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The problem of shortage of physicians has been discussed controversially in Germany for years, and the different positions of the interest groups involved have not been resolved. The question of the present and anticipated future requirement of physicians is central for an appropriate and necessary medical care of the population. In the analysis, supply and demand of medical care have to be distinguished. Relatively reliable data do exist for the supply of physicians; however, the changing number of working hours that male and--in particular female--physicians are willing to contribute should be taken into consideration. Reliable data for the future demand are presently not available. Several variables (e.g., demography, disease spectrum of an aging society, medical progress, the changing rules of working hours, and the shift of medical care between hospital and practice care) depend on future developments. Considering the existing serious indicators of a growing shortage of physicians, it is recommended to put more effort into the scientific investigation of these factors. More profound data should improve the basis for decisions in health and education politics.

Objectives: In the areas of psychosomatic medicine and psychotherapy, the relative proportion of female physicians is above average compared with other medical specialty areas. Is there a gender-specific affinity for the subject even among medical students and if so, how does it affect the students' choice of their subsequent specialty and their further professional career?, Methods: Gender proportions were studied in a) students of elective courses in psychosomatics and psychotherapy at the University of Goettingen, b) graduate students of German medical faculties between 1993 and 2004 and c) advanced ranks of medical career., Results: Female preponderance in psychosomatics and psychotherapy is already to be found among students and extends to the rank of specialists. However--as in other medical specialties--women are not adequately represented in managerial positions., Conclusions: The relatively high proportion of female physicians might be the result of women's special disposition for the field. While an adequate representation of both sexes among medical psychotherapists is desirable for clinical practice, an increase of female physicians in management and research positions would be expedient in order to direct more attention to gender-specific questions in psychosomatics and psychotherapy.

Background and Objective: In Germany leadership positions in medicine are characterized by an almost complete lack of women. The goal of this study was to determine the representation of women among different career ranks during medical school, residency and academic advancement during the past 20 years., Methods: The annual reports of the German Federal Statistic Office in Wiesbaden were checked for the numbers of medical students, dissertations, physicians, internists, fellows and trainees at universities, habilitations and professorships., Results: Among medical students, final examination, dissertation, physicians, internists and trainees at universities a proportion of women can be found nowadays which is at a 15% higher percentage level than 20 years ago. Among assistant professors and habilitations at universities there is a very low proportion of women, which did increase only slightly from 5 to 10% during the past 20 years. Within the same period of time the total number of professors and the proportion of female professors were nearly unchanged. Reunification of East and West Germany led to an increase of the representation of women among all levels of qualification which is due to the much higher proportion of female physicians in the former GDR., Conclusions: The lack of women in leadership positions in medicine in Germany is not due to a general lack of women in medicine. Among all other career ranks the proportion of women increased by 15%. The completely unchanged number and composition of the professors during the past 20 years suggests that the lack of women among this professional group has to do with conservatism which is an inherent trait of university professors in Germany.