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. 2020 Aug 21;21(5):1131-1139.
doi: 10.5811/westjem.2020.5.47313.

Intention to Leave Emergency Medicine: Mid-career Women Are at Increased Risk

Michelle D Lall  1 , Sarah M Perman  2 , Nidhi Garg  3 , Nina Kohn  4 , Kristy Whyte  5 , Alexa Gips  6 , Tracy Madsen  7 , Jill M Baren  8 , Judith Linden  9
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Intention to Leave Emergency Medicine: Mid-career Women Are at Increased Risk

Michelle D Lall et al. West J Emerg Med. .

Abstract

Introduction: Burnout is prevalent among emergency physicians and may cause physicians to consider leaving the practice of emergency medicine (EM). This study sought to determine whether there is a gender difference in reporting burnout and seriously considering leaving the specialty of EM, and secondarily to explore the factors reported as contributing to burnout.

Methods: This was a secondary analysis of the 2014 American Board of Emergency Medicine Longitudinal Survey of Emergency Physicians. We used multiple logistic regression to determine which factors were associated with reporting serious consideration of leaving EM, when stratified by years in practice and adjusting for individual, departmental, and institutional factors.

Results: The response rate was 82%, (n = 868); 22.6% (194) were female and 77.4% (664) were males; and 83.9% (733) White. The mean age of men responding was significantly higher than women (52.7±11.9 vs. 44.9±10.4, p<0.001). Overall, there were no significant gender differences in reporting having had serious thoughts of leaving EM in either unmatched or age-matched analyses. More women reported that burnout was a significant problem, while men more often were equivocal as to whether it was a problem. When stratified by years in practice, mid-career women had a seven-fold increase in the odds ratio (OR) of seriously considered leaving EM, compared to men of similar years in practice (OR 7.07, 95% confidence interval, 2.45-20.39). Autonomy at work, control over working conditions, fair compensation, personal reward, and a sense of ownership were factors associated with a lower rate of reporting considering leaving EM.

Conclusion: Our findings suggest that the intention to leave EM is not more prevalent in women. However, mid-career women more often reported seriously considering leaving the specialty than mid-career men. Further research on the factors behind this finding in mid-career women in EM is needed.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Figures

Figure 1
Figure 1
Flow diagram of participant exclusion in survey of emergency physicians. ABEM, American Board of Emergency Medicine; LSEP, Longitudinal Study of Emergency Physicians; EM, emergency medicine.
Figure 2
Figure 2
Association between burnout and considering leaving emergency medicine for all respondents (n = 852). Responses were pooled in a Likert scale of 0,1,2 (burnout is not a problem in everyday work for pay), 3 (ambivalent if it is or is not), 4,5 (burnout is a problem in everyday work for pay).
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