Seventeen Physician Specialties Are Now Severe Shortages at One in Five VA Facilities or More
The VA inspector general's 2026 survey found severe physician shortages at 135 of 139 facilities, with radiology, urology and anesthesiology rising most.
Officials at 135 of the Veterans Health Administration's 139 health care systems told the VA Office of Inspector General this year that they have a severe shortage of physicians in at least one specialty. That is 97 percent, up from 94 percent in 2025 and 86 percent in 2024.
The figures come from the inspector general's fiscal 2026 report on severe occupational staffing shortages, published Sept. 11 and required every year by a 2014 law Congress passed after the Phoenix wait-time reports. On Veterans Day it is the closest thing to a national census of where the VA struggles to hire doctors. The report lists 4,712 severe shortages across 389 occupations, and 48 occupations reported by at least one facility in five. We compared its specialty table with the fiscal 2025 report to see which physician specialties moved.
Which physician specialties are short?
Seventeen physician specialties crossed the inspector general's 20 percent reporting threshold in fiscal 2026, up from 12 the year before. Psychiatry was the most widely reported, at 75 facilities, but the biggest increases were in procedural and imaging specialties.
| Specialty | FY 2025 | FY 2026 | Change |
|---|---|---|---|
| Psychiatry | 76 | 75 | -1 |
| Radiology, diagnostic | 49 | 68 | +19 |
| Urology | 47 | 64 | +17 |
| Primary care | 67 | 64 | -3 |
| Anesthesiology | 44 | 58 | +14 |
| Gastroenterology | 49 | 57 | +8 |
| Neurology | 34 | 43 | +9 |
| Orthopedic surgery | 34 | 40 | +6 |
| Cardiology, noninvasive | 33 | 40 | +7 |
| Hematology and oncology | 28 | 38 | +10 |
| General surgery | under 28 | 38 | new |
| Emergency medicine | under 28 | 35 | new |
| Radiology, interventional | under 28 | 33 | new |
| Pulmonary diseases | under 28 | 32 | new |
| Geriatrics | 31 | 30 | -1 |
| Dermatology | 29 | 30 | +1 |
| Ophthalmology | under 28 | 28 | new |
The five specialties marked new were below the 20 percent line in fiscal 2025, so the earlier report does not give their exact counts. Diagnostic radiology rose from 35 to 49 percent of facilities, urology from 34 to 46 percent and anesthesiology from 32 to 42 percent, by our calculation from the counts.
Psychiatry and primary care have been on this list for years. The new entries are the specialties that keep a hospital's procedure schedule running.
The long view
The physician series as a whole has rarely been far from universal. The fiscal 2024 report charts the share of facilities reporting a severe medical officer shortage at 99 percent in 2018, 94 percent in 2019, 87 percent in 2020, 90 percent in 2021, 87 percent in 2022, 88 percent in 2023 and 86 percent in 2024. This year's 97 percent is the highest since 2018's 99 percent.
Psychiatry shows a different pattern in the same charts: 70 percent of facilities in 2018, falling to 47 percent by 2024, then back to 55 percent in 2025 and 54 percent this year. Primary care moved between 37 and 48 percent over the whole period and stood at 46 percent in 2026.
The 2026 report names the extremes. The VA Gulf Coast Healthcare System in Biloxi, Miss., reported the fewest severe shortages across all occupations, four. The Birmingham VA Health Care System in Alabama reported the most, 148, including 108 clinical occupations.
What does "severe shortage" mean?
It is a judgment about how hard a job is to fill. It does not count empty positions. Facility officials applied criteria from federal personnel rules, including local labor markets, recruitment efforts, candidate quality and the desirability of the location. The inspector general says it did not consider vacancy data and that a facility could report a severe shortage whether it had no vacant positions or 100. It also did not check whether officials had documentation to support their answers.
That matters for reading the trend. A rise from 12 to 17 specialties could reflect more vacancies, more difficulty recruiting, or more officials choosing to flag a specialty. The designation has a practical use: under 38 U.S.C. 7412, the report can inform the VA Secretary's authority to recruit and directly appoint people in shortage occupations. Physicians are already hired under Title 38, outside the competitive civil service process, the report notes.
The Veterans Health Administration did not dispute the findings. In a memorandum dated Aug. 27, Acting Under Secretary for Health John Figueroa wrote that VHA "has no comments and appreciates OIG's comprehensive review." The inspector general made no recommendations.
What it means for physicians
For a physician weighing a VA position, the useful part of the report is appendix B, which lists every shortage each of the 139 facilities reported. If your specialty is on a facility's list, that is leverage to ask about recruitment incentives, relocation and schedule before signing. Rural states are trying to fill some of the same gaps with rural health transformation money, and Mississippi is using part of its share to recruit physicians and open psychiatric emergency units. If the law's annual schedule holds, the fiscal 2027 report will land next August or September, and it will show whether the five new specialties stay on the list.
Reported, fact-checked and edited by The Script Pad's editorial staff. See How we use AI.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
