Healthcare personnel statistics - physicians
Data extracted in July 2022.
Planned article update: August 2024.
There were approximately 1.75 million practising physicians across the EU in 2020.
In 2020, more than half of all physicians in Italy and Bulgaria were aged 55 years and over.
More than two thirds of the total number of physicians in Latvia, Estonia, Lithuania and Romania were women.
The number of medical doctors graduating per 100 000 inhabitants rose in nearly all of the EU Member States.
This article presents an overview of European Union (EU) statistics on physicians. It provides information on specialist healthcare personnel, as well as data on 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.
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.
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 1.75 million physicians working in the EU
In 2020, there were approximately 1.75 million practising physicians in the EU (see Table 1 footnotes for more details). The highest overall numbers of practising physicians were recorded in the largest EU Member States: Germany (372 000, equivalent to 21.2 % of the EU total), followed at some distance by Italy (238 000), Spain (217 000) and France (214 000). Together, these four Member States accounted for close to 60 % of the total number of practising physicians in the EU. The next highest number of practising physicians was in Poland, 90 000 (2017 data), equivalent to 5.2 % of the EU total.
Greece had the highest number of physicians per 100 000 inhabitants
In terms of the number of practising physicians relative to the population, Greece (physicians licensed to practise) recorded the highest number of physicians per 100 000 inhabitants among the EU Member States, at 619.5 per 100 000 inhabitants in 2019. This was considerably higher than in any of the other EU Member States; Portugal (548.8 physicians licensed to practise per 100 000 inhabitants) and Austria (534.7 per 100 000 inhabitants) had the next highest ratios. By contrast, there were fewer than 300 practising physicians per 100 000 inhabitants in only two Member States: Luxembourg and Poland, where the rates were 298.5 and 237.8 physicians per 100 000 inhabitants, respectively, in 2017.
In the 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. 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, anaesthesiology or accident and emergency medicine.
A closer examination of the data in Table 1 reveals that in 2020, there were approximately 454 000 generalist medical practitioners (GPs) across the EU. The highest number of GPs was recorded in France (94 000), followed by Germany (85 000), while Portugal (physicians licensed to practise) and Ireland reported the highest number of GPs per 100 000 inhabitants (292.3 and 187.7 per 100 000 inhabitants, respectively).
The proportion of physicians who are GPs was highest Ireland (54 %), Portugal (53 % of licensed physicians were GPs) and the Netherlands (46 %). In 2020, there were 17 countries where there were more medical specialists than GPs; the Member States with the highest number of medical specialists was Germany (121 000), and Italy (89 000). Greece reported the highest number of medical specialists per 100 000 inhabitants (262.3 per 100 000 inhabitants, licensed to practice in 2019) followed by Bulgaria (183.5 per 100 000 inhabitants), and Lithuania (159.9 per 100 000 inhabitants).
In terms of surgical specialists, there were more surgical specialists than GPs in 16 Member States. Once again the highest number of surgical specialist were reported in Germany (103 000) and Italy (59 000), and Greece reported the highest number per 100 000 inhabitants (138.4 per 100 000 inhabitants in 2019). This was followed by Germany (123.6 per 100 000 inhabitants, and Cyprus (122 per 100 000 for 2019). Malta was the only Member State to report more surgical specialists (487) than either medical specialists (467) or GPs (415).
The number of physicians per 100 000 inhabitants rose in all EU Member States between 2015 and 2020
The number of physicians per 100 000 inhabitants increased in each of the EU Member States between 2015 and 2020 (see Figure 1). Note that these increases could result from a higher absolute number of physicians or from a smaller total number of inhabitants. This increasing trend may be reflective of demographic shifts with ageing populations in Europe; as the proportion of older generations in the EU has gradually increased in the last years, there is increased demand for health and social care services.
The largest relative increase was recorded in Romania where the number of licensed physicians rose from 276.6 per 100 000 inhabitants in 2015, to 333 per 100 000 inhabitants in 2020 (an overall increase of 20.4 %). By contrast, there was a minimal increase in the number of physicians per 100 000 inhabitants in Hungary and Estonia, with overall increases of less than 2.0 %.
Italy had the highest share of physicians aged 55 years and over
There has been a rapid ageing of the (healthcare) workforce across much of the EU as the baby-boom generation has started to reach retirement age. In 10 Member States, the share of physicians aged 55 years and over was over 40 %, while in Italy and Bulgaria this percentage was over 50 % (56.2 % and 53 %), respectively. 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 22 % and 37 %. Conversely, the highest proportion of younger physicians (under 35 years) was in Malta (44.5 %), followed by Romania (34 %), and the Netherlands (31.4 %).
More than two thirds of the total number of physicians in Latvia, Estonia, Lithuania and Romania were women
The analysis presented in Figure 3 shows that there were considerable differences between EU Member States with respect to each sex’s share of the total number of physicians. Over the last decade, the overall proportion of female physicians has been gradually increasing. By 2018, there was already a slight majority of physicians in the EU who were female, and this proportion has risen even in the last 2 years, from 50.4 % to 51.5 %.
In 2020, a majority (17) of the EU Member States reported that they had a higher number of female (rather than male) physicians. In Croatia, Slovenia and Finland, more than 60 % of all physicians were women; in Romania and the Baltic Member States, this proportion increased to over 70 % , with the highest percentages of female doctors recorded in Latvia (74 %) and Estonia (73 %). By contrast, the highest share of male physicians (64 %) was recorded in Luxembourg, while relatively high proportions of male physicians were also recorded in Cyprus (62 %); Greece, Malta, and Italy (all within the range of 55-57 %). In Sweden, Austria and France the share of male to female physicians was less than 3%, with Sweden having the smallest gap between the sexes (less than 1 %).
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. This has led some to promote measures designed to encourage more students to pursue medical degrees.
Figure 4 provides information on the number of medical doctors graduating per 100 000 inhabitants. In 2020, there were an estimated 15.9 medical doctors graduating in the EU for every 100 000 inhabitants. The highest ratios were recorded in Romania (26.3 per 100 000 inhabitants), Malta (26 per 100 000 inhabitants), and Ireland (25.4 per 100 000 inhabitants). Most of the remaining EU Member States for which data are available recorded ratios of 10.0-23.0 graduates per 100 000 inhabitants, although no medical students graduated in Luxembourg. While Cyprus recorded zero medical graduates prior to 2019, in 2019 they had 5.1 medical graduates per 100 000 inhabitants.
A comparison between 2010 and 2020 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 Member States this may have reflected a fall in the total population as opposed to, or in addition to, an increase in the number of graduates. In relative terms, the biggest increases were recorded in Latvia, Bulgaria, Romania and Malta. The only Member States to report a lower ratio of medical graduates per 100 000 inhabitants in 2020 than in 2010 were Austria, Estonia, Germany and Finland. In all of these Member States, except Austria the decrease represented less than 1.0 medical graduate per 100 000 inhabitants.
Source data for tables and graphs
Physicians are split into two broad occupational groups:
- generalist medical practitioners, which can, in turn, be divided into:
- general practitioners (GPs); and
- other generalist medical practitioners;
- 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).
Practising physicians provide services directly to patients. They include people who have completed studies in medicine at university level and who are licensed to practise, 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.
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.
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 healthcare professionals. Three main concepts are used to present this data; Eurostat gives preference to the concept of ‘practising’ physicians:
- ‘practising’, in other words, healthcare professionals providing services directly to patients;
- ‘professionally active’, in other words, ‘practising’ professionals plus healthcare professionals for whom their medical education is a prerequisite for the execution of their job;
- ‘licensed’, in other words, healthcare professionals who are registered and entitled to practise as healthcare 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:
- a colon ‘:’ is used to show where data are not available;
- a dash ‘–‘ is used to show where data are not applicable/relevant.
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. Given shortages of health professionals ,some countries may however experience important outflow of health professionals, which may exacerbate imbalances. Directive 2005/36/EC on the recognition of professional qualifications provides an EU-wide legal framework enabling Member States to recognise qualifications of health professionals from other EU countries. 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 practise 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 is expected to 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, staff shortages in certain medical specialisations or geographic areas may increase. In 2020, over a third of all doctors in the EU were aged 55 years and over.
The Commission has initiated different actions which seek to help EU Member States tackle this challenge, by improving workforce planning and forecasting, anticipating future skills’ needs and training initiatives under the EU4Health programme.
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