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In 2022, over one-third of doctors in EU countries were aged 55 and over. This share was 40 per cent or more in half of the member states.

According to the ‘Health at a Glance: Europe 2024’ report, co-published by the OECD and the European Commission, which said over one-third (35 per cent) of doctors in the EU were aged 55 or more. 

This figure is an unweighted average, meaning it does not take population size into account. Since the proportion was over 40 per cent in the most populous member states, the weighted average is likely higher than 35 per cent.

The situation is more serious in nearly half of the countries, where almost one in five doctors is 65 or older.

“The ageing of the medical workforce, particularly in combination with ongoing shortages and rising healthcare demands, poses a serious risk to the sustainability of healthcare systems in Europe,” Dr Ole Johan Bakke, President of the Standing Committee of European Doctors (CPME), told Euronews Health.

So, which countries have the highest share of older doctors? And where is the greatest risk of an ageing medical workforce?

Majority of doctors in Italy and Bulgaria are over 55

The share of doctors aged 55 and over ranged from 21 per cent in Romania to 54 per cent in both Bulgaria and Italy. When including the UK (2021 data) and selected EU candidate and EFTA countries with available data, the UK had the lowest proportion at 14 per cent, followed by Turkey at 15 per cent.

The reasons there is such disparity between Italy at the top of the table and the UK at the bottom are twofold.

“The large gap between countries such as the UK and Italy can be attributed to policies regarding the number of contracts for postgraduate training – which in Italy have been reduced for many years due to a lack of economic investment and foresight – and to the different level of attractiveness these countries hold for doctors educated abroad,” Dr Alessandra Spedicato, President of the European Federation of Salaried Doctors (FEMS) explained. 

Germany and France report high shares of older doctors

In Germany and France, the share of doctors aged 55 and over was close to half, at 44 per cent and 43 per cent respectively.

Other countries where this proportion reached 40 per cent or more include Latvia, Estonia, Hungary, Belgium, Czechia, Lithuania, Luxembourg, Poland, and Cyprus.

All Nordic countries reported shares below the EU average, with some notably low such as Norway and Finland, where only 24 per cent of doctors were aged 55 and over.

Doctors aged 65+ make up 1 in 5 in several countries

The ageing of the medical workforce is especially concerning in several European countries, where those aged 65 and over account for nearly one in five doctors in more than 10 of them. 

In 11 EU countries, the share of doctors aged 65 and over was above 18 per cent, exceeding 20 per cent in most of them. This was 27 per cent in Italy according to Eurostat. 

In the EU, Malta has the highest share of younger doctors – those under 35 years old – at 46 per cent, followed by Romania at 34 per cent.

No other EU country exceeds 30 per cent in this category, except for candidate country Turkey, which stands at 41 per cent.

This proportion was 11 per cent in Italy, 16 per cent in France and 20 per cent in Germany.

Why is the share of older doctors so different across Europe?

Gaetan Lafortune, Coordinator of the ‘Health at a Glance: Europe’ report and Senior Economist at OECD Health Division, stated that the significant variation in the proportion of older doctors (aged 55+) across European countries can be attributed to a combination of structural policies as well as cultural factors that influence both the inflow of new doctors and the retention or exit of existing practitioners.

He explained that the first key factor was differences in entry rates of new doctors. This is the first key factor. For example, several countries with limited medical school seats or residency programmes have struggled to produce enough young doctors to replace retirees.

The second key point was retention rates. This is also a key determinant of the huge differences observed.

“Poor work-life balance, high administrative burdens and inadequate pay in some countries drive younger doctors to emigrate or leave the profession altogether, skewing the remaining clinical workforce toward older practitioners,”  Lafortune told Euronews Health. 

Lastly, exit rates from the profession play a major part. In some countries, doctors can work past the standard retirement age, with phased retirement options or part-time roles, often incentivised by pension supplements, while some systems historically enforced retirement at age 65, thereby restricting the proportion of older doctors.

Careers in medicine are becoming less attractive to youth

Spedicato of FEMS also emphasised that the attractiveness of the medical profession to newer generations is declining due to social changes that have diminished the traditional value attributed to the role of a doctor, favouring instead a greater work-life balance. 

She noted that the tendency of young doctors to emigrate to countries offering better working conditions further contributes to these differences.

Johan Bakke from CPME pointed out that becoming a fully qualified doctor can take between 10 to 14 years in many countries.

“Past decisions to limit medical school admissions – often driven by cost-containment strategies – have had lasting effects, which now manifest as an ageing workforce,” he said. 

Spedicato stressed that political and economic investments in medical degree programmes only reveal their effects years later.

Nurses ageing slower than doctors

In nearly all countries with available data, the share of nurses aged over 55 is generally lower than that of doctors.

The unweighted EU average stood at 24 per cent, with national figures ranging from 10 per cent in Romania to 39 per cent in Latvia.

In Italy, this share was just 24 per cent among nurses, in sharp contrast to 54 per cent among doctors – the highest rate alongside Bulgaria.

Health workforce lags behind the EU’s ageing population

According to the report, 20 EU countries reported doctor shortages in 2022 and 2023, while 15 also faced shortages of nurses.

The shortage of health workers in Europe is largely driven by a “double demographic” challenge, which is an ageing population combined with an ageing health workforce.

As seen in the line chart above, projections show that the EU’s health workforce is struggling to keep up with the ageing population. 

In 2022, the ratio of people aged 65 and over to total employment in the EU’s health and social care sector was 3.49.

This is projected to rise to 3.94 by 2050, indicating a decline in the number of health and social care workers available per older person.

James Buchan of the Health Foundation emphasised the need for evidence-informed approaches, recommending longer-term workforce projections to address the challenge.