Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
JAMA Netw Open. 2023 Jul 3;6(7):e2323872. doi: 10.1001/jamanetworkopen.2023.23872.
Retaining female physicians in the academic health care workforce is necessary to serve the needs of sociodemographically diverse patient populations.
To investigate differences in rates of leaving academia between male and female physicians.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used Care Compare data from the Centers for Medicare & Medicaid Services for all physicians who billed Medicare from teaching hospitals from March 2014 to December 2019, excluding physicians who retired during the study period. Data were analyzed from November 11, 2021, to May 24, 2022.
Physician gender.
The primary outcome was leaving academia, which was defined as not billing Medicare from a teaching hospital for more than 1 year. Multivariable logistic regression was conducted adjusting for physician characteristics and region of the country.
There were 294 963 physicians analyzed (69.5% male). The overall attrition rate from academia was 34.2% after 5 years (38.3% for female physicians and 32.4% for male physicians). Female physicians had higher attrition rates than their male counterparts across every career stage (time since medical school graduation: <15 years, 40.5% vs 34.8%; 15-29 years, 36.4% vs 30.3%; ≥30 years, 38.5% vs 33.3%). On adjusted analysis, female physicians were more likely to leave academia than were their male counterparts (odds ratio, 1.25; 95% CI, 1.23-1.28).
In this cohort study, female physicians were more likely to leave academia than were male physicians at all career stages. The findings suggest that diversity, equity, and inclusion efforts should address attrition issues in addition to recruiting more female physicians into academic medicine.
留住女性医师在学术医疗保健队伍中是必要的，以满足不同社会人口学背景的患者群体的需求。
调查男女医师离开学术界的比率差异。
设计、设置和参与者：这项队列研究使用医疗保险和医疗补助服务中心的 Care Compare 数据，对 2014 年 3 月至 2019 年 12 月期间向教学医院开具 Medicare 账单的所有医师进行了分析，不包括研究期间退休的医师。数据分析于 2022 年 11 月 11 日至 5 月 24 日进行。
医师性别。
主要结果是离开学术界，定义为在教学医院不开具 Medicare 账单超过 1 年。对医师特征和国家地区进行多变量逻辑回归分析。
分析了 294963 名医师（69.5%为男性）。5 年后，学术界的整体离职率为 34.2%（女性为 38.3%，男性为 32.4%）。在每个职业阶段，女性医师的离职率都高于男性（医学院毕业时间：<15 年，40.5%比 34.8%；15-29 年，36.4%比 30.3%；≥30 年，38.5%比 33.3%）。在调整分析中，女性医师离开学术界的可能性高于男性（比值比，1.25；95%置信区间，1.23-1.28）。
在这项队列研究中，女性医师在所有职业阶段离开学术界的可能性都高于男性医师。研究结果表明，多样性、公平性和包容性努力除了应招募更多女性医师进入学术医学领域外，还应解决离职问题。
