The allure of a medical career lies in its perceived job stability. However, this notion may no longer hold true for all medical specialties. The Association of American Medical Colleges (AAMC) projects a physician shortage of 38,000 to 124,000 by 2034, but not all specialties face the same future.[]
Advancements in artificial intelligence (AI), global staffing shortages, and shifting healthcare paradigms are ushering in a wave of transformation that could render some medical specialties obsolete.
Here, we’ll examine the specialties that are most likely to bear the brunt of these factors to help guide you and your fellow residents down the most advantageous—and secure—career path.
The impact of AI
Radiology
Radiology, which involves interpreting medical images like X-rays and MRIs, has been a cornerstone of diagnostic medicine. However, the physician workforce in radiology is limited due to limited positions. There is also a growing apprehension among medical students regarding the potential encroachment of AI on radiology jobs.[]
A study conducted in 2022 found that concerns about AI deterred 16% of medical students from selecting radiology as their primary career choice.[]
The crux of the concern lies in the fact that AI has demonstrated proficiency in recognizing disease patterns on medical images. AI technologies have already been seamlessly integrated into clinical practice. These technologies are enhancing workflow prioritization, streamlining image reconstruction, and improving image quality control. AI can process images faster, more accurately, and without fatigue, potentially reducing the need for human radiologists.
Related: ChatGPT: A pocket-sized mentor or a useless AI gadget? Doctors debate its role in medicine
Clinical dermatology
Dermatology is another image-intensive specialty. AI’s significant strides in image recognition has spurred extensive research into approaches for automating the diagnosis of skin diseases, such as melanoma and other skin cancers. AI-based Deep Convolutional Neural Networks (CNNs) have gained prominence in addressing the melanoma prediction challenge. In a 2021 study, AI outperformed every dermatologist to diagnose melanoma.[]
Although AI shows promise in efficiency, specialists such as radiologists, pathologists, and dermatologists remain essential for nuanced interpretations vital to patient care.
Pathology
This specialty stands as a prime example of a field likely to be completely taken over by AI.[] It is widely anticipated that by the year 2030, a multitude of AI algorithms will have seamlessly integrated into routine pathology practices, having the potential to supplant pathologists in specific tasks completely. In fact, it has recently emerged as the most prolifically researched specialty among 17 medical disciplines engaged in AI-related research.
Notable applications include computational pathology, automated prostate cancer grading, lymph node metastasis diagnosis in breast cancer, assessment of breast cancer prognosis biomarkers, and efficient clinical lab processes with automated quality control.
Mid-level encroachment
Emergency medicine
While this might be an unpopular opinion, some health specialties are more likely to become obsolete from mid-level encroachment than from technological advancements.
Mid-level encroachment refers to the expansion of responsibilities and roles of non-physician healthcare providers, such as nurse practitioners and physician assistants, into areas previously reserved for physicians.
Emergency medicine is one specialty affected by this trend.[] Healthcare systems are using mid-level providers to cut costs and extend physician coverage. There was a 66% increase in the utilization of non-physician healthcare staff in the emergency department between 2012 and 2018, and this trend is expected to persist.
Additionally, the number of accrediting programs for emergency medicine doubled from 133 in 2005 to 265 in 2019, which, combined with reduced patient volumes during the pandemic, has made it challenging for new emergency medicine physicians to find employment.
Anesthesiology
The adoption of anesthesia care teams also raises concerns about diminishing employment opportunities for anesthesiologists, according to a 2022 article on the riskiest doctor specialties.[] With an anesthesia care team, a single MD anesthesiologist oversees multiple certified registered nurse anesthetists working in different operation theaters.
Physician shortages vs oversaturation
Radiation Oncology
In the case of radiation oncology, it’s a matter of oversupply: The supply of radiation oncologists significantly exceeds the demand, as evidenced by a 227% increase in annual match positions between 2001 and 2019.
This is largely a result of efforts to address future physician shortages that increased the number of medical school seats.
Since 2002, that number has increased substantially.Allopathic schools expanded to over 22,000 first-year positions, from 16,000, with osteopathic colleges following suit, raising the number of DO students from 5,000 to 8,000. While this trend benefits some fields, it oversupplies others.
Technological advancements and improved treatment efficiency have contributed to the oversaturation of radiation oncologists in the US, creating intense job competition.
Aesthetics and plastic surgery
The field of plastic surgery, particularly aesthetics, is also vulnerable to oversaturation as non-plastic surgeons increasingly enter the domain. Weekend workshops enable non-specialists to perform cosmetic procedures as more states grant independent-practice rights to mid-levels, including aestheticians.
Regardless of any external factors, specialists will be irreplaceable in consultative roles, focusing on complex cases that require human judgment and patient communication.
What this means for you
Given ongoing changes in all areas of healthcare, it’s imperative that residents be adaptable. While some specialties face uncertainties, future physicians must choose their field based on genuine passions and the potential for long-term commitment rather than relying on perceived stability. Specialties may transform, but machines or code do not easily replicate human emotions and the complexity of thought. Despite the challenges they face, these specialties may still require a specialist's supervision, especially those most vulnerable to an AI takeover.
Read Next: These physician specialties have the brightest futures: 2023 update
