Doctors Are Leaving Academic Medicine. Most Of Them Are Women

In the years following the onset of the Covid-19 pandemic, the medical workforce has been challenged on many fronts. Despite the negative impacts on the pandemic on the medical workforce, there continues to be a rise in the number of women entering medical school, with 50% or more of most entering medical school classes being comprised of women. However, there remains low numbers of women entering surgical specialties, and now a study has shown that women are leaving academic medicine at higher and higher rates.

A study published in this month’s JAMA Network Open looked at the rates of women leaving academic medical center positions in comparison to their male counterparts. The investigators, based at Harvard Medical School and the University of Massachusetts, assessed attrition rates of nearly 300,000 physicians in academic medicine between 2014 and 2019. Across all stages of academic careers, women were 25% more likely to leave academia than men.

While gender equity in the workplace is something that has been paramount in providing opportunities for underrepresented groups to thrive, disparities remain in the academic medical environment. Women are less likely to hold higher academic ranks and leadership positions. In addition, it is estimated that female physicians earn an average of $2 million less over a 40-year career than male physicians, in and out of academic practices. For female surgeons, this difference reaches upwards of $2.5 million over a 40-year career.

The current JAMA study looked specifically at academic physicians, regardless of income levels or academic rank. Overall, the attrition rate of male physicians was 32% and 38% for female physicians. This difference was statistically significant. The difference was noted all across the country, at all stages of careers, regardless of medical or surgical specialty, and regardless of the national ranking of the medical school from which the physicians graduated.

Many studies have looked at how women at early- and mid-career academic medicine become discouraged, due to insufficient mentorship, challenges in promotion, and being assigned to committees that lack the relevance for career growth yet take up significant time and effort. That said, this study found that women in mid-career positions (greater than 15 but less than 29 years) as well as males at this career phase, had lower attrition rates than early- and late-career physicians. This may speak to increased recognition of the importance of early-career mentorship in recent decades for both male and female physicians beginning their academic careers.

From this study, addressing female physicians leaving academics, there was no data regarding whether or not women were leaving medicine altogether or working in medical settings outside of academics. This is an important factor to understand, especially in the setting of many physicians leaving medicine overall in the coming years.

There is a growing national shortage of physicians, with a projected estimate of a relative deficiency of close to 125,000 physicians by 2034. This relative dearth is due, in part, to the growing U.S. population, and the notable rise in the number of individuals over aged 65 years, which will put added strain on the health system in the near future. Concurrently, over 40% of physicians will be over age 65 years in the coming decade, which will translate to relatively higher numbers of physicians retiring.

The shortage of physicians overall will need to be addressed on several fronts. New graduate medical schools are opening, and programs to encourage physicians to work in underserved areas remains a critical yet not fully met challenge in the present as well as in the future. With over half of medical school graduates being female, more emphasis on support of this demographic will need to be addressed at all career stages.