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Why Are a Quarter of Faculty Considering Leaving Academic Medicine? A Study of Their Perceptions of Institutional Culture and Intentions to Leave at 26 Representative U.S. Medical Schools

Pololi, Linda H. MD; Krupat, Edward PhD; Civian, Janet T. EdD; Ash, Arlene S. PhD; Brennan, Robert T. EdD

Academic Medicine:
doi: 10.1097/ACM.0b013e3182582b18
Faculty Issues

Purpose: Vital, productive faculty are critical to academic medicine, yet studies indicate high dissatisfaction and attrition. The authors sought to identify key personal and cultural factors associated with intentions to leave one’s institution and/or academic medicine.

Method: From 2007 through early 2009, the authors surveyed a stratified random sample of 4,578 full-time faculty from 26 representative U.S. medical schools. The survey asked about advancement, engagement, relationships, diversity and equity, leadership, institutional values and practices, and work–life integration. A two-level, multinomial logit model was used to predict leaving intentions.

Results: A total of 2,381 faculty responded (52%); 1,994 provided complete data for analysis. Of these, 1,062 (53%) were female and 475 (24%) were underrepresented minorities in medicine. Faculty valued their work, but 273 (14%) had seriously considered leaving their own institution during the prior year and 421 (21%) had considered leaving academic medicine altogether because of dissatisfaction; an additional 109 (5%) cited personal/family issues and 49 (2%) retirement as reasons to leave. Negative perceptions of the culture—unrelatedness, feeling moral distress at work, and lack of engagement—were associated with leaving for dissatisfaction. Other significant predictors were perceptions of values incongruence, low institutional support, and low self-efficacy. Institutional characteristics and personal variables (e.g., gender) were not predictive.

Conclusions: Findings suggest that academic medicine does not support relatedness and a moral culture for many faculty. If these issues are not addressed, academic health centers may find themselves with dissatisfied faculty looking to go elsewhere.

Author Information

Dr. Pololi is senior scientist and resident scholar, Women’s Studies Research Center, and director, National Initiative on Gender, Culture and Leadership in Medicine: C-Change, Brandeis University, Waltham, Massachusetts; and director, faculty mentoring programs, Department of Medicine, Weill Cornell Medical College, New York, New York.

Dr. Krupat is director, Center for Evaluation, Harvard Medical School, and associate professor of psychology, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Dr. Civian is analyst, Women’s Studies Research Center, Brandeis University, Waltham, Massachusetts.

Dr. Ash is professor and division chief, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. At the time of this study, she was research professor of medicine and public health, Boston University School of Medicine, Boston, Massachusetts.

Dr. Brennan is research associate, Harvard School of Public Health, Boston, Massachusetts.

Correspondence should be addressed to Dr. Pololi, National Initiative on Gender, Culture and Leadership in Medicine: C-Change, Brandeis University, 415 South St., Mailstop 079, Waltham, MA 02454-9110; telephone: (781) 736-8120; fax: (781) 736-8117; e-mail:

© 2012 Association of American Medical Colleges