Documenting the US Physician Workforce: Past, Present, and Future

Since 2010, the Federation of State Medical Boards (FSMB) has conducted a biennial census of actively licensed physicians in the US to understand workforce trends concerning demographic, educational, and licensure patterns.^1–7  The forthcoming eighth census, scheduled for publication in the next issue of the Journal of Medical Regulation, will provide updated physician workforce trends. FSMB's censuses serve as valuable resources for state and federal policymakers and other leaders in healthcare by facilitating informed decision-making around physician workforce assessments and planning.

Although there are various datasets that track physician activity, the FSMB's Physician Data Center (PDC) is uniquely positioned to provide a comprehensive and authoritative analysis of all physicians licensed by state medical and osteopathic boards across the US. State boards, operating under the jurisdiction of their respective Medical Practice Acts, are responsible for both the licensure and, when necessary, discipline of physicians. Supported by data from state boards, the PDC serves as a centralized repository of physician licensure data encompassing all US states, the District of Columbia, and US territories, offering unparalleled insights into the national physician workforce.

Over the past decade, FSMB's censuses have chronicled notable transformations within the physician workforce that reflect demographic and educational shifts within the medical profession. Some of these changes have included a growing number of Doctors of Osteopathic Medicine (DO), an increase in the average age of physicians, greater gender diversity with a higher representation of female physicians, and a rising number of graduates from Caribbean medical schools. The total population of licensed physicians in the US and the District of Columbia expanded by 23% between 2010 and 2022, and projections for the next census indicate that the number of licensed physicians is expected to approach 1.1 million.

Concurrently, the physician workforce has faced challenges such as shortages in underserved specialties and geographic regions, the impact of the pandemic, and increasing rates of burnout. One of the more significant developments in healthcare delivery during this period has been the rapid expansion of telehealth services, which continues to play a role in addressing healthcare access issues for various segments of the population. Evolving demand and supply dynamics in healthcare have also prompted regulatory adaptations to physician licensure processes. Notable changes include the establishment of the Interstate Medical Licensure Compact (launched in 2015) to facilitate multi-state licensure, which has substantially increased the number of licenses issued to physicians to enable them to lawfully practice in more jurisdictions, and the discontinuation of the Step 2 Clinical Skills component of the United States Medical Licensing Examination.

FSMB's upcoming census will continue to provide demographic and educational statistics, including the average age of physicians, gender distribution, degree type, medical school graduation location, and specialty board certification. The census will present aggregate physician licensure statistics, covering the number of newly issued medical licenses, physician-to-population ratios, and the percentage of physicians holding licenses in multiple US jurisdictions. Beyond the numbers, FSMB's census will also provide a deeper analysis of licensed physicians graduating from international medical schools, adding context to the recent surge of interest among some states to streamline longstanding licensure pathways.