CHICAGO — Surgeons are an integral part of the health care system, supplying critical and urgent care in nearly every field of medicine. But surgeons are already in short supply, with the gap between the number needed and the number working expected to get worse.
In a new study, researchers at The Ohio State University and The Ohio State University Wexner Medical Center found that nearly 10 % of surgeons left clinical practice within an eight-year period. These results are published in the Journal of the American College of Surgeons (JACS).
“Surgeons deliver a disproportionate amount of high severity, sensitive health care, which is especially critical right now in a country with an aging population,” said Timothy M. Pawlik, MD, MPH, PhD, FACS, a surgical oncologist at The Ohio State University Wexner Medical Center, and co-author on the study. “These findings show that surgical attrition is a real problem, and that we need to address it in a nuanced and tailored way, focusing on certain subspecialties that are highest risk, and focusing on mid-level providers who are most likely to leave surgery.”
Study Results
In this retrospective study, researchers linked the Medicare Physician & Other Practitioners Public Use Files to the National Plan and Provider Enumeration System (NPPES) using National Provider Identifiers. This created a cohort of 224,629 unique surgeons in 19 specialties between 2013 and 2023. Across the study period, the number of active surgeons ranged from 154,000 to 157,000 annually.
They found an overall cumulative attrition rate of 9.7% over eight years, with overall attrition rates steady from 2013 to 2018 before rising sharply in 2020, most likely due to higher rates of retirement during the COVID-19 pandemic, Pawlik explained. They also found that surgeons most likely to leave were mid-career surgeons with five to nine years of practice.
When it comes to subspecialties, researchers found the highest five-year accumulative attrition rates in oral and maxillofacial surgery (25.1%), obstetrics and gynecology (23.2%), and plastic and reconstructive surgery (19.3%). The lowest annual attrition rates were observed in orthopedic surgery (0.7%), otolaryngology (0.5%), podiatry/foot and ankle surgery (0.4%), and vascular surgery (0.8%).
Researchers found demographic changes, too. The percentage of female surgeons rose from 21.2% in 2013 to 28.6% in 2023. The percentage of surgeons practicing in rural and non-metropolitan areas decreased from 10.5% to 8.5% during the same period.
While the study doesn’t examine why surgeons are leaving, it does show where policy changes and support are most needed, according to the researchers. “By identifying who is most likely to leave, we can create targeted retention strategies to support surgeons most likely to leave, and close these gaps,” said Pawlik.
Recently, the American College of Surgeons released the first-ever national workplace standards framework for surgeons aimed at, among other things, workforce sustainability and improving surgeon well-being.
Coauthors are Abdulaziz Elemosho, MD; Odysseas P. Chatzipanagiotou, MD; Meher Angez, MD; Jeffrey E. Janis, MD, FACS.
This study is published as an article in press on the JACS website.
The authors have no disclosures to report.
Citation: Elemosho A, Chatzipanagiotou OP, Angex M, et al. A National Analysis of Trends and Factors Associated with Surgeon Attrition in the United States. Journal of the American College of Surgeons, 2026. DOI: 10.1097/XCS.0000000000001905
