The proportion of women within the active physician workforce continues to increase, as does the proportion of those nearing retirement age and those with a Doctor of Osteopathic Medicine (DO) degree. Late last month the Association of American Medical Colleges (AAMC) released its 2020 Physician Specialty Report, which provides demographic and specialty trends within the active physician and resident/fellow workforces. It is important to note that the data used to populate the 2020 report was reflective of the 2019 physician workforce.
Active Physicians
In 2019, over one-third of active physicians were women (36.3 percent); this percentage has been steadily rising since 2007 when women made up just over a quarter of the workforce (28.3 percent). This growth reflects the steady increase in female medical students, with women making up the majority (50.5 percent) in medical school for the first time in 2019. The report notes, however, that women still tend to remain concentrated in specialties pertaining to women and children, including pediatrics (64.3 percent), obstetrics and gynecology (58.9 percent), and pediatric hematology/oncology (55.1 percent), and have marginal representation elsewhere. Women make up less than a quarter of the physician workforce in a great number of specialties, including various surgery sub-specialties where the number ranges from 22 percent in general surgery to just 5.8 percent in orthopedic surgery. About ten percent of physicians in pulmonary disease (12.3 percent) and urology (9.5 percent) are female. There are no specialties where male physicians make up less than 35 percent of the workforce.
Just under half of the physicians were 55 and over (44.9 percent) in 2019, which is a marginal increase from 44.1 percent in 2017 but a more significant increase from 37.6 percent in 2007. Over 50 percent of the following specialties are made up of physicians aged 55 and over: preventative medicine (69.6 percent), thoracic surgery (60.1 percent), orthopedic surgery (57.1 percent), and urology (50.5 percent). Several of the specialties which are populated with older doctors also have the highest percentages of males, and conversely several of those with the lowest percentage of older doctors are among the highest in female doctors.
Another slow-moving trend is the increase in practicing physicians with a DO degree. In 2019, 8.2 percent of physicians held the DO degree, while U.S. MDs made up 66.1 percent of the workforce and international medical degrees made up 24.7 percent. This is subtle, but real growth from 2007, when 69.5 percent of physicians held a U.S. MD, 24 percent held an international medical degree, and just 6.5 percent held a DO. In one of the fastest growing specialties, sports medicine, 18.9 percent of practicing physicians were DOs in 2019.
Residents and Fellows
Among the Residents and Fellows in 2019, 45.8 percent were women, like the 2017 figure (45.6 percent), and up slightly from 44.6 percent in 2007. As seen in the physician workforce, female residents/fellows tend to pursue the care of women and children in high percentages, with obstetrics and gynecology (83.8 percent), neonatal-perinatal medicine (74.9 percent), and pediatrics coming in at the top (72.4 percent). However, large percentages of women are also pursuing specialties in endocrinology (70.8 percent), allergy/immunology (68.2 percent), and geriatrics (67.8 percent).
Just as the percentage of DO graduates increased within the active physician workforce, it was also more prominent within the resident/fellow population. In 2019, 15.7 percent of the resident/fellow workforce had a DO degree, an increase from 12.5 percent in 2017 and 6.4 percent in 2007. The percentage of U.S. MDs showed a relative decline over the same period, with 61.1 percent of the 2019 population compared to 65.9 percent in 2007; similarly, international medical school graduates declined from 27.4 percent of the resident/fellow population in 2007 to 23.1 percent in 2019.