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2026 U.S. Physician Shortage: 141,160 by 2038, Live Hiring Signals

October 13, 2026
2026 U.S. Physician Shortage: 141,160 by 2038, Live Hiring Signals

The United States faces a projected shortfall of up to 141,160 full-time equivalent physicians by 2038, according to federal workforce projections. Primary care accounts for 70,610 of those missing FTEs. Nonmetro and rural communities absorb the worst of the gap, meaning longer waits and fewer local specialists for patients outside major metro areas.

TL;DR:

  • HRSA lists 8,466 designated primary care shortage areas affecting roughly 92 million residents; filling them would require 15,628 additional primary care physicians.
  • H.R.3890 proposes phased residency positions from fiscal year 2026 through 2032, prioritizing rural programs, but slots take three to seven years to produce physicians.
  • Patients can check county HPSA status and seek federally qualified health centers, which often offer sliding scale fees tied to income in designated shortage areas.
  • Care teams, expanded roles for nurse practitioners and physician assistants, and telehealth can extend existing clinicians’ reach before new doctors complete training.
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Table of Contents

Core Numbers and How to Read the Physician Shortage Projections

Federal projections measure capacity in full-time equivalents, or FTEs: a standardized unit that accounts for part-time work, administrative time, and actual patient-facing hours rather than a simple headcount. This matters because raw physician counts can look stable while adequacy still declines.

HRSA's workforce model tracks three forecast horizons: 2028, 2033, and 2038. The gap widens over time as demand climbs faster than new supply enters practice.

  • By 2038, the national shortfall reaches 141,160 FTE physicians across all specialties.
  • Primary care alone accounts for 70,610 of those missing FTEs.
  • The shortfall grows at each forecast checkpoint, from 2028 through 2038, rather than stabilizing.

141,160 FTE physicians: the projected national shortage by 2038, a figure that captures lost patient-facing capacity, not just a headcount gap.

Specialties Facing the Largest Projected Gaps

Primary care carries the single largest projected shortfall, at 70,610 FTE physicians by 2038. Several other specialties face disproportionate pressure because of long training pipelines, aging practitioner pools, or demand that is rising faster than supply.

  • Primary care: the largest absolute gap, driven by population aging and chronic disease management needs.
  • Anesthesiology: tight supply relative to surgical volume, with long fellowship timelines limiting fast adjustment.
  • OB-GYN: closures of labor and delivery units compound workforce gaps, producing so-called maternity deserts in nonmetro counties.
  • Cardiology and nephrology: growing demand from an aging population outpaces the number of new fellows trained each year.
  • Geriatrics: one of the smallest specialty pipelines relative to the size of the population it serves.

The practical result shows up as surgery backlogs, longer waits for a cardiology consult, and fewer labor and delivery options in rural counties.

Geographic Disparities: Metro, Nonmetro, and HPSA Patterns

Geography drives much of the variation hidden inside the national numbers. HRSA's primary care workforce report documents 8,466 designated primary care Health Professional Shortage Areas, or HPSAs, affecting roughly 92 million residents nationwide. Filling every one of those designations would take an estimated 15,628 additional primary care physicians, based on a population-to-provider ratio of 3,500 to 1.

Nonmetro counties show consistently lower adequacy than metro areas in the same projections, meaning a rural clinic and an urban one of similar size can face very different staffing realities.

  • Rural hospitals often operate with single-coverage specialty roles, so one departure can eliminate a service line entirely, highlighting why rural health transformation and infrastructure matters.
  • Community health centers in designated HPSAs frequently rely on a mix of federal incentive programs and locum coverage to stay open.
  • Readers can check a county's shortage designation through HRSA's public HPSA lookup tools before assuming local access matches national averages.

Local conditions vary enough that facility-level staffing crises can occur even in regions with adequate average supply, since one small hospital's single-specialty vacancy does not show up in national totals.

What Is Driving the 2026 Physician Workforce Gap

The shortage traces back to a mix of demographic and policy forces, several of which compound each other.

  1. A large share of practicing physicians are approaching retirement age, and burnout has pushed many toward early exits rather than extending careers.
  2. Graduate Medical Education, or GME, residency slots remain capped by federal funding formulas that have not kept pace with medical school growth, bottlenecking how many new doctors can complete training each year.
  3. Rising medical student debt and recent changes to loan forgiveness programs are shifting specialty choices, often away from lower-paying primary care and toward higher-reimbursement fields.
  4. International medical graduates, who fill a meaningful share of residency and rural positions, face visa fee increases and Conrad 30 waiver uncertainty that can delay or block their entry into practice.

The American College of Physicians has flagged recent loan and visa policy shifts as risks that could worsen supply if left unaddressed, urging Congress to expand GME capacity and protect pathways for international medical graduates.

Policy and Legislative Moves That Could Change the Outlook

Congress has several bills in play that would directly affect how many residency slots exist and who can fill them.

  • The Resident Physician Shortage Reduction Act, H.R.3890, proposes distributing additional residency positions in phased rounds from fiscal year 2026 through 2032, with priority given to rural programs.
  • Separate proposals address Medicare GME payment rules tied to non-citizen residents, which affect how training programs recruit and fund international medical graduates.
  • Visa policy changes, including fee increases, interact directly with the residency pipeline since many programs depend on IMGs to fill slots in underserved areas.

Legislative changes to GME and visa rules can move the needle faster than almost any other lever, because they directly control the number of training slots and the flow of physicians into shortage areas rather than waiting on a multi-year education cycle.

Pro Tip: Track HRSA's annual workforce data releases alongside GME bill status on Congress.gov. New funded residency slots take three to seven years to produce a practicing physician, so today's legislative action affects supply well into the next decade.

Workforce Strategies Health Systems Are Using Right Now

Health systems cannot wait on federal policy timelines, so many are adjusting how care gets delivered today.

  • Expanded scope-of-practice rules in a growing number of states let nurse practitioners and physician assistants handle more primary care visits independently.
  • Team-based care models pair physicians with NPs, PAs, and care coordinators to stretch physician time across more patients without adding headcount.
  • Telehealth and virtual-first clinician roles let a single physician cover a wider geographic area, particularly useful for specialties like psychiatry and some cardiology follow-ups.
  • Recruitment incentives, including signing bonuses and flexible scheduling, have become standard tools for filling hard-to-staff roles.

Deloitte's 2026 global health care outlook finds that health system leaders are prioritizing workforce resilience over simple headcount growth, investing in retention, flexible roles, and digital fluency to get more effective capacity out of the physicians already in practice.

A shift in strategy: Deloitte's analysis shows health systems moving away from pure hiring volume toward investments that keep existing physicians practicing longer.

What the Shortage Means for Patients Right Now

Patients in shortage-affected areas can expect longer waits for a new-patient appointment, fewer local specialists for conditions like high-risk pregnancy or advanced kidney disease, and more reliance on emergency departments when primary care access is thin. The 92 million residents living in designated primary care HPSAs feel this most directly.

  • Ask about telehealth options for routine follow-ups, which many practices now offer as a standard alternative to an in-person visit.
  • Look for team-based clinics where NPs or PAs can see you sooner for non-complex needs while a physician oversees care.
  • Check your county's HPSA status through HRSA's public data tools to understand whether your area qualifies for federal safety-net resources.

Community health centers and federally qualified health centers remain a reliable fallback in designated shortage areas, often with sliding-scale fees tied to income.

Real-Time Hiring Signals From the ConnectedMedics Jobs Board

Federal projections describe a multi-year trend, but live hiring data shows where pressure is building right now. There are over 22,000 active healthcare vacancies across specialties and regions on healthcare-specific jobs platforms, reflecting where employers are actively competing for talent today rather than where they expected to need it years ago.

  • Data from some recruitment sources shows signing bonuses rising in 2026, a signal that employers are competing harder for scarce specialties.
  • Vacancy concentration by specialty on our jobs board tends to mirror the HRSA gaps in primary care, anesthesiology, and OB-GYN.
  • A specialty-filtered jobs board can shorten time-to-hire by connecting employers with credentialed candidates rather than sorting through a generalist applicant pool.

How COVID-19 Reshaped Physician Supply Projections

The pandemic altered both sides of the supply-and-demand equation that workforce models rely on. On the supply side, waves of early retirements among older physicians, paired with elevated burnout across emergency medicine, critical care, and primary care, pulled experienced clinicians out of the workforce faster than projection models had anticipated before 2020.

On the demand side, deferred care during pandemic peaks created a backlog of chronic disease management and preventive visits that surfaced in the years after, adding pressure that earlier models did not fully capture. Mental health visit volume also rose and has not fully receded, adding sustained demand in psychiatry and primary care alike.

Workforce projection models generally assume relatively stable patterns in attrition and hours worked. A shock like a pandemic, or a sudden policy shift such as a visa fee increase or a change to loan forgiveness rules, can move short-term supply in ways the underlying models were not built to anticipate. That is part of why current HRSA projections get revisited and updated rather than treated as fixed. Readers tracking the issue should expect periodic revisions as real-world attrition and hiring data come in, rather than assuming the 2038 figures are locked in stone.

How COVID-19 Reshaped Physician Supply Projections — overview diagram

Technology's Role in Stretching Physician Capacity

Telehealth has moved well past basic video visits. Remote patient monitoring programs now let a single physician oversee chronic disease patients across a wider geographic area, flagging only the cases that need direct attention. This matters most in specialties like cardiology and endocrinology, where routine follow-ups for stable patients do not require an in-person visit.

AI-assisted diagnostic tools are also entering clinical workflows, particularly in radiology and pathology, where pattern recognition software can triage images and flag likely abnormalities for physician review. The goal is not replacing physician judgment but reducing the volume of routine reads a radiologist has to work through manually, freeing time for complex cases.

Virtual-first clinician roles, where a physician practices entirely through telehealth platforms, have expanded access to specialties like psychiatry and some subspecialty consults in areas with no local provider. None of these tools close the projected 141,160 FTE gap on their own, but together they increase the effective capacity of the physicians already in practice, which matters most in the years before new residency slots or policy changes can add physicians to the pipeline.

Fixing the Education Pipeline Beyond Residency Caps

GME residency caps get most of the policy attention, but the pipeline problem starts earlier, at the medical school level. A growing number of medical schools have expanded enrollment over the past decade, and new regional campuses have opened specifically to serve underserved states. More graduates, however, only translate into more practicing physicians if residency capacity grows alongside them, since every MD or DO graduate still needs a residency slot to practice.

Medical graduates move through residency into practice

Curriculum reforms are also part of the response. Some medical schools have added rural health tracks, early community clinic rotations, and primary care pathways designed to expose students to underserved settings before they choose a specialty. The reasoning is straightforward: students who train in rural or community settings during medical school are more likely to practice in similar settings afterward.

Accelerated three-year MD programs, offered by a small but growing number of schools, aim to get primary-care-bound students into practice faster while reducing the debt burden that often pushes graduates toward higher-paying specialties. None of these reforms replace the need for more funded residency slots, but they address the earlier bottleneck that caps alone cannot fix.

The Financial Toll of Physician Shortages on Hospitals and Care Costs

Physician shortages carry a direct cost beyond patient wait times. Hospitals facing vacancies in specialties like anesthesiology or OB-GYN often rely on locum tenens coverage, temporary physicians staffed through agencies at a substantial premium over a permanent hire's salary and benefits. Extended reliance on locum coverage strains hospital operating budgets, particularly in rural facilities already running thin margins.

Unfilled specialist positions also translate into lost procedural revenue. A surgical service line without a dedicated anesthesiologist or surgeon on staff can lose the ability to schedule elective procedures, cutting into a hospital's highest-margin revenue source while patients get referred elsewhere, sometimes hours away.

Emergency department overuse compounds the financial pressure. When patients cannot get timely primary care appointments, many default to the ED for conditions that a scheduled visit could have managed more cheaply, driving up costs for both hospitals and the patients themselves, especially the uninsured and underinsured. Rural hospitals facing single-coverage specialty gaps are especially exposed, since losing one physician can shut down an entire service line rather than simply reducing its capacity.

What to Watch Through 2026 and 2027

Three indicators will tell us whether the outlook improves or worsens: how many new GME slots actually get funded and distributed under bills like H.R.3890, how visa and Conrad 30 waiver rulings affect IMG placement in underserved areas, and whether HRSA's next data update revises the 141,160 figure up or down.

Watch federal budget cycles and Congress.gov bill status closely. Those two sources will move the real numbers faster than any single hospital's hiring announcement.

— David

How ConnectedMedics Supports Hiring Through the Shortage

Filling a vacancy in a shortage specialty takes more than posting to a generalist job board. Our employer plans, including Free, Growth, and Enterprise tiers, connect postings directly with verified, credential-checked clinicians across specialties instead of a broad, unfiltered applicant pool.

Connectedmedics

For organizations competing for scarce specialists, our Premium Employer tools add visibility and faster candidate matching. Explore current openings and specialty hiring trends on our knowledge hub, or visit ConnectedMedics to see how our verified network supports recruitment during a tight physician market.

FAQ

Which states have the worst doctor shortages?

Shortage severity varies by county more than by entire state, since HRSA's data tracks 8,466 designated primary care HPSAs concentrated heavily in rural and nonmetro counties nationwide. Readers can check a specific county's shortage designation through HRSA's public HPSA lookup tool rather than relying on broad state-level averages.

What is the average retirement age for physicians by specialty?

Retirement age varies by specialty and is not tracked in a single standardized federal figure, though physically demanding fields like surgery tend to see earlier exits than office-based specialties. HRSA's workforce projections factor aging-related attrition into the overall 141,160 FTE shortfall estimate for 2038 rather than publishing per-specialty retirement ages.

What drives high physician compensation in certain specialties?

Pay in medicine generally tracks procedural volume, training length, and local supply gaps, so specialties facing the steepest shortages often see the strongest compensation growth. Our compensation trend data shows signing bonuses rising 12% in 2026 as employers compete harder for scarce specialties.

Can physician compensation vary significantly by setting and location?

Yes. Rural and underserved areas facing acute shortages sometimes offer substantially higher compensation packages, including signing bonuses and loan repayment incentives, to attract physicians away from saturated metro markets. Practice setting, ownership structure, and procedural volume also shape total compensation more than specialty alone.

How quickly can new GME legislation affect the physician shortage?

Not quickly. Even if bills like the Resident Physician Shortage Reduction Act pass and fund new residency slots starting in fiscal year 2026, it takes three to seven years of training before those residents become practicing physicians. Short-term relief depends more on workforce strategies like expanded NP and PA scope of practice and telehealth than on new legislation alone.

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