Posted on Sep. 04, 2022

The United States faces a looming doctor shortage. According to a recent report from the Association of American Medical Colleges, we could be short as many as 124,000 physicians in the next 12 years.

There are several reasons for the growing gap between doctor supply and patient demand, but the main one is demographic. Between 2019 and 2034, the population of people who are 65 and over is projected to grow by 42.4% — four times the rate of overall U.S. population growth. An older population means more demand for health care.

At the same time, we can expect a wave of physician retirements. More than two in five practicing U.S. doctors will be 65 or older within the next decade.

The projected shortage of doctors is expected to cut across the medical profession, but some specialties will be affected more than others. Medical students choosing their career tracks may want to consider which specialties will be in highest demand.

"Future doctors want to know where they can do the most good," said Dr. G. Richard Olds, president of St. George's University, which graduates more medical students into U.S. residency programs than any other school.

Interestingly, graduates of international medical schools, including St. George's, make up a disproportionate share of the doctors practicing in some of the specialties where demand will be greatest in the years to come. About one-fourth of doctors practicing in the United States today graduated from an international medical school.

Here are five specialties facing acute shortages of doctors in the future.

Psychiatry

Even before the pandemic, the United States faced a mental health crisis, with one in 10 adults reporting symptoms of anxiety or depression. The United States was already short about 6,100 psychiatrists in 2019, according to federal data.

Since then, the problem has gotten worse. The Covid-19 pandemic caused a 25% spike in anxiety and depression, according to the World Health Organization. Substance abuse and difficulties with sleeping and eating have also increased.

Psychiatry is a specialty for doctors who like building relationships with the people they are treating. They spend about 60% of their work hours with patients and treat some individuals over long periods of time.

After medical school, most psychiatrists complete a four-year residency. Many undertake an additional year-long fellowship in a subspecialty such as forensic psychiatry, sleep medicine, or addiction.

Critical Care

Critical care physicians look after extremely ill patients, including those on life support or with severe trauma. Also known as intensive care doctors, these professionals have been on the front lines of the pandemic, caring for patients with life-threatening cases of Covid-19. Critical care is one of a subset of 12 specialties for which the AAMC report projects a total shortage of up to 13,400 doctors by 2034.

Needless to say, this specialty puts doctors in high-pressure situations on a regular basis. Some are drawn to the field because of the variety: there is no such thing as a typical day because the pace is fast and unpredictable. While intensive care teams may witness death and loss on any given day, they also have daily opportunities to offer hope and save lives.

The current critical care workforce is quite diverse. International medical graduates account for over 40% of active critical care physicians. These doctors hail from medical schools in the Caribbean, Asia, Europe and elsewhere. Many are U.S. citizens who went abroad for their schooling.

After medical school, these doctors typically complete a three-year residency in internal medicine followed by a one- or two-year fellowship in critical care.

Infectious Disease

Living in the time of a global pandemic, we're all aware of the potential impact of infectious diseases. Unfortunately, we still don't have enough doctors trained in this field.

Nearly 80% of counties in the United States have no infectious disease specialist, according to a study in the Annals of Internal Medicine. The number of medical students entering the field has dropped for years, and in 2020, more than a fifth of infectious disease resident positions went unfilled.

Infectious disease doctors treat people for viruses, bacteria and other pathogens that spread among populations. Infectious diseases are always evolving, so these doctors often play medical detective, trying to identify new ailments. Since infectious disease can affect such large populations, the specialty offers the opportunity to help people on a community-wide or even global scale.

After attending medical school, infectious disease specialists usually complete a three-year internal medicine residency as well as a two- or three-year fellowship.

Endocrinology

Like critical care and infectious disease, endocrinology is one of the 12 medical specialties for which the AAMC projects a total shortage of up to 13,400 doctors in the next dozen years.

Endocrinology focuses on the endocrine system, which controls the body's hormones. It's an increasingly crucial specialty as hormone-related illnesses become more common.

Perhaps the most well-known endocrine disease is diabetes, which is now the seventh-most common cause of death in the United States. Endocrinologists also treat hypertension, obesity, osteoporosis and thyroid disorders, among other ailments. The average wait time for a consultation with an endocrinologist in the United States is 37 days. Without an influx of doctors into the field, that will grow longer.

Endocrinology tends not to involve emergencies. It does involve building relationships with patients and helping them make lifestyle choices that can improve long-term health.

After graduating from medical school, most endocrinologists complete a three-year internal medicine residency and a two- to three-year fellowship focused on endocrinology. Currently, about 41% of practicing endocrinologists are internationally trained.

Geriatrics

Geriatricians treat illnesses related to aging. The shortage in this field is one of the most severe in the medical profession. The American Geriatrics Society warns that we will likely need nearly 27,000 additional geriatricians by 2025.

Geriatric medicine is considered part of primary care, and these doctors need a wide breadth of skills. But they also need high-level knowledge of the diseases and chronic conditions that primarily affect older adults — among them heart disease, arthritis and Alzheimer's.

Unfortunately, the number of geriatricians doesn't appear to be growing. As with infectious disease, residency programs in this specialty have struggled to fill slots in recent years.

Geriatrics attracts doctors who strive to provide compassionate, patient-centric care and solve complex problems, as many older patients have overlapping ailments. According to the Association of American Medical Colleges, over half of actively practicing geriatricians received their degrees at an international medical school.

Geriatricians generally complete a three-year family or internal medicine residency, followed by a one- or two-year fellowship.

A Few More Things to Consider

These specialties will all be in demand in the coming years. However, Darlene Diep, a Medical Admissions Counselor at Moon Prep, stresses that students will want to consider other factors, including salary, lifestyle and their own talents and interests.

The schedule and pace of work vary depending on your career focus. And while the honor of highest average salary in the medical profession goes to plastic surgeons, doctors in these five specialties still make lucrative wages. The doctor shortage is likely to push salaries even higher for in-demand specialties.

Tomorrow's doctors may want to think about their future specialty even before enrolling in medical school. A large school with many hospital relationships will give students the widest range of opportunities when it comes time to choose their residency and specialty.

"We love helping students find their passion — and meet critical medical needs," Olds said. In the years to come, those medical needs will disproportionately be in these five specialties.

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