Few of us, few of us, come and join us. Few of us?

Czech version

Authors: Martin Dúbrava
Authors‘ workplace: I. klinika geriatrie Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice Bratislava
Published in: Geriatrie a Gerontologie 2025, 14, č. 4: 192-197
Category: Comment
doi: https://doi.org/10.61568/geri/50-6616/20251121/142121

Overview

Dúbrava M. Few of us, few of us, come and join us. Few of us?

Shortage of doctors has been worsening worldwide in recent years. The causes of this deficit could be seen in the lower interest in studying medicine (given the lower social and economic status of doctors compared to the past), in the disproportionate interest of doctors in working in certain medical fields and geographical locations, in defensive medicine and in the demotivating paramedical activities that doctors have to perform. The aim of this article is to try to evoke a discussion on the matter, ideally to stimulate research activities in this area.

Keywords:

human resources – shortage of physicians

Sources

1. Dúbrava M, Šuba J ml., Bořucký J, et al. Odhad personálnych rezerv internej medicíny na Slovensku –⁠ zmeny od roku 2019. Interná Med 2024; 24(2): 65–70.

2. WHO. Human resources for health Working for Health: draft 2022–2030 action plan. 2022. https://www.who.int/news/item/02-06-2022-global-strategy-on-human-resources-for-health--workforce-2030.

3. IHS Markit Ltd. The complexities of physician supply and demand: projections from 2017 to 2032. 2019. Dostupné na: www.aamc.org.

4. Kirch DG, Petelle K. Addressing the physician shortage: the peril of ignoring demography. JAMA 2017; 317(19): 1947–1948.

5. Montgomery FU. Es ist höchste Zeit, den Ärztemangel ernsthaft zu bekämpfen, 2019. Dostupné na: https://www.bundesaerztekammer.de/ueber-uns/aerztestatistik/aerztestatistik-2018/.

6. Klimek P, Ledebur K, Gyimesi M, et al. Forecasting the early impact of COVID-19 on physician supply in EU countries. Int J Health Policy Manag 2024; 13 : 7555.

7. Castioni J, Kraege V, Bovey F, et al. Comment planifier une formation en médecine interne hospitalière au CHUV. Rev Med Suisse 2024; 20 (896): 2188–2193.

8. Schröter T. Primärmedizinische Versorgung in Deutschland am Scheideweg. Inn Med (Heidelb) 2024; 65(9): 865–870.

9. Lambert TW, Smith F, Goldacre MJ. Career specialty choices of UK medical graduates of 2015 compared with earlier cohorts: questionnaire surveys. Postgrad Med J 2018; 94(1110): 191–197.

10. Dumesnil H, Lutaud R, Bellon-Curutchet J, et al. Dealing with the doctor shortage: a qualitative study exploring French general practitioners’ lived experiences, difficulties, and adaptive behaviours. Fam Pract 2024; 41(6): 1039 –1047.

11. Walsh R, Telner D, Butt DA, et al. Factors associated with plans for early retirement among Ontario family physicians during the
COVID-19 pandemic: a cross-sectional study. BMC Prim Care 2024; 25(1): 118.

12. Małyszko K, Pędziński B, Maślach D, et al. Medical staff in Poland in 2012-2022 -⁠ challenges related to the distribution of human resources. Ann Agric Environ Med 2024; 31(3): 382–387.

13. Mohos A, Szőllősi GJ, Kolozsvári LR, et al. Rural family medicine as a career option among Hungarian medical students. Eur J Gen Pract 2023; 29(1): 2174258.

14. Park JH, Lee J, Kim KH, et al. Expansion of medical school admission quotas in Korea, is it really necessary? BMC Public Health 2025; 25(1): 322.

15. Inštitút zdravotnej politiky Ministerstva zdravotníctva Slovenskej republiky. Predikcia potreby zdravotníc-
keho personálu v SR. 2019. Dostupné na: https://izp.sk/wp-content/uploads/2019/07/ predikcia_potreby_zdravotnickeho_personalu.pdf.

16. Agarwal V, Prabhakar V. Are doctors putting their health last? Cureus 2024; 16(10): e71018.

17. Dúbrava M, Šuba J ml., Jánošiová J. Odhad personálnych rezerv internej medicíny na Slovensku. Interná Med 2019; 19(10): 369–375.

18. Palleti SK. Fellowship in the United States as an exceptionally qualified applicant. Postgrad Med J 2023; 99(1176): 1115–1119.

19. Herrick C, Armstrong D. How many doctors does a health system need? Histories of workforce planning in the NHS. Soc Sci Med 2025; 371 : 117882.

20. Gilbey P, Rudolf MCJ, Spitzer-Shohat S, et al. The dedicated enough doctor: the limits of medical altruism in the 21st century. Isr Med Assoc J 2016; 18(12): 714–718.

21. Dúbrava M. Defenzívna medicína v geriatrii. Geriatria 2020; 26(1): 19–24.

22. Berlin L. Medical errors, malpractice, and defensive medicine: an ill-fated triad. Diagnosis (Berl) 2017; 4(3): 133–139.

23. Scheffer M, Mosquera P, Cassenote A, et al. Brazil’s experiment to expand its medical workforce through private and public schools: Impacts and consequences of the balance of regulatory and market forces in resource-scarce settings. Global Health 2025; 21(1): 14.

24. Rigby PG, Gururaja RP. World medical schools: The sum also rises. JRSM Open 2017; 8(6): 2054270417698631.

25. Leiva Tobelem LF, Ynoe de Moraes F, Santos FNC. Expanding healthcare capacity in Canada: the potential of internationally trained physicians. Lancet Reg Health Am 2025; 46 : 101095.

26. Bello FO, González R, Elnicki DM, et al. Bridging the gap: the essential role of international medical graduates in addressing the US physician shortage—Where do we stand? J Gen Intern Med 2025.

27. Chojnicki X, Moullan Y. Is there a ‚pig cycle‘ in the labour supply of doctors? How training and immigration policies respond to physician shortages. Soc Sci Med 2018; 200 : 227–237.

28. Ahmed AA, Hwang WT, Thomas CR Jr, et al. International medical graduates in the US physician workforce and graduate medical education: Current and historical trends. J Grad Med Educ 2018; 10(2): 214–218.

29. National Center for Health Workforce Analysis. State of the U.S. Health Care Workforce, 2024. Dostupné na: https://bhw.hrsa.gov/data-research/review-health-workforce-research.

30. Gruppuso PA, Adashi EY. Rethinking the standards for state licensure of physicians. J Am Board Fam Med 2025; 38(2): 348–
351.

31. Klingler C, Marckmann G. Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview