Because an active license is required to legally practice medicine, and physicians sometimes have licenses in more than one state, accurate and up-to-date information about a physician’s credentials and licensure status is crucial to state medical boards to enable them to effectively oversee and regulate the practice of medicine. Accurate and timely aggregated information about physicians’ licensure status and credentials is also of critical value to state and federal policymakers as they engage in health care workforce assessments, predictions and planning. Since 2010, the FSMB has been publishing information about physician licensure status it in the form of a biennial national census of licensed physicians. The FSMB has published five censuses since 2010.
About the FSMB’s Physician Licensure Data
License data is continuously provided throughout the year to the PDC by the 51 composite state medical boards (which regulate both allopathic and osteopathic physicians) and 14 state osteopathic boards (which regulate osteopathic physicians only) in the United States and the District of Columbia. Four additional territorial medical boards [Guam, Puerto Rico, the U.S. Virgin Islands and the Commonwealth of the Northern Mariana Islands] are also member boards of the FSMB, but their physician licensure data was excluded from the current analysis. Because of their differing capacities and resources, state medical boards submit information to the PDC at varying intervals throughout the year. Most state boards provide medical licensure information to the PDC on a monthly basis, with some boards able to provide such data weekly or even daily.
When the PDC receives physician data, each record is matched to a master physician-identity table using a set of algorithms developed by the FSMB. This systematic process ensures accuracy and allows the PDC to centralize all data and track physicians across multiple jurisdictions.
Though physicians in the United States are not licensed based on their specialty or practice focus, and specialty board certification is not a requirement for medical licensure, the PDC receives and supplements license data provided by state boards with specialty and subspecialty certification information obtained from the ABMS and the AOA. Deceased physicians are also identified and flagged in the PDC through information from state boards and an independent audit.
Provided in this report are a summary, analysis and discussion of the updated license statistics using FSMB’s 2019 data from each of the state medical boards in the United States and the District of Columbia. In aggregate, the information included in this report offers a snapshot of the number, gender, age, specialty board certification and practice location by state of all licensed physicians in the United States.
Physician Licensure—Key Findings
The 2019 physician licensure data analysis reveals that there were 1,004,788 physicians with an active license to practice medicine, representing a net increase of 18% since 2010 (Figure 1). State medical boards issued 99,724 new licenses to physicians during 2019, a figure which includes physicians obtaining their first license, one or more additional licenses (enabling practice in multiple jurisdictions) or a new license when moving from one jurisdiction to another; 14,556 physicians received their first medical license from a state medical board in 2019.
As in 2010, the vast majority 90% of licensed physicians in the United States in 2019 continued to be allopathic physicians (MDs), while osteopathic physicians accounted for 9% of the licensed population (Table 1). Although there are substantially fewer physicians with a DO degree compared to those with an MD degree, the osteopathic medical profession is growing at a faster rate. From 2010 to 2019, the number of licensed physicians with a DO degree increased by 63%, compared to an 15% increase in the number of licensed physicians with an MD degree.
In 2019, 76% of physicians graduated from a U.S. or Canadian medical school (allopathic or osteopathic), 23% were International Medical Graduates (IMGs), and for 1% of physicians, the medical school of graduation could not be determined because the information was not provided to the PDC. The licensed physicians identified in 2019 graduated from a total of 2,193 medical schools in 170 countries around the world. From 2010 to 2019, the number of licensed physicians who graduated from U.S. or Canadian medical schools increased by 18%, compared to a 21% increase of IMGs.
Table 2 lists the ten U.S. allopathic and osteopathic medical schools with the largest number of graduates who have an active license to practice medicine in the United States. These ten medical schools have produced about 12% of all licensed allopathic physicians. The 10 colleges of osteopathic medicine produced the largest number of licensed osteopathic physicians accounting for the majority (66%) of the nation’s osteopathic physicians.
Table 3 provides a list of the ten international medical schools with the largest number of graduates who are licensed in the United States. These ten international medical schools have produced about 22% of all IMGs with an active license in the United States.
Among the 228,766 licensed IMG physicians, the greatest percentage graduated from India (51,247 or 22%), followed by the Caribbean (43,444 or 19%), Pakistan (13,518 or 6%), the Philippines (12,522 or 6%), and Mexico (10,087 or 4%). Physicians who graduated from all other international medical schools constitute the remaining 43% of IMGs who are licensed in the United States (Figure 2).
The data also highlight a continued and substantial increase in the number of licensed physicians who graduated from a medical school in the Caribbean (Figure 3).1
Caribbean medical school graduates represented 19% of licensed IMG physicians in 2019 compared to 13% in 2010. While the total number of IMGs with an active license in the United States increased by only 21% since 2010, the number of physicians who graduated from the Caribbean increased by 90% during the same time period (Figure 3). About 64% of the licensed IMGs from Caribbean medical schools are U.S. citizens, an increase of 151% since 2010 (Figure 4).
The age composition of the licensed physician population reflects the gradual, but significant and certain shift seen in the general population during the past several years. Figure 5 shows that the population of licensed physicians who are 60 years of age or older has continued to grow up to 31% in 2019, from 25% in 2010.
During the same period, the physician population 60 years of age or older increased by 44%, compared to 15% for the population of physicians 49 years of age or younger.
While the nation’s physician population is aging on the whole and the total distribution by gender remains relatively stable (with males constituting 64% of licensed physicians), some disparities do exist between male and female physicians in different age groups. From 2010 to 2019, the number of licensed physicians who were female increased by 42%, compared to an increase of 9% for male physicians. When looking at more detailed segments by age and gender, 33% of female physicians in 2019 were 39 years of age or younger compared with 19% of male physicians. This trend is reversed when looking at older physicians — that is, 38% of male physicians are 60 years of age or older, compared to 18% of female physicians (Figure 6).
According to the FSMB’s 2019 license data, about 83% of licensed physicians in the United States and the District of Columbia are certified by an ABMS or AOA specialty board (Table 1). As demonstrated in Figure 7, the strong and expected relationship between specialty certification and age continues to exist. The percentage of licensed physicians with ABMS or AOA certification dramatically increases from 20% for individuals who are less than 30 years old to 79% for those 30 to 39 years old; peaks at 92% for those 40 to 49 years old; and decreases to 70% for physicians 70 years and older.
The overall percentage of physicians with multiple active licenses remains stable: 78% of physicians currently hold one active license, 15% hold two active licenses and 7% hold three or more active licenses. A closer look at the data shows some differences by gender and specialty certification. Twenty-four percent of male physicians, compared with 19% of female physicians, hold more than one license.
Physicians with an ABMS/AOA certification are also more likely to have two or more active licenses (24%) than physicians without a certification (15%).
The 2019 state totals in Table 4 provide additional information about the geographic breakdown of licensed physicians in the United States. The 1,004,788 physicians with an active license to practice medicine in the United States represent a physician-to-population ratio of 306 licensed physicians for every 100,000 people in the United States and the District of Columbia, a figure that has increased from 277 per 100,000 people in 2010.
1 Note: Medical schools in Puerto Rico and the U.S. Virgin Islands are not included in the FSMB’s census in the listing of graduates from medical schools in the Caribbean because they are territories of the United States and have medical schools that are accredited by the LCME.