Over the last few decades, physicians are increasingly pursuing subspecialty training.
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A new study released last week by the American Medical Association found that medical residents and fellows are reporting lower rates of burnout and dissatisfaction than previous years. The study, based on responses from over 3,000 physicians, measured several key indicators including job satisfaction, job stress, burnout and intent to leave the profession. The results: 28.6% reported burnout symptoms, compared to nearly 34% the prior year; 34.2% reported having job stress, compared to nearly 40% in 2024; and 90.1% of residents reported satisfaction with their enlisted programs, as compared to 36% the prior year.
These are significant findings. The Accreditation Council for Graduate Medical Education (ACGME) reports that there are currently 167,000+ residents and fellows actively training in the United States, with more than a million graduated physicians in practice. These numbers represent a large part of the healthcare workforce, and trainees’ wellbeing must be prioritized in order to build a sustainable pipeline and workforce for the future.
This news also comes at a time when attrition and turnover in the healthcare labor markets have reached all time highs. The impacts of physician turnover are significant for both systems and local communities alike. In fact, research indicates that there are numerous direct and indirect impacts that are typically not even considered when a healthcare worker leaves, including separation costs, hiring costs, training and resources needed for new employees and perhaps most importantly, a loss of consistency and stability for existing patients. Especially for high-touch specialties such as primary care or clinic based specialties, physicians often establish a professional relationship with their patients over the course of many years, if not decades. When physicians leave their position, it places existing patient panels in a very challenging spot to replace their established care infrastructure and find someone new to catch up on years of knowledge and intangible understanding.
Residency and fellowship are among the most challenging aspects of medical training. Residency takes place right after completion of medical school, often ranging from 3 to 7 years. Graduates may then choose to pursue subspecialty training after that, entailing another 1-5 years. Therefore, burnout and attrition during these phases are incredibly common. Studies indicate that physicians are increasingly pursuing specialization and subspecialization into incredibly niche areas in medicine; in fact, the percentage of US primary care physicians has decreased from 50% in 1961 to 33% in 2015. Some of this may be due to the fact that there is now more access to subspecialties, or the fact that there are simply more specialties that physicians can choose from. Other reasons include the fact that different subspecialties may offer unique patient care, research, lifestyle, compensation or career opportunities. While this does not necessarily pose favorable for primary care as a field (which is also facing a nationwide shortage), the growth of super specialists is not going to slow down. Thus, it is paramount that the system continues to work on measures to protect and safeguard the learning experience for trainees.