The Leaky Pipeline: Female Physician Attrition from Academic Medicine Across the US

Abstract

INTRODUCTION: The purpose of the study was to investigate gender differences in attrition rate between male and female physicians working in academia. METHODS: All physicians who billed Medicare from a teaching hospital in March 2014 were included and were followed up until December 2019. Physicians who retired during the study period were excluded. The primary outcome was leaving academia and was defined as not having billed Medicare from a teaching hospital for more than 1 year. The primary independent variable was physician gender. Multivariate logistic regression was conducted, adjusting for physician experience, medical school ranking, specialty (surgery vs nonsurgery), and region of the country. Stratified subset analyses were also performed for the variables listed above. RESULTS: There were 294,963 physicians included, 30.5% female. The overall attrition rate was 34.2% after 5 years, 38.3% and 32.4% for female and male physicians, respectively. Female physicians had higher attrition rate than their male counterparts across every career stage (Figure). On the adjusted analysis, female physicians were 25% more likely to leave academia than their male counterparts (odds ratio [OR] = 1.25, 95% CI = 1.23, 1.28). The results were qualitatively similar on all subset analyses.CONCLUSION: Female physicians are more likely to leave academia than male physicians at all career stages, in all regions of the country, in both surgical and nonsurgical specialties, and regardless of medical school ranking. Successful diversity, equity, and inclusion efforts should address attrition in addition to pipeline issues.