Where Are They Now? Attrition Rates of Emergency Medicine Residency Graduates by Gender - 14/11/24

Doi : 10.1016/j.annemergmed.2024.09.017

Nikita A. Salker, MD ^a, Andrea Fang, MD ^b, Michelle Lall, MD ^c, Michael Bond, MD ^d, Melissa White, MD ^c, Pooja Agrawal, MD, MPH ^e, Kinjal N. Sethuraman, MD, MPH ^d,^⁎
^a Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY
^b Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA
^c Emory Department of Emergency Medicine, Emory School of Medicine, Atlanta, GA
^d Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
^e Department of Emergency Medicine, Yale School of Medicine, New Haven, CT

^∗Corresponding Author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 14 November 2024

Abstract

Study objective

Prior studies examined the retention of women emergency physicians through residency training, but their career paths on completing residency are less well understood. Our primary objective was to identify a difference in attrition rates between binary genders of practicing clinical emergency physicians within 10 to 30 years after residency graduation. Our secondary aims investigated gender differences in geographic practice location, academic, and community practice. We hypothesized that women emergency physicians have higher rates of attrition from clinical practice than men.

Methods

In this cohort study, we tracked employment over 10 to 30 years of graduates from allopathic emergency medicine residency programs established before 2005 and those who graduated before 2010. We obtained graduate lists from 21 residency programs representing geographically diverse training programs in the United States. We utilized public databases to investigate current licensure, board certification, practice location, and occupation for graduates more than 10 years after residency graduation. Physicians who do not practice clinically in emergency medicine or an emergency medicine subspecialty were placed in the “attrition” category. “Not available” was defined as those individuals who did not have adequate information available online. We analyzed differences in attrition of women and men emergency physicians in clinical practice in 2020. We also noted whether they worked in an academic or community setting and assessed their geographic clinical practice region.

Results

We identified a total of 4,170 graduates. Of those, 445 (10.6%) were excluded because of insufficient information. Of the 3,725 emergency medicine residency graduates, 71% were men. The attrition rate from clinical emergency medicine for men was 5.3% (95% confidence interval, 4.4% to 6.1%) and the attrition rate for women was 5.8% (95% confidence interval, 4.4% to 7.2%). The difference between the 2 proportions was –0.005 (95% confidence interval, –0.02 to 0.01). There were no gender differences in geographic location or practice type.

Conclusion

We did not observe differences in attrition rates by gender in our sample from 21 programs over a 30-year period. The findings from this cohort are disparate from reports of recent emergency medicine graduates and identifying reasons for attrition of emergency physicians will be important to understanding the workforce needs of the future.

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Plan

Introduction

Background

Goal of This Investigation

Materials and Methods

Study Design and Setting

	Please see page XX for the Editor’s Capsule Summary of this article.
	Supervising editor: Donald M. Yealy, MD, Specific detailed information about possible conflict of interest for individual editors is available at editors.
	Author contributions: KS conceived the idea and designed the study. KS, NS, ML, AF, MB, MW, and PA were responsible for data gathering. KS, NS, and AF were responsible for data management and analysis. All authors were involved with writing and editing the manuscript. KS takes responsibility for the manuscript as a whole.
	Data sharing statement: Partial or complete deidentified datasets and data dictionary are available upon request to Dr. Sethuraman (email: ksethuraman@som.umaryland.edu) to investigators who provide an IRB letter of approval.
	All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
	Funding and support: By Annals’ policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). Dr. Salkar participated in the study as a medical student, receiving her MD after study completion. The other authors have stated that no such relationships exist.