Healthcare personnel statistics - physicians

Data extracted in July 2018

Planned article update: August 2019

Highlights

There were approximately 1.8 million practising physicians in the EU in 2016.

Between 2005 and 2016, the share of physicians aged 55 or over in the EU rose from 27 % to 38 %.

In 2016, 51 % of physicians in the EU were men and 49 % were women.

Physicians, by age, 2016
(%)
Source: Eurostat (hlth_rs_phys)

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.

Full article

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 2016, there were approximately 1.8 million practising physicians in the EU-28 (2015 data for Denmark, Poland and Sweden; 2014 data for Finland; 2013 data for Czechia; data for Slovakia refers to professionally active physicians; data for Greece and Portugal refer to physicians who are licensed to practice). The highest overall numbers of practising physicians were recorded in the largest EU Member States: Germany (345 000), followed at some distance by Italy (240 000), France (209 000), the United Kingdom (183 000) and Spain (178 000). Together, these five Member States accounted for close to two thirds (63.4 %) of the total number of practising physicians in the EU. The next highest number of practising physicians was in Poland, 88 000, equivalent to 4.9 % of the EU-28 total.

Table 1: Physicians, by speciality, 2016
Source: Eurostat (hlth_rs_prs1) and (hlth_rs_spec)

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 659 per 100 000 inhabitants in 2016. This was considerably higher than in any of the other EU Member States; Austria (513) and Portugal (480 physicians licensed to practise) had the next highest ratios and along with Lithuania (447) 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 five Member States, including Ireland, Luxembourg, Romania and the United Kingdom (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; 2015 data).

The ratio of the number of physicians to the number of inhabitants rose in all but one of the EU Member States between 2011 and 2016

The number of physicians per 100 000 inhabitants increased in each of the EU Member States between 2011 and 2016 (see Figure 1 for data availability), with the sole exception of Spain which recorded a small decrease. 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 time series.

Figure 1: Practising physicians, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_prs1)

The largest relative increase for this ratio was recorded in Cyprus, where the number of physicians or doctors rose from 297 per 100 000 inhabitants to 377 per 100 000 inhabitants, but it should be noted that there was a break in series. Malta, Slovenia and Portugal (licensed to practice) each recorded increases of just over 20 % during the period under consideration. By contrast, as in Spain, the number of physicians relative to the total number of inhabitants was almost unchanged in Denmark (2011-2015), France, Latvia, the United Kingdom (break in series), Italy (2011-2015) and Luxembourg (note there is a break in series), with increases of less than 5.0 %. 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 nine of the EU Member States, including one of the largest ones (France), the most common specialisation in 2016 was generalist medical practitioners (see Table 1; 2015 data for Denmark, Poland, Finland and Sweden; 2013 data for Czechia; no detailed data by specialism for Hungary or Slovakia). By contrast, there were more medical specialists and/or surgical specialists in the remaining 17 Member States for which data are available. In 2016, the highest ratio of generalist medical practitioners to population size — 253 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 (252 and 140 physicians licensed to practice per 100 000 inhabitants) followed by Lithuania and Czechia (2013 data) for medical specialists (both with more than 150 per 100 00 inhabitants) and by Germany, Lithuania, Cyprus, Austria and Bulgaria 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 (among the EU Member States, data for Greece and Portugal refer to physicians who are licensed to practice and data for Finland refer to practising physicians; 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.

Figure 2: Physicians — ratio of specialists to generalists, 2006, 2011 and 2016
Source: Eurostat (hlth_rs_spec)

Apart from Ireland and Portugal (physicians licensed to practice), there were more specialist physicians than generalist physicians in 2016 in each of the EU Member States. Over time there has been a widespread — but not uniform — movement towards more specialist physicians relative to 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 Ireland, Romania and Croatia (note that each of these had at least one break in series during the period under consideration). By contrast, there were six Member States where there was a decline in the ratio of specialists to generalists — Lithuania, the Netherlands, Greece (each of which had a break in series), Slovenia, Portugal and Latvia.

Italy had the highest share of physicians aged 55 years 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 years or over, which rose from 27 % in 2005 to 38 % by 2016; this comparison is based on information for 22 EU Member States which accounted for 88 % of all physicians in 2016; it also uses alternative reference periods for some countries to complete the data set. The share of physicians aged 55 years or over in the total number of physicians was within the range of 42-49 % in Hungary, Luxembourg, Cyprus, Germany, Belgium, France, Latvia, Estonia and Bulgaria, peaking at 54 % in Italy. In most of the remaining EU Member States for which data are available, the relative importance of this age group in the total number of physicians was between one and two fifths, with only Malta (19 %) and the United Kingdom (13 %) below this range.

Figure 3: Physicians, by age, 2016
(%)
Source: Eurostat (hlth_rs_phys)

More than two thirds of the total number of physicians in Latvia, Estonia, Lithuania and Romania 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 2006 and 2016 the proportion of female physicians in the total number of physicians generally rose. By 2016, a majority (15) of the EU Member States reported that they had a higher number of female (rather than male) physicians (2015 data for Denmark, Poland, Finland and Sweden; 2013 data for Czechia).

In 2016 in Croatia and Slovenia, just over three fifths of the total number of physicians were women. In Romania and the Baltic Member States, this share passed two thirds. By contrast, the highest share of male physicians (65 %) was recorded in Luxembourg, while relatively high shares for men were also recorded in Cyprus (62 %) and Malta (59 %).

Figure 4: Physicians, by sex, 2016
(%)
Source: Eurostat (hlth_rs_phys)

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, Sweden or the United Kingdom.

Medical doctors employed in hospitals accounted for just over four fifths (83 %; 2015 data) of the total number of physicians in France and 78 % in Denmark (2015 data). By contrast, medical doctors employed in hospitals accounted for around one quarter of the total number of physicians in Cyprus (25 %) and Belgium (24 %; 2015 data); elsewhere among the EU Member States the share ranged from 33 % to 68 %.

In 2016, the highest absolute number of medical doctors employed in hospitals was recorded in Germany (190 000), ahead of France (172 000; 2015 data), Italy (129 000; 2011 data) and Spain (107 000), and followed at some distance by Poland, with 42 000 medical doctors employed in hospitals.

Table 2: Medical doctors employed in hospitals, 2006, 2011 and 2016
Source: Eurostat (hlth_rs_prshp1)

Although only a partial set of information is available for 21 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 2006 and 2016. In absolute terms, the highest increases in doctor numbers were recorded in Germany (an additional 48 000 doctors), France (20 000 more; 2006-2015) and Spain (18 000 more); note there is a break in series for both France and Spain. In relative terms, the fastest growth rates were recorded in Malta (2007-2016), Cyprus, Germany and Hungary, 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).

The availability of data converted into full-time equivalent units indicates that physicians working in hospitals generally worked close to full-time: among the 15 EU Member States with data available for 2016 (or another recent year), the ratio between the data in head counts and that in full-time equivalents was 81 % or higher, except in France where it was notably lower at 73 % (2015 data). As such, despite Germany having some 11 % 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 32 % higher; note that this comparison is based on 2016 data for Germany and 2015 data for France.

A comparison between 2006 and 2016 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 14 of the 16 EU Member States for which data are available (see Table 2 for data availability), the number of doctors in full-time equivalents increased between 2006 and 2016 by at least 10 % overall, the two exceptions being Finland where there was a smaller increase (up 8 % between 2006 and 2015; note there is a break in series) and Estonia where there was a decline (down 3 %). The most rapid growth was recorded in Malta (2007-2016) and Cyprus, both higher than 40 %, although there is a break in series for Cyprus.

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 128 and 257 medical doctors per 100 000 inhabitants in 2016 (see Table 2 for data availability), with Cyprus and Belgium (2015 data) recording values less than the lower limit of this range and Denmark (2015 data) and Lithuania recording values above it (peaking in Lithuania at 340 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 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 2016, there were 12.4 medical doctors graduating in the EU-28 for every 100 000 inhabitants. The highest ratios were recorded in Ireland (24.4 medical graduates per 100 000 inhabitants), Malta (22.6), Romania (22.2) and Denmark (22.1; 2015 data); most of the remaining Member States for which data are available recorded ratios of 10.0-16.4 graduates per 100 000 inhabitants, although Greece (2011 data) and France (2015 data) had ratios under 10.0, while there were no medical students graduating in Cyprus or Luxembourg.

Figure 5: Graduates — medical doctors, 2006, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_grd)

A comparison between 2006 and 2016 shows that the number of medical doctors graduating per 100 000 inhabitants rose in nearly all 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 relative terms, the biggest increases were recorded in Latvia (note there is a break in series), Slovenia and Ireland. Austria was the only Member State for which data are available to report a lower ratio of medical graduates to population in 2016 than in 2006.

Source data for tables and graphs

Data sources

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

Some health professionals seek jobs in other EU Member States: 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 an EU-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 probably decline. As a result, there could be staff shortages in certain medical specialisations or geographic areas. In 2016, nearly two fifths 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 60 000 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).

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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)