Re-evaluation of the methodology for estimating the US specialty physician workforce.

Area of Science:

• Medical Education
• Health Workforce Research
• Pathology

Background:

• Subspecialized training has become increasingly prevalent in physician education.
• Existing physician workforce estimates may not accurately reflect the current physician landscape.
• The Association of American Medical Colleges (AAMC) Physicians Specialty Data Reports are a primary source for US physician workforce data.

Purpose of the Study:

• To investigate the impact of subspecialized training on physician workforce estimates.
• To identify discrepancies in pathology workforce data compared to the American Medical Association (AMA) Physician Professional Data (PPD).
• To highlight the need for updated methodologies in physician workforce estimation.

Main Methods:

• Comparison of AAMC Physicians Specialty Data Reports with AMA Physician Professional Data (PPD).
• Analysis of specialty designations within the AMA PPD, considering multiple and intercalated fellowship placements.
• Evaluation of the impact of training sequence on specialty designation fields.

Main Results:

• The 2020 AAMC report for pathologists undercounted the workforce by 39% compared to the AMA PPD.
• Omission of pathology subspecialty designations accounted for most of this undercount.
• Reliance on only the first of two AMA PPD specialty data fields contributed to the discrepancy.

Conclusions:

• Current methodologies for US physician workforce estimates, specifically for pathology, are inadequate.
• The increasing trend of subspecialized and intercalated fellowships necessitates revised definitions and data collection.
• Similar underestimations may exist in other medical specialties affected by these training trends.