The landscape of medicine is undergoing significant transformations, notably marked by an increasing number of women entering the field. Coupled with a considerable portion of physicians approaching retirement age and the rapid expansion of specialties like sports medicine, these shifts are reshaping healthcare as we know it. Internal medicine, family medicine, and pediatrics continue to be the most sought-after specialties, while others, such as pulmonary disease, are experiencing a decline in specialists.
These insights are drawn from the 2020 Physician Specialty Data Report by the Association of American Medical Colleges (AAMC), which offers a detailed analysis of physician demographics across 47 major specialties in 2019. This biennial report, a recurring publication since 2008, sheds light on key trends in the medical profession. The 2019 data, collected before the onset of the COVID-19 pandemic, reveals several noteworthy patterns.
The Ascendancy of Women in Medicine
One of the most consistent trends observed is the steady growth of women in the physician workforce. From 2007 to 2019, the percentage of female physicians rose from 28.3% to 36.3%, as documented in AAMC’s Physician Specialty Data Reports spanning 2008 to 2020. This progression is illustrated below:
- 2007 — 28.3%
- 2010 — 30.4%
- 2013 — 32.6%
- 2015 — 34.0%
- 2017 — 35.2%
- 2019 — 36.3%
This increase is largely attributed to the growing enrollment of women in medical schools. The AAMC’s annual report on medical school enrollment highlighted a significant milestone in 2019: for the first time, women constituted the majority (50.5%) of U.S. medical school students. As these students graduate and enter practice, the proportion of female physicians is expected to climb even further, solidifying the crucial role of Doctors For Women in the future of healthcare.
However, despite this overall progress in gender diversity, disparities persist across different medical specialties. While women are making significant strides in medicine, their representation is still concentrated in specific fields, indicating ongoing gender imbalances within the profession.
Michael Dill, director of workforce studies at the AAMC, points out, “We have a good deal more work to do in terms of gender equity. If the majority of female physicians are still concentrated in a handful of specialties, then we haven’t gotten where we need to be.”
Specialties with the highest representation of women tend to focus on areas concerning women and children’s health:
- Pediatrics — 64.3%
- Obstetrics and Gynecology — 58.9%
- Child and Adolescent Psychiatry — 54.0%
- Neonatal-Perinatal Medicine — 52.8%
Conversely, women remain underrepresented in specialties such as urology (9.5%), pulmonary disease (12.3%), and surgical fields, including general surgery (22%) and orthopedic surgery (5.8%). This uneven distribution underscores the need for continued efforts to promote gender balance across all medical disciplines, ensuring that women doctors have equal opportunities and representation throughout the medical field.
Growth Specialties and Shifting Preferences
The report also identifies specialties that have experienced notable growth since 2014. Sports medicine leads this expansion, with a remarkable growth rate of 55.3%. Orthopedic surgery within sports medicine also saw a significant increase of 39.8%. While these are impressive figures, it’s important to note that these specialties started from a smaller base. For instance, sports medicine had 2,897 specialists in 2019, compared to emergency medicine, which, despite a substantial growth of 17.2%, already had a much larger base of 45,202 doctors.
The following list details the percentage changes in physician numbers across selected specialties from 2014 to 2019:
- Pediatric Anesthesiology — up 52.8%
- Critical Care Medicine — up 38.3%
- Internal Medicine — up 5.5%
- Family Medicine/General Practice: up 5.3%
- General Surgery — 0%
- Anatomic/Clinical Pathology — down 7.0%
- Pulmonary Disease — down 10.6%
These shifts in specialty preferences and growth rates reflect evolving healthcare needs and the dynamic nature of the medical field.
The Aging Physician Workforce: Implications for the Future
Another critical trend highlighted in the report is the aging of the physician workforce. In the past year, 44.9% of physicians were 55 years or older, a rise from 44.1% in 2017 and 37.6% in 2007. This demographic shift contributes to concerns about a projected physician shortage, as many experienced doctors approach retirement. The AAMC emphasizes the need to expand graduate medical education to address this potential shortfall and ensure continued access to quality healthcare.
Age distribution varies significantly across specialties, mirroring some gender distribution patterns. Pulmonary disease, the specialty with the highest percentage of older physicians (91.3%), is also experiencing the most significant decline in specialists. Conversely, sports medicine, the fastest-growing specialty, has the lowest percentage of physicians aged 55 and above (8.3%). Interestingly, specialties with a higher proportion of older doctors, such as surgical fields, often also have a higher percentage of male doctors. Conversely, specialties with fewer older physicians tend to have a higher representation of female doctors. This correlation suggests potential future shifts in specialty demographics as younger, more diverse physicians enter the workforce.
Specialties with a Higher Proportion of Older Physicians (Age 55+) in 2019:
- Preventive Medicine — 69.6%
- Thoracic Surgery — 60.1%
- Orthopedic Surgery — 57.1%
- Urology — 50.5%
- Pediatrics — 44.5%
- Pediatric Critical Care Medicine — 23.3%
- Pediatric Anesthesiology — 8.9%
Trends in Residents and Fellows
Data on residents and fellows in ACGME-accredited programs largely echo the trends observed among practicing physicians, with some notable nuances. Primary care specialties continue to attract the largest number of first-year residents and fellows, with internal medicine leading at 10,379, followed by family medicine/general practice (4,456), and pediatrics (2,993).
Women constitute 45.8% of residents and fellows. Obstetrics and gynecology residencies have the highest percentage of women (83.8%), while sports medicine (orthopedic surgery) residencies have the lowest (12.9%). Between 2014 and 2019, sports medicine and neurology saw increased specialization among first-year residents and fellows, whereas ophthalmology, plastic surgery, and vascular and interventional radiology experienced declines.
For a more comprehensive understanding, including detailed tables and figures, the full report is available online.
Conclusion
The 2020 AAMC Physician Specialty Data Report paints a picture of a dynamic and evolving medical profession. The increasing presence of women in medicine, particularly as doctors for women’s health, is a significant and positive trend. As the physician workforce ages and specialty preferences shift, understanding these demographic changes is crucial for addressing future healthcare needs and ensuring equitable and effective medical care for all populations. The continued rise of female physicians promises to bring diverse perspectives and expertise to all areas of medicine, ultimately enriching the healthcare landscape.
