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, especially since an active license is required to legally practice medicine and physicians sometimes have licenses in more than one state. 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 in the form of a biennial national census of licensed physicians and six censuses have been published to-date.
About the FSMB’s Physician Licensure Data
License data is continuously provided throughout the year to the PDC by the nation's state medical and osteopathic boards. Four additional territorial medical boards (Guam, Northern Mariana Islands, Puerto Rico and U.S. Virgin 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 providing 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 physician record information with specialty and subspecialty certification data obtained from the American Board of Medical Specialties (ABMS) and the American Osteopathic Association (AOA). Deceased physicians are also identified and flagged in the PDC through information from state boards and an independent audit.
Provided in this report is a summary of the updated license statistics using FSMB’s 2021 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 of all licensed physicians in the United States such as medical degree, medical school location, age, sex, specialty board certification and practice location by state.
Physician Licensure—Key Findings
The 2021 physician licensure data analysis reveals that there are 1,026,545 physicians with an active license to practice medicine, representing a net increase of 21% since 2010 (Figure 1). State medical boards issued a total of 112,994 first-time and licensure renewals during 2021, and 21,993 physicians received their first medical license from a state medical board.
As in 2010, the vast majority (90%) of licensed physicians in the United States in 2021 continue to be allopathic physicians (MDs), while osteopathic physicians account for 10% 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 2021, the number of licensed physicians with a DO degree increased by 79%, compared to a 17% increase in the number of licensed physicians with an MD degree.
The majority (77%) of licensed physicians in 2021 graduated from a U.S. or Canadian medical school (allopathic or osteopathic) and 23% are international medical graduates (IMGs). The licensed physicians identified in 2021 graduated from a total of 2,225 medical schools in 168 countries around the world. From 2010 to 2021, the number of licensed physicians who graduated from U.S. or Canadian medical schools increased by 22%, compared to a 25% increase for 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 account for 10% of all licensed allopathic physicians, while the ten colleges of osteopathic medicine with the largest number of licensed osteopathic physicians account for 63% 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 account for 22% of all IMGs with an active license in the United States.
Among the 235,508 licensed IMG physicians, the greatest percentage graduated from India (n=51,153; 22%), followed by the Caribbean (n=46,421; 20%), Pakistan (n=14,326; 6%), the Philippines (n=11,700; 5%), and Mexico (n=9,860; 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 represent 20% of licensed IMG physicians in 2021 compared to 13% in 2010. While the total number of IMGs with an active license in the United States has increased by 25% during the past eleven years, the number of physicians who graduated from the Caribbean has increased by 103% (Figure 3). There has also been an increase in licensed physicians from the Caribbean who are U.S. citizens, rising from 48% to 66% between 2010 and 2021, an increase of 176% (Figure 4).
The age composition of the licensed physician population reflects the gradual, but certain shift of an aging population during the past several years. Figure 5 shows that the population of licensed physicians who are 60 years of age or older has grown to 31% in 2021, up from 25% in 2010.
During the same period, the physician population 60 years of age or older increased by 50%, compared to 16% for the population of physicians 49 years of age or younger.
While the nation’s physician population is aging on the whole and men constitute the majority (63%) of licensed physicians, percentage differences exist between male and female physicians by age group. From 2010 to 2021, the number of female licensed physicians increased by 49%, compared to an increase of 10% for male physicians. When looking by sex and age, 31% of female physicians in 2021 are under the age of 40 compared with 19% of male physicians. This trend is reversed when looking at older physicians — that is, 38% of male physicians are 60 years and older, compared to 19% of female physicians (Figure 6).
The large majority (85%) 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, specialty certification varies greatly by age group. The percentage of licensed physicians with ABMS or AOA certification dramatically increases from 27% for individuals who are less than 30 years old to 81% for those 30 to 39 years old, peaks at 94% for those 40 to 49 years old, and decreases to 72% for physicians 70 years and older.
When looking at the number of licenses a physician holds, 77% of physicians hold one active license, 16% hold two active licenses and 7% hold three or more active licenses. A closer look at the data shows some differences by sex and specialty certification: 25% of male physicians, compared with 21% 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%).
Table 4 provides additional information about the number of licensed physicians by state. The 1,026,545 physicians with an active license to practice medicine in the United States represent a physician-to-population ratio of 310 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.