America is facing a growing shortage of surgeons, and new research suggests the problem may be more serious than many people realize. Nearly one in ten U.S. surgeons left clinical practice between 2013 and 2020, creating concerns about whether patients will be able to access the operations they need in the years ahead. The issue is especially troubling because surgeons often handle some of the most serious, urgent, and life-changing medical conditions, from cancer treatment to emergency procedures and childbirth complications.
A major national study published in the Journal of the American College of Surgeons found that surgeon attrition, meaning doctors leaving active clinical practice, is affecting certain specialties far more heavily than others. Researchers tracked nearly 225,000 surgeons across 19 specialties over roughly a decade to understand who is leaving, when they are leaving, and what the trend could mean for the future of American medicine.
The Numbers Behind the Surgeon Shortage
The statistics paint a concerning picture. Researchers found that 15,753 surgeons exited active practice during the study period, representing nearly 10% of the surgical workforce over about eight years. In total, 224,629 surgeons were studied using Medicare billing records and national provider databases to track long-term practice patterns.
At any given time, the United States had between roughly 154,000 and 157,000 practicing surgeons year to year. While that number remained relatively stable on the surface, attrition steadily chipped away at the workforce underneath. Annual surgeon losses ranged between 1.5% and 1.7% between 2013 and 2018, before climbing sharply in later years. Researchers noted that attrition accelerated around the COVID-19 pandemic period, likely because some surgeons opted to retire earlier than planned.
The overall finding is simple but troubling: America is losing surgeons at a time when an aging population increasingly depends on complex surgical care.
Senior researcher Dr. Timothy Pawlik, a surgical oncologist at Ohio State University Wexner Medical Center, warned that surgeons provide care that is disproportionately severe and time-sensitive.
“Surgeons deliver a disproportionate amount of high severity, sensitive healthcare, which is especially critical right now in a country with an aging population,” Pawlik said.
Which Surgeons Are Leaving?
Not all surgeons are leaving at the same rate.
The study found that oral and maxillofacial surgeons had the highest five-year attrition rate at roughly 25%, meaning about one in four left clinical practice over a five-year period. Obstetrics and gynecology followed closely at approximately 23%, while plastic and reconstructive surgery reached about 19%. These specialties experienced much heavier losses than the broader surgical profession.
By comparison, some specialties remained relatively stable. Orthopedic surgery reported annual attrition of only 0.7%, otolaryngology about 0.5%, podiatry and foot and ankle surgery 0.4%, and vascular surgery 0.8%. The contrast suggests that some parts of medicine are facing much deeper workforce challenges than others.
Researchers also discovered a surprising pattern involving career stage. The surgeons most likely to leave were not necessarily older doctors nearing retirement. Instead, mid-career surgeons appeared especially vulnerable to attrition.
Overall, surgeons with roughly five to fourteen years of practice showed elevated risks of leaving, with doctors in the 10 to 14-year range experiencing more than double the likelihood of attrition compared with some peers. Meanwhile, surgeons with fewer than five years in practice or those practicing 15 to 19 years had lower attrition risks.
That finding raises difficult questions for hospitals and policymakers. Losing experienced surgeons in the middle of their careers can leave major gaps in care, mentorship, and institutional knowledge.
Why Are Surgeons Leaving?
One of the biggest frustrations in the study is that researchers cannot definitively explain why surgeons are walking away from practice.
The study was designed to identify who is leaving rather than directly investigate motivations. Researchers acknowledged that they could not say for certain why surgeons quit, though they observed a rise in departures during and after the COVID-19 period that may reflect retirement decisions or broader professional pressures.
Still, clues emerge from the broader findings. Surgeon attrition threatens access to “complex and time-sensitive operative care,” according to the study authors, particularly in specialties where patient needs can be urgent or life-altering. Obstetrics and gynecology, for example, plays a central role in maternal care and emergency childbirth complications. Oral and maxillofacial surgeons often handle facial trauma and serious dental reconstruction, while plastic and reconstructive surgeons may perform medically necessary procedures following accidents, burns, or cancer treatment.
The researchers also pointed to changing workforce patterns. The percentage of surgeons practicing in rural areas declined from 10.5% in 2013 to 8.5% in 2023, suggesting access problems could become especially severe outside urban centers. Patients in smaller communities may face longer waits or farther travel distances if local surgical care becomes harder to find.
Meanwhile, the percentage of female surgeons increased from about 21% to 29% during the study period, though researchers found that sex itself was not associated with higher attrition. Female surgeons left practice at roughly the same rate as male colleagues.
Researchers argue that simply acknowledging the shortage is not enough. Instead, they say solutions must target the surgeons most at risk of leaving.
“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,” Pawlik said.
“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,” Pawlik said.
The message from the research is clear: America’s surgeon shortage is no longer a distant concern. Nearly one in ten surgeons has already stepped away from clinical practice, certain specialties are seeing alarming levels of attrition, and mid-career doctors appear especially likely to exit. If the trend continues without meaningful solutions, access to critical surgical care could become harder to find for millions of Americans.
