title: Forecasting Japan's physician shortage in 2035 as the first full-fledged aged society.
abstract: BACKGROUND
  Japan is rapidly becoming a full-fledged aged society, and physician shortage is a significant concern. The Japanese government has increased the number of medical school enrollments since 2008, but some researchers warn that this increase could lead to physician surplus in the future. It is unknown how many physicians will be required to accommodate future healthcare needs.
  
  
  METHODS
  We simulated changes in age/sex composition of the population, fatalities (the number of fatalities for the consecutive five years), and number of physicians from 2010 to 2035. Two indicators were defined: fatalities per physician and fatalities by physician working hour, based on the data of the working hours of physicians for each tuple of sex and age groups. We estimated the necessary number of physicians in 2035 and the number of new physicians to maintain the indicator levels in 2010.
  
  
  RESULTS
  The number of physicians per 1,000 population is predicted to rise from 2·00 in 2010 to 3·14 in 2035. The number of physicians aged 60 years or older is expected to increase from 55,375 (20% of physicians) to 141,711 (36%). In 2010 and 2035, fatalities per physician were 23·1 and 24·0 for the total population, and 13·9 and 19·2 for 75 years or older, respectively. Fatalities per physician working hour are predicted to rise from 0·128 to 0·138. If working hours are limited to 48 hours per week in 2035, the number of fatalities per physician working hour is expected to be 0·196, and the number of new physicians must be increased by 53% over the current pace.
  
  
  CONCLUSIONS
  The number of physicians per population continues to rise, but the estimated supply will not fulfill the demand for healthcare in the aging society. Strategies to increase the number of physicians and improve working conditions are urgently needed.
authors.affiliation: Department of Internal Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan. yuji-tky@umin.ac.jp
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yuji
authors.forename: Seiya
authors.initials: S
authors.lastname: Imoto
authors.forename: Rui
authors.initials: R
authors.lastname: Yamaguchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Matsumura
authors.forename: Naoko
authors.initials: N
authors.lastname: Murashige
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kodama
authors.forename: Satoru
authors.initials: S
authors.lastname: Minayo
authors.forename: Kohzoh
authors.initials: K
authors.lastname: Imai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008507:Medically Underserved Area; D008875:Middle Aged; D015233:Models, Statistical; D010820:Physicians / Q000600:supply & distribution* / Q000639:trends*; D013997:Time Factors; D000078329:Workforce