The ageing of the medical workforce is a growing concern in many OECD countries. In 2023, nearly one‑third (32%) of doctors across OECD countries were aged over 55. In nine OECD countries, this proportion reached 40% or more (Figure 8.6). Bulgaria, an OECD accession country, is facing the most pressing concerns, with more than half of physicians aged over 55. Latvia, Estonia, Italy and Hungary are the OECD countries with the highest proportion of doctors aged over 55, with at least 44% of doctors in this age group. However, the share of doctors aged over 55 has stabilised over the past decade in several countries, with the entry of many new young doctors into the profession offsetting the progressive retirement of the baby-boom generation of doctors.
Countries with a large share of doctors aged over 55 will need to train sufficient numbers of new doctors to replace those retiring over the next decade, while simultaneously implementing policies to encourage current doctors who are willing and able to continue working beyond the standard retirement age. Flexible work-to-retirement arrangements can play a key role in retaining experienced doctors in the workforce for longer. Indeed, the decision of many doctors to continue working beyond the standard retirement age has helped to avoid an exacerbation of shortages in many OECD countries over the past decade, as shown by the growing proportion of doctors aged over 65 in countries including Italy, Germany, France and Belgium.
Italy stands out, with over 20% of doctors aged 65 and over in 2023, foreshadowing substantial doctor attrition in the coming years. To mitigate the impact of this anticipated retirement wave on its health system, Italy has implemented measures to retain older physicians longer in the system while simultaneously boosting the training of new doctors in recent years. In 2024, legislation was passed to temporarily suspend the obligation for doctors employed by public facilities to retire at age 70, allowing them to remain active until they are 72. In addition, those who have retired since September 2023 can be readmitted to service within these limits.
The proportion of female doctors has increased in nearly all OECD countries over the past decade. For the first time in 2023, over half of all doctors on average across OECD countries were female. This proportion ranged from over 70% in Baltic countries (Latvia, Estonia and Lithuania) as well as accession country Romania to around 25% in Japan and Korea (Figure 8.7). The share of female doctors increased particularly rapidly over the past decade in Iceland, Norway, the Netherlands and Belgium. Female doctors generally tend to work more in general medicine and medical specialties like paediatrics, and less in surgical specialties. They also tend to work fewer hours than male doctors (about 10% less on average across EU countries, according to the EU Labour Force Survey), often reflecting uneven family responsibilities (OECD/European Commission, 2024[1]).
General practitioners (GPs) – also known as family doctors – represented about one‑fifth (21%) of all doctors on average across OECD countries in 2023. This share ranged from over one‑third in Canada, Finland and Belgium to just 6% of all doctors in Greece and Korea (Figure 8.8). However, the number of GPs is difficult to compare across countries, owing to variation in the ways doctors are categorised. For example, in the United States and Israel, general internal medicine doctors often play a role similar to that of GPs in other countries, yet they are categorised as specialists.
Many countries have taken steps to increase the number of training places in general medicine in response to concerns about shortages of GPs (see section on “Medical graduates”).
