Early career attrition among the most common surgical and nonsurgical specialties

Abstract Purpose Early career attrition, defined as attrition within the first 10 years of a physician’s practice, is a significant concern for health care professionals and policymakers because it contributes to the growing physician shortage. Previous studies examined attrition within single specialties or institutions, but comparisons between surgical and nonsurgical fields remain limited. This study aims to determine early-career attrition rates among the 5 surgical and nonsurgical specialties with the largest physician population and investigate predictors influencing departure from clinical practice. Method This study analyzed the Centers for Medicare and Medicaid Services’ Physician Compare National Downloadable Files from 2014 through 2023 to identify physicians in the first 10 years of their career in 2014 who left practice between the third quarters of 2014 and 2015 and did not return. Those who remained absent in subsequent years, excluding clinically active physicians who opted out of Medicare, were considered early attrition cases. The study population included physicians from the 5 most common surgical and nonsurgical specialties based on practicing physician count. Logistic regression models evaluated attrition rates while adjusting for surgical status, gender, region, Area Deprivation Index, and Rural-Urban Commuting Area codes. Results Among 94,638 early-career physicians across 10 specialties, 1164 (1.2%) experienced early career attrition. After adjusting for physician demographic variables, psychiatrists had significantly higher adjusted odds of early career attrition than all other nonsurgical specialties and obstetricians/gynecologists had significantly higher adjusted odds of early career attrition than all surgical specialties except for general surgery. Among all early career physicians, females, surgical specialists, and those practicing in areas with lower Area Deprivation Index had significantly greater adjusted odds of experiencing early career attrition. Conclusions These findings highlight the need to determine reasons behind specialty-specific differences and implement targeted interventions aimed at improving physician retention to ensure current physicians do not contribute to the growing physician shortage.