He is a doctor working an exhausting schedule. There may be no end to this until he retires in 30 or 40 years. He wants more sex. But in a passive sense. Kinda like I would like to win the lottery. Doesn't mean I buy any tickets, but I sure would like to win. Doctors work very hard for a very long time. That is one of the reasons they earn big bucks. Very hard to separate the big bucks from being on call, working long hours, covering for colleagues, etc. I know of a woman on another internet forum who is married to a surgeon and has been discussing this exact issue for years.
So I agree with @SunCMars
: may be time for you to choose. Your husband may not be physically capable of fulfilling his obligations as a doctor and fulfilling his obligations as a lover. He has made it clear which he prioritizes. Now you have to decide your priorities.
I had two things I was going to add, which have more or less already been said.
One, his priority is his work. Whether that's right or wrong is up to you to decide. It's hard for it not to be when you're a surgeon, but that's the life he chose, and the life you knew he would be living.
Two, his desire for sex doesn't seem to have changed - he still wants it. BUT, he wants it on his terms.
It very much sounds to me that he wants a wife who jumps him when he gets home, or gives him BJs when he's relaxing on the couch. Because he's 'too tired' to do the initiation (which is something he keeps telling you over and over).
Perhaps he thinks he's earned this 'right', because he's a surgeon who works long hours and dedicates his life to his job. So when he gets home, he wants a wife who will pleasure him. From his POV, you want more sex, and he's not making himself unavailable to that - he's just not willing to go get it
. He likely believes that this is now something for YOU to get.
Like many others in this thread, my wife has a similar mindset (though she's not a surgeon, and doesn't work crazy hours, etc.) But it's up to me
to have sex. She's 'available', and doesn't often reject me, but she also never does any of the 'work' to get it started.
I think with her, the mindset may be somewhat similar to OP's husbands. I'm self-employed, don't have long hours, I didn't give birth to two children, etc etc etc. But I have the time to feed everybody, get the kids to school, keep the house moderately clean and tidy, do laundry, and many other things. I keep myself busy. But the optics are still that she's the one that has a 9-5 job, pays the bills and manages the finances (her choice), does the grocery shopping (also her choice). Because I have an unconventional day and I don't wear a suit or a hardhat to work, I think there's a stigma there that I'm not a "working man" or that I don't know what a 'hard day at work' is, therefore when it comes time for marital things (like sex), it should be me that has to do the heavy lifting. Because she's the one who comes home tired, those responsibilities should lie on me instead of her.