Proper access to medical care requires having a sufficient number of doctors, with a proper mix of generalists and specialists, and a proper geographic distribution to serve the population in the whole country.
The number of doctors in EU countries increased from about 1.65 million in 2010 to 1.83 million in 2022. In all EU countries, the number of doctors increased more rapidly than the size of the population since 2010, so on average the number of doctors rose from 3.4 per 1 000 population in 2010 to 4.2 in 2022. However, this does not mean that the shortages of doctors have reduced if the demand for medical care increased more rapidly than the supply, if the average working hours of doctors have reduced, if there is not an appropriate mix of doctors or if there is a more uneven geographic distribution.
In 2022, Greece had the highest number of doctors per population followed by Portugal, but the number in these two countries is an over-estimation as it includes all doctors licensed to practice, including retired physicians and those who might have emigrated to other countries but have kept their licence in the country. The number of doctors per population was the lowest in Luxembourg (although the latest data dates back to 2017) and France (although the number does not include physicians-in-training, resulting in an under-estimation compared to other countries). The density of doctors was also relatively low in Slovenia and Latvia, although it increased in these two countries since 2010, particularly in Slovenia (Figure 7.9).
One of the main reasons why the overall number of doctors has increased is that the number of female doctors has grown rapidly in many countries, replacing a predominantly male generation of doctors who is gradually retiring. In the EU as a whole, over half (53%) of doctors in 2022 were female doctors, up from 45% in 2010. However, female doctors generally work fewer hours than male doctors, often because they are doing more unpaid work at home. According to the EU Labour Force Survey, female doctors worked about 10% less than male doctors in 2022 (39.4 hours per week compared to 43.0 hours) on average across EU countries.
In many countries, the main concern about the shortage of doctors has been about a growing shortage of general practitioners (GPs), particularly in rural and remote areas, restricting access to primary care. Whereas the overall number of doctors per capita has increased in all countries, the share of GPs has come down in most countries. On average across EU countries, only about one in five doctors were GPs in 2022, whereas two‑thirds were specialists (Figure 7.10). A few countries such as Portugal, Finland, Belgium and France have been able to maintain a better balance between GPs and specialists, with GPs accounting for at least 30% of all doctors.
Several countries have increased the number of postgraduate training places in general medicine to address GP shortages. For example, in France, at least 40% of all new postgraduate training places have been allocated to general medicine since 2017. In Belgium, the government has also increased the share of postgraduate training places in general medicine from 39% in 2022 to 43% during the period 2023‑26. However, many countries are struggling to attract a sufficient number of new medical graduates to fill available places in general medicine because of the lower prestige and remuneration of general practice (see indicator “Remuneration of doctors”).
In all countries, the density of physicians is generally greater in urban areas than in rural areas, reflecting the concentration of specialised services such as surgery in urban centres and physicians’ preferences to live and work in cities. Differences in the density of doctors between urban and rural areas are particularly large in Lithuania, Latvia, Hungary, the Slovak Republic, Slovenia and France (OECD, 2023[1]).
Following the pandemic, many countries have increased the number of medical students to address current or expected future shortages of doctors (OECD, 2023[2]), although the effect of these decisions will only be felt in a few years’ time as it takes 8‑12 years to train new doctors. Some countries have also increased the recruitment of doctors from other countries as a quicker way to address current shortages, but this can raise issues about “brain drain” when the recruitment is from lower-income countries that are confronted with even greater shortages of doctors (see Chapter 1).
