Healthcare personnel statistics - physicians

Data extracted in September 2017. Most recent data: Further Eurostat information, Main tables and Database. Planned article update: October 2018.

This article presents an overview of European Union (EU) statistics on physicians. It provides information on specialist healthcare personnel, as well as data pertaining to the number and ratio of graduates in this field (note that all physicians need to possess a degree in medicine).

Physicians are licensed to provide services to patients as consumers of healthcare, including: giving advice, conducting medical examinations and making diagnoses; applying preventive medical methods; prescribing medication and treating diagnosed illnesses; giving specialised medical or surgical treatment.

Physicians are split into two broad occupational groups:

  • generalist medical practitioners (which includes general practitioners (GPs));
  • specialist medical practitioners, which can, in turn, be subdivided into:
    • medical specialists (doctors specialising in the diagnosis and non-surgical treatment of physical disorders and diseases);
    • surgical specialists (doctors who specialise in the use of surgical techniques to treat disorders and diseases).

This article is one of a set of statistical articles concerning healthcare resources in the EU which forms part of an online publication on health statistics.

Table 1: Physician by speciality
Source: Eurostat (hlth_rs_prs1) and (hlth_rs_spec)
Figure 1: Practising physicians, 2010 and 2015
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_prs1)
Figure 2: Physicians — ratio of specialists to generalists, 2005, 2010 and 2015
Source: Eurostat (hlth_rs_spec)
Figure 3: Physicians, by age, 2015
(%)
Source: Eurostat (hlth_rs_phys)
Figure 4: Physicians, by sex, 2015
(%)
Source: Eurostat (hlth_rs_phys)
Table 2: Medical doctors employed in hospitals, 2005, 2010 and 2015
Source: Eurostat (hlth_rs_prshp1)
Figure 5: Graduates — medical doctors, 2005, 2010 and 2015
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_grd)

Main statistical findings

Healthcare personnel

For physicians, Eurostat collects data for three concepts:

  • ‘practising’, in other words, physicians providing services directly to patients;
  • ‘professionally active’, in other words, ‘practising’ physicians plus physicians for whom their medical education is a prerequisite for the execution of their job;
  • ‘licensed’, in other words, physicians who are registered and entitled to practise as physicians.

In this article preference is given to the concept of ‘practising’ physicians which is also used for the European core health indicator (ECHI) on practising physicians. For some EU Member States data are not available for this concept and therefore data are presented for one of the alternative concepts instead: footnotes indicate these exceptions in each table and figure.

There were approximately 1.8 million physicians working in the EU

In 2015, there were approximately 1.8 million practising physicians in the EU-28 (2014 data for Denmark, Finland and Sweden; 2013 data for the Czech Republic; data for Slovakia refers to professionally active physicians; data for Greece and Portugal data refer to physicians who are licensed to practice). The highest overall numbers of practising physicians were recorded in the largest EU Member States: Germany (338 thousand), followed at some distance by Italy (233 thousand), France (208 thousand), the United Kingdom (182 thousand) and Spain (179 thousand). Together, these five Member States accounted for close to two thirds (63.5 %) of the total number of practising physicians in the EU. The next highest number of practising physicians was in Poland, 88 thousand, equivalent to 4.9 % of the EU-28 total.

Greece had the highest number of physicians per 100 000 inhabitants

On the basis of a comparison in relation to population numbers, Greece (physicians licensed to practice) recorded the highest number of physicians among the EU Member States, at 632 per 100 000 inhabitants in 2015. This was considerably higher than in any of the other EU Member States; Austria (510) and Portugal (461 physicians licensed to practise) had the next highest ratios and along with Lithuania (434) were the only other Member States to record over 430 physicians per 100 000 inhabitants. By contrast, there were fewer than 300 practising physicians per 100 000 inhabitants in six Member States, including Luxembourg, Ireland, Slovenia the United Kingdom and Romania (where rates were above 275 physicians per 100 000 inhabitants), as well as Poland, where the lowest ratio was recorded (233 physicians per 100 000 inhabitants).

General rise in the ratio of physicians per 100 000 inhabitants throughout the EU between 2010 and 2015

The number of physicians per 100 000 inhabitants increased in each of the EU Member States between 2010 and 2015 (see Figure 1 for data availability). Note that the increases could result from a higher absolute number of physicians or from a smaller total number of inhabitants and that in Estonia, Cyprus, Luxembourg, Hungary and the United Kingdom there were also breaks in the series.

The largest relative increases for this ratio were recorded in Portugal, where the number of physicians or doctors licensed to practise rose from 384 per 100 000 inhabitants to 461 per 100 000 inhabitants, while Malta, Cyprus (note there is a break in series) and Lithuania each recorded increases of more than 50 additional physicians (during the period under consideration). By contrast, the number of physicians relative to the total number of inhabitants was almost unchanged in Denmark (2010-2014), the United Kingdom (break in series), France (2011-2015) and Spain, with increases of less than 10 additional physicians per 100 000 inhabitants. These figures should be viewed within the context of demographic ageing, whereby a higher proportion of the EU’s population is living longer and where the elderly account for a growing share of the total number of inhabitants, thereby leading to increased demands for health and social care services.

In a small majority of EU Member States there were more medical specialists than general medical practitioners

Generalist medical practitioners do not limit their practice to certain disease categories or methods of treatment, and may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families and communities. By contrast, medical specialists include doctors who specialise in the diagnosis and non-surgical treatment of physical disorders and diseases, for example specialists in internal medicine, cardiology, oncology and radiology, whereas surgical specialists include doctors who specialise in the use of surgical techniques to treat disorders and diseases, for example, specialists in general surgery, neurological surgery, plastic surgery, anaesthesiology as well as accident and emergency medicine.

In 11 of the EU Member States, including Germany, France and the United Kingdom, the most common specialisation in 2015 was generalist medical practitioners (see Table 1; 2014 data for Denmark, Finland and Sweden; 2013 data for the Czech Republic; no detailed data by specialism for Hungary or Slovakia). By contrast, there were more medical specialists in the remaining 15 Member States for which data are available. In 2015, the highest ratio of generalist medical practitioners to population size — in excess of 200 per 100 000 inhabitants — was recorded in Portugal (physicians licensed to practice). The highest ratios for medical and surgical specialists were both recorded in Greece (246 and 135 physicians licensed to practice per 100 000 inhabitants) followed by Lithuania and the Czech Republic (2013 data) for medical specialists (both with in excess of 150 per 100 00 inhabitants) and by Bulgaria, Lithuania and Austria for surgical specialists (each with more than 100 per 100 000 inhabitants).

A widespread — but not uniform — increase in the ratio of specialists to generalists

Figure 2 shows the development of the ratio of specialist to generalist physicians for three reference periods (data for Greece and Portugal refer to physicians who are licensed to practice; no data for Slovakia); note that specialists for this analysis include not only medical and surgical specialists, but also other specialist physicians such as paediatricians, gynaecologists, obstetricians and psychiatrists.

Apart from Ireland and Portugal (physicians licensed to practice), there were more specialist physicians than generalist physicians in each of the EU Member States in 2015. Over time there has been a widespread — but not uniform — movement towards more specialist physicians relative to the generalist physicians.

In a majority of the EU Member States there was an increase in the ratio of the number of specialists relative to the number of generalists between the years shown in Figure 2. This was particularly clear in Croatia, Romania and Ireland (note that each of these had at least one break in series during the period under consideration). Among the three Member States for which data are only available to compare 2010 and 2015 — Poland, Italy and Malta — there was also an increase in the ratio of specialists to generalists. By contrast, there were six Member States where there was a decline in the ratio of specialists to generalists — Greece, the Netherlands, Lithuania (each of which had a break in series), Portugal, Slovenia and Latvia.

Italy had the highest share of physicians aged 55 or over

There has been a rapid ageing of the (healthcare) workforce in the EU-28 as the baby-boom generation started to reach retirement age. This is reflected in the estimated share of physicians who were aged 55-74, which rose from 26 % in 2005 to 37 % by 2015; this comparison is based on information for 18 EU Member States which accounted for 84 % of all physicians in 2015; it also uses alternative reference periods for some countries to complete the data set. The share of physicians aged 55-74 in the total number of physicians was within the range of 41-47 % in Hungary, Luxembourg, Germany, Cyprus, Belgium, Bulgaria, Latvia, France and Estonia, peaking at 53 % in Italy. By contrast, the relative importance of this age group in the total number of physicians was less than one fifth in Malta (18 %) and the United Kingdom (16 %).

Almost three quarters of the total number of physicians in Estonia and Latvia were women

An additional analysis is presented in Figure 4, which shows that there were considerable differences between EU Member States with respect to the share of physicians accounted for by each of the sexes. Between 2005 and 2015 the proportion of female physicians in the total number of physicians generally rose. By 2015, a majority (15) of the EU Member States reported that they had a higher number of female (rather than male) physicians (2014 data for Denmark and Sweden, 2013 data for the Czech Republic).

In 2015, the highest female shares (60 % or more of the total number of physicians) were recorded in the Baltic Member States, Romania, Slovenia and Croatia, with women accounting for almost three quarters of the total number of physicians in both Estonia and Latvia. By contrast, the highest share of male physicians (66 %) was recorded in Luxembourg, while relatively high shares for men were also recorded in Cyprus (62 %) and Malta (60 %).

Hospitals employed more than half of the total number of physicians in the majority of EU Member States

Table 2 provides further information in relation to the number of medical doctors who were employed in hospitals; note that these data refer to the number of physicians directly employed by a hospital and physicians with service contracts (for example, self-employed physicians employed to treat hospital patients); note that there is no information available for Luxembourg, Slovakia, Sweden or the United Kingdom.

Medical doctors employed in hospitals accounted for just over four fifths (83 %) of the total number of physicians in France and 77 % in Denmark (2014 data). By contrast, medical doctors employed in hospitals accounted for around one quarter of the total number of physicians in Cyprus (26 %) and Belgium (23 %; 2014 data); elsewhere the share ranged from 35 % to 68 %.

In 2015, the highest absolute number of medical doctors employed in hospitals was recorded in Germany (184 thousand), ahead of France (172 thousand). Italy (125 thousand) and Spain (105 thousand) were the only other EU Member States for which data are available to record in excess of 42 thousand medical doctors employed in hospitals.

Although only a partial set of information is available for 20 EU Member States (see Table 2 for data availability), this shows that with the exception of Greece, the number of medical doctors employed in hospitals increased between 2005 and 2015. In absolute terms, the highest increases in doctor numbers were recorded in Germany (an additional 44 thousand doctors), France and Spain (both 21 thousand more; note there is a break in series for both of these countries). In relative terms, the fastest growth rates were recorded in Cyprus, the Netherlands, Hungary (2006-2015) and Germany, where the number of medical doctors employed in hospitals increased by at least 30 % over the period under consideration (note there is a break in series for Cyprus and the Netherlands).

The availability of data converted into full-time equivalent units indicates that physicians working in hospitals generally worked close to full-time: among the 16 EU Member States with data available for 2015 (or another recent year), the ratio between the data in head counts and that in full-time equivalents was 83 % or higher, except in France where it was notably lower at 73 %. As such, despite Germany having some 7 % more medical doctors employed in hospitals than France when measured as a head count, after converting to full-time equivalents the number in Germany was around 30 % higher.

A comparison between 2005 and 2015 for the number of medical doctors employed in hospitals expressed in full-time equivalents confirmed the pattern of an increase (as observed for the data based on head counts). In 13 of the 14 EU Member States for which data are available (see Table 2 for data availability), the number of doctors in full-time equivalents increased between 2005 and 2015 by at least 10 % overall, the one exception was Estonia where there was a decline (-3 %). The most rapid growth was recorded in Cyprus and the Netherlands, both higher than 50 %, although there is a break in series for both countries.

The final three columns in Table 2 show the number of medical doctors employed in hospitals in full-time equivalents calculated as a ratio per 100 000 inhabitants. In general, this number ranged between 100 and 250 medical doctors per 100 000 inhabitants in 2015 (see Table 2 for data availability), with Belgium (2014 data) and Cyprus recording a value less than the lower limit of this range and Austria, Denmark (2014 data) and Lithuania recording values above it, peaking in Lithuania (336 full-time equivalent medical doctors employed in hospitals per 100 000 inhabitants).

Health graduates

Some EU Member States face concerns over a lack of supply in relation to the expected future number of physicians available to their healthcare workforces and this has led some to promote measures that are designed to encourage more students to follow medical degrees.

Figure 5 provides information on the number of medical doctors graduating per 100 000 inhabitants. In 2015, there were 12.4 medical doctors graduating in the EU-28 for each 100 000 inhabitants. The highest ratios were recorded in Malta (25.2 medical graduates per 100 000 inhabitants), Ireland (23.7), Romania (19.6) and Denmark (19.5; 2014 data); most of the remaining Member States for which data are available recorded ratios of 10.0-17.5 graduates per 100 000 inhabitants, although Greece (2013 data) had a ratio under 10.0, while there were no medical students graduating in Cyprus or Luxembourg.

A comparison between 2005 and 2015 shows that the number of medical doctors graduating per 100 000 inhabitants rose in most of the EU Member States; note that in some countries this may have reflected a fall in the total population as opposed to an increase in the number of graduates. In absolute terms, the biggest increases were recorded in Malta, Latvia (note there is a break in series), Lithuania, Ireland, Slovenia and Portugal.

Data sources and availability

Key concepts

Practising physicians provide services directly to patients. They include people who have completed studies in medicine at university level and who are licensed to practice, be they salaried or self-employed, irrespective of the place of service provision. Unemployed physicians, retired physicians and students who have yet to graduate are excluded, as are physicians working in administration, research and other posts that exclude direct contact with patients.

Employment data cover the number of health care staff (head counts) and the number of full-time equivalent (FTE) persons directly employed in hospitals (both general and specialised hospitals); the self-employed working in hospitals are also included, for example, those working with service contracts as non-employed health professionals.

Data on medical graduates for any given year cover the number of students who have graduated in medicine from medical faculties or similar institutions. The data exclude those who have graduated in pharmacy, dentistry/stomatology, or public health and epidemiology, as well as individuals who have completed post-graduate studies or training in medicine.

Healthcare resources

Statistics on healthcare resources (such as personnel and medical equipment) are documented in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.

Common definitions have been agreed between Eurostat, the OECD and the World Health Organisation (WHO) with respect to the employment of various health care professionals. Three main concepts are used to present this data; Eurostat gives preference to the concept of ‘practising’ physicians:

  • ‘practising’, in other words, health care professionals providing services directly to patients;
  • ‘professionally active’, in other words, ‘practising’ professionals plus health care professionals for whom their medical education is a prerequisite for the execution of their job;
  • ‘licensed’, in other words, health care professionals who are registered and entitled to practise as health care professionals.

Data on physicians are classified according to the International Standard Classification of Occupations (ISCO); they are defined under ISCO 08 as code 221:

  • 221 Medical doctor;
  • 2211 Generalist medical practitioner;
  • 2212 Specialist medical practitioner.

For country specific notes, please refer to these background information documents:

Note on tables: the symbol ‘:’ is used to show where data are not available.

Context

An increasing number of health professionals seek jobs in another EU Member State: aside from the potential benefits for the individuals concerned, their movement can help rectify labour market imbalances between countries. Directive 2005/36/EC on the recognition of professional qualifications provides a Europe-wide legal framework enabling Member States to recognise each other’s qualifications. A range of health professionals — including doctors — enjoy automatic recognition, in other words, if they are a certified practitioner in their home country then they are automatically entitled to practice anywhere else in the EU. The directive defines basic medical training as comprising a total of at least six years of university study or 5 500 hours of theoretical and practical training.

In the coming decades, population ageing will be a major challenge for the EU’s health sector. The demand for healthcare will probably increase substantially as a result of an ageing population and at the same time the proportion of the people in work will likely decline. As a result, there could be staff shortages in certain medical specialisations or geographic areas. In 2014, more than one third of all doctors in the EU were aged 55 or over. According to the European Commission’s Directorate-General for Health and Food Safety, more than 60 thousand doctors (or 3.2 % of the workforce) are expected to leave the profession each year by 2020.

An action plan for the EU health workforce seeks to help EU Member States tackle this challenge, by: improving workforce planning and forecasting; anticipating future skills’ needs; improving the recruitment and retention of health professionals; mitigating the negative effects of migration on health systems. The plan is part of the broader strategy ‘Towards a job-rich recovery’ (COM(2012) 173).

See also

Online publications

Healthcare human and physical resources

Methodology

General health statistics articles

Further Eurostat information

Main tables

Database

Health care resources (hlth_res)
Health care staff (hlth_staff)
Health personnel employed in hospital (hlth_rs_prshp1)
Physicians by medical speciality (hlth_rs_spec)
Physicians by sex and age (hlth_rs_phys)
Health personnel by NUTS 2 regions (hlth_rs_prsrg)
Health graduates (hlth_rs_grd)
Health personnel (excluding nursing and caring professionals) (hlth_rs_prs1)

Dedicated section

Methodology / Metadata

Source data for tables and figures (MS Excel)

External links

European Union, OECD and WHO

Other external links