25% of practicing doctors in the U.S. are foreign born, a share which has been roughly stable for some time, rising from single digits since the 1980s. While the total number of physicians grew from 700,000 in 2000 to about one million in 2024, during that time foreign-trained doctors rose from about 140,000 to 250,000.  Thus foreign-trained doctors appear to have accounted for a third of the increase in the total.

Is it not reasonable to project that more foreign-born doctors will be needed in the future. But by how much?

The drivers of doctor supply and shortages are mainly (1) the production of new domestically educated doctors, (2) the pace of retirement of doctors, (3) the distribution of care among doctors and other medical professional categories, and (4) the supply of foreign-born doctors.

Supply of U.S. trained doctors: In 1980s and 1990s, when the foreign-born doctor population surged, the nation’s population grew by 24% while the number of students matriculating at American medical schools was flat – about 16,000 a year.

Some 124 medical schools existed in the U.S. in 2000; 158 in 2024. The number of students matriculating grew from16,000 to 23,000, a 40% increase.  The total population grew from   by 20%. 65s and over increased by 74%.  This elderly population is less than 20% of total population but is responsible for 40% + of all medical spending.  This population will continue to grow much faster than the rest.

The “cartel” critique: the Heritage Foundation says that the medical education establishment’s policy is to restrict the growth of medical education slots and residencies. A similar critique can be levelled against the forces which control the flow of foreign-trained doctors into the country – spear-headed by the Educational Commission for Foreign Medical Graduates

The distribution of new doctors: pretty much left to newly minted doctors is what area of medicine they go into. Psychiatry and geriatric medicine have severe shortages, more acute than in other areas.

Allied medical professionals, the number of physician assistants grew from about 50,000 in 2000 to over 168,000 in 2024, per the National Commission on Certification of Physician Assistants. The number of nurse practitioners in practice rose from about 80,000 to 300,000 over the same period. In other words, in the combined number of PAs and NP in 2000 was about 18% of physicians and in 2024 45% of physicians.  Until one digs down into the details, it is not clear if these professions are taking care of the doctor supply in some major areas such as internal medicine.