Yes, the United States faces a growing shortage of surgeons, and it’s projected to worsen over the next decade. The gap between supply and demand is already significant in rural and suburban areas, and roughly one in four practicing surgeons is 65 or older. By 2037, the national general surgeon workforce is expected to meet only 86% of demand, down from 95% today.
How Big the Shortage Is Now
The shortage isn’t evenly distributed. In urban areas, there are actually more general surgeons than needed, roughly 119% of demand in 2017. But rural areas had only enough surgeons to meet 69% of demand that same year, and suburban areas sat at 75%. The surplus in cities masks what is a genuine crisis in less populated parts of the country.
Looking at the broader physician landscape, the Association of American Medical Colleges projects a total national shortage of between 13,500 and 86,000 physicians by 2036. Within surgical specialties, some are far worse off than others. Federal projections for 2038 show vascular surgery at just 66% of needed supply, thoracic surgery at 73%, and plastic surgery at 74%. General surgery sits at 91%, and colorectal surgery is nearly balanced at 98%. Neurological surgery falls in between at 89%.
Where the Shortage Hits Hardest
Geography is the defining factor. By 2037, non-metropolitan areas are projected to have a general surgeon workforce adequacy of just 42%, compared to 113% in metropolitan areas. That means rural communities will have fewer than half the surgeons they need, while cities will have a comfortable surplus. Idaho is projected to have the lowest state-level adequacy at 48%, followed by Arkansas at 61% and Mississippi at 64%.
In large metro areas, there are roughly 2,470 more general surgeons than needed to serve the local population. Some of that excess capacity absorbs patients who travel from underserved areas, but that travel itself is a burden, particularly for people who need urgent or repeated surgical care. Projections for 2030 show the urban surplus actually growing to 128% of demand, while rural areas improve only slightly to 79%.
Why the Shortage Is Getting Worse
Three forces are converging. First, the existing workforce is aging out. About 25.6% of all surgeons in the U.S. are 65 or older, and most physicians plan to retire by 70. Second, burnout is pushing surgeons out early. A 2023 survey of nearly 19,000 physicians found that 32.6% had a moderate or strong urge to leave clinical practice within two years. In thoracic and neurological surgery, that number approached 40%.
Third, and perhaps most consequential, the pipeline for training new surgeons has been artificially capped for nearly three decades. In 1997, Congress passed the Balanced Budget Act, which froze the number of residency positions that Medicare would fund at each teaching hospital. Since residency training is required for medical licensure in all 50 states (typically three or more years, and longer for surgical specialties), this cap functions as a hard ceiling on how many new surgeons can enter practice each year. The U.S. population has grown by over 70 million people since that cap was set, and it has aged considerably, yet the number of funded training slots has barely budged.
The result: thousands of medical school graduates fail to match into residency positions each year. The country is producing more medical graduates than ever, but the bottleneck isn’t in medical schools. It’s in the training slots that come after.
What This Means for Patients
The most direct consequence is longer waits. Even before the pandemic, elective surgery wait times averaged around 86 days. After COVID-19 disrupted surgical schedules in 2020, average waits rose to about 93 days, an 8% increase. Some specialties saw steeper jumps: genitourinary procedures increased 19%, and cancer-related surgeries saw monthly spikes of 18% to 28% above normal during parts of the year. While the pandemic was a one-time shock, the underlying workforce shortage means wait times are unlikely to return to pre-pandemic levels as demand continues to climb.
National demand for general surgeons is projected to rise 7.2% through 2037, while supply is expected to drop 2.8%. That widening gap translates to delayed procedures, longer travel for patients in rural areas, and increased strain on the surgeons who remain in practice.
How the Gap Is Being Managed
One of the most effective strategies already in use is integrating physician assistants and nurse practitioners into surgical teams. These providers can manage post-surgical patients, handle follow-up visits, and assist in the operating room, freeing surgeons to focus on procedures and new patient consultations. When surgical practices add these team members, the results are measurable. Orthopedic and urological practices saw increases of 112 and 205 total patient visits per surgeon, respectively, in the year after bringing on an advanced practice provider. General surgery practices gained about 42 additional established patient visits per surgeon. These practices also saw reductions in hospital stays, complications, and readmissions.
On the training side, some medical schools now offer condensed three-year programs with guaranteed residency placement in select fields, shaving a year off the traditional timeline. There’s also growing interest in competency-based training, where residents advance by demonstrating skill mastery rather than simply completing a set number of years. A resident who learns faster could finish sooner, opening up that training slot for someone else. Neither approach has been adopted at scale, but both address the core structural problem: too few training slots producing too few surgeons for a growing, aging population.