,009
- Clinical cardiac electrophysiology — 2,632
Asked to identify their major professional activity, the physicians reported:
- Patient care — 819,007
- Research — 12,357
- Teaching — 12,248
- Other — 106,046
Wide varieties in race/ethnicity
Physicians could report more than one race or not respond. Among the findings, by percentage of active physicians:
- Native Hawaiian or Other Pacific Islander — 0.1%
- American Indian or Alaska Native — 0.3%
- Multiple races, non-Hispanic — 1.3%
- Black or African American — 5.7%
- Hispanic — 6.9%
- Asian — 20.6%
- White — 63.9%
Among the most popular specialties, by race/ethnicity:
- Native Hawaiian or Other Pacific Islander — Sports medicine, pediatric anesthesiology, pain medicine and pain management
- American Indian or Alaska Native — Family medicine/general practice, preventive medicine, pain medicine and pain management
- Multiple races, non-Hispanic — Pediatric anesthesiology, sports medicine, vascular and interventional radiology
- Black or African American — Obstetrics and gynecology, preventive medicine, child and adolescent psychiatry
- Hispanic — Geriatric medicine, infectious disease, child and adolescent psychiatry
- Asian — Nephrology, interventional cardiology, geriatric medicine
- White — Orthopedic surgery, sports medicine (orthopedic surgery), otolaryngology
“One clear takeaway is that physicians from groups underrepresented in medicine are more concentrated in primary care and a few other specialties, like pain medicine and pain management,” says Michael Dill, the AAMC’s director of workforce studies.
Different genders, different specialties
More than one-third (37.1%) of the active physician workforce in the United States were women, continuing a steady rise. According to the Physician Specialty Data Reports from 2008 to 2022, the percentage of active physicians who were women stood at:
- 2007 — 28.3%
- 2010 — 30.4%
- 2013 — 32.6%
- 2015 — 34.0%
- 2017 — 35.2%
- 2019 — 36.3%
- 2021 — 37.1%
The increase in women physicians reflects the continuing rise in the number of medical students who are women. Data released last month by the AAMC show that for the 2022-23 school year, women accounted for the majority of applicants, matriculants, and total enrollees — the fourth consecutive year that women have made up the majority of all three groups.
Most of the specialties in which women made up the majority of active physicians focus on children, women, and families, including:
- Pediatrics — 65%
- Obstetrics and gynecology — 60.5%
- Pediatric hematology/oncology — 55.7%
- Child and adolescent psychiatry — 54.6%
- Neonatal-perinatal medicine — 54.2%
Women also accounted for just over half of physicians in dermatology, geriatric medicine, and endocrinology, diabetes, and metabolism.
However, they remained a significant minority in several specialties, especially surgeries, including:
- Orthopedic surgery — 5.9%
- Thoracic surgery — 8.3%
- Neurological surgery — 9.6%
“Year after year, we see women physicians remain concentrated in the same specialties,” Dill says. “That tells us we have much more work to do in terms of gender equity in the physician workforce.”
Specialty preferences change
Several specialties grew significantly from 2015 through 2021, while some declined. Among those that grew or decreased the most, with the percentage change:
- Sports medicine — up 42.5%
- Pediatric anesthesiology — up 37.7%
- Interventional cardiology — up 32.6%
- General surgery — down 2.2%
- Radiology and diagnostic radiology — down 2.4%
- Orthopedic surgery — down 3.7%
Aging Workforce
The physician workforce continues to grow older, on average: 46.7% of active physicians in the United States were age 55 or older — up from 44.9% in 2019 and 37.6% in the first specialty report, which covered 2007.
The specialties with the highest share of doctors ages 55 and above included:
- Preventive medicine — 71.4%
- Cardiovascular disease — 64.9%
- Thoracic surgery — 62.7%
Those with the highest share of doctors under age 55 included:
- Sports medicine — 91%
- Pediatric anesthesiology — 89.4%
- Internal medicine/pediatrics — 83.3%
The AAMC has said that the growing number of physicians nearing retirement age is one factor behind a projected physician shortage.
Moving away or staying nearby
Some specialists are more likely than others to practice close to where they trained. The specialties with the highest percentages of active physicians practicing in the same state where they trained were child and adolescent psychiatry (57.0%), family medicine/general practice (56.0%), and psychiatry (55.5%).
The specialties with the lowest percentages of physicians remaining in state after training included thoracic surgery (29.2%), plastic surgery (33.0%), and neurological surgery (33.4%).
Residents and fellows
These data are for residents and fellows in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME).
Specialties: The specialties with the largest numbers of first-year residents and fellows ranged greatly, topped by 11,297 in primary care. Here are some data about other specialties:
- Family medicine/general practice — 4,856
- Emergency medicine — 2,820
- Cardiovascular disease — 1,072
- Gastroenterology — 619
- Nephrology — 413
- Vascular surgery — 210
- Preventive medicine — 97
Gender: 47.3% of residents and fellows were women, ranging from a high of 86.4% in obstetrics and gynecology to a low of 10.7% in sports medicine (orthopedic surgery).
Types of doctors: Medical doctors from the United States accounted for most residents and fellows (60.1%). Doctors of osteopathic medicine made up 16.9% and international medical graduates made up 22.9%.
From 2015 through 2021, sports medicine and psychiatry saw the most growth in first-year ACGME residents and fellows (27.2% and 26.3%, respectively). The biggest decreases came in preventive medicine (39.4%) and pediatric anesthesiology (16.0%).
For more details, including tables, read the full report.