Why aren’t there enough ophthalmologists?

According to an article published in Becker's Hospital Review, a number of medical subspecialties are predicted to face major workforce shortages by the year 2038. It is interesting that the 4 areas facing the greatest deficits are all surgical subspecialties. The worst is a predicted 34% shortage of vascular surgeons, followed by ophthalmologists (28%), thoracic surgeons (27%), and plastic surgeons (26%).¹

The shortage of ophthalmologists does not come as a shock, as I have been hearing from the American Academy of Ophthalmology for quite some time that the number of ophthalmology residents trained in residency programs is not keeping up with the growth in the US population and the simultaneous changing demographics in favor of a disproportionate percentage of older individuals.

Given how gratifying and attractive to bright medical students the profession of ophthalmology is, I can only conclude that the predicted shortage is at least partly a self-inflicted wound caused by poor public policy. When I was a young (and yes, that was a long time ago) ophthalmology department chair in a prestigious state university on the West Coast, the state legislature mandated that the number of training slots in all the medical subspecialties (including the ones listed above) could not exceed the number of training slots in “primary care” (ie, pediatrics, internal medicine, obstetrics and gynecology).

The rationale, as explained at the time, was that having more primary care doctors would reduce or prevent problems requiring the expertise of subspecialists and thereby lower medical expenditures in the US. Ophthalmologists know this is a false premise, as more visits to primary care doctors have no measurable impact on the prevalence of glaucoma, retinal detachment, cataract, etc. If the belief was that counseling patients who are overweight and giving them dietary advice would prevent obesity and diabetic eye disease, then time has proven that this strategy failed as well. In a free market, I believe the number of ophthalmology residency slots would increase to meet current and growing demand.

Another interesting aspect of the article is the prediction of a 16% oversupply of emergency medicine physicians.¹ This surprises me, given that just about every article I have read on the subject of physician burnout and resulting early retirement lists emergency medicine as the field most affected.

So why are more students pursuing this as a career than are required to meet the country's needs, when so many (according to survey results) burn out? Is it that the training is intellectually stimulating and fun, whereas subsequent practice, without the reward of long-term doctor-patient relationships, is less rewarding?

Reference

1. Taylor M. Physician specialties ranked by greatest shortages in 2038. Becker's Hospital Review. May 28, 2026. Accessed July 7, 2026. https://www.beckershospitalreview.com/quality/hospital-physician-relationships/physician-specialties-ranked-by-greatest-shortages-in-2038/