Representation of female physicians in the United States, 2014-2024

PURPOSE: The gender composition of the physician workforce in the United States is constantly evolving. This study aimed to determine how female physician representation has changed from 2014 to 2024 with attention to geographic and temporal trends. METHOD: Data were obtained on US physicians from the Centers for Medicare and Medicaid Services (CMS) Doctors and Clinicians national downloadable file (2014-2024). Pediatricians were excluded due to Medicare data limitations. Gender diversity was quantified using the Gender Diversity Index (GDI), a metric that relates to the likelihood that 2 randomly selected providers in a given area are of different genders. Local Indicators of Spatial Association (LISA) mapping of counties identified statistically significant areas with higher and lower GDIs than average. RESULTS: Female physician representation across the United States rose in 2014 from 159,850 (28.7%) to 224,377 (34.9%) in 2024, and the mean GDI per state rose from 79.4 in 2014 to 88.7 in 2024 (P < .001). Female physician representation increased from 2014 to 2024 in urban areas from 142,354 (29.7%) to 198,667 (36.3%) and in rural areas from 17,496 (22.5%) to 25,710 (26.7%). Clustering revealed GDI "hotspots" primarily in the Northeast, West Coast, and other urban hubs, with "coldspots" concentrated in the Midwest and South. CONCLUSIONS: Although there have been broad increases in female representation in many regions throughout the United States, variations persist across specialties, geographic regions, and degrees of rurality that underscore the complexity of achieving gender-balanced representation. Initiatives focused on recruiting and retaining female physicians should target the regions highlighted by this analysis.