Thinking About Giving Up Clinical Practice? A Gender-Stratified Approach to Understanding Junior Doctors' Choices

Ochsmann, Elke B. MD

doi: 10.1097/ACM.0b013e31823aba03
Gender Issues

Purpose: This study examined the association between workplace factors and thinking about leaving clinical care by junior doctors (i.e., doctors in postgraduate training) in Germany, and used a gender-stratified approach to address the so-called feminization of medicine.

Method: In this cross-sectional questionnaire study, 1,494 German junior doctors working in patient care in Bavaria in 2006–2007 were sent a questionnaire about considering leaving patient care (outcome variable). Logistic regression analyses were used to calculate the predictive influence of workplace factors on the outcome variable (adjusted odds ratio [aOR], 95% confidence interval [95% CI]).

Results: Of the 637 responding junior doctors, altogether 52% (men 49.3%, women 54.2%) had thought about leaving clinical practice. Support of colleagues and superiors (men aOR 2.70, 95% CI 1.20–6.04; women aOR 3.46, 95% CI 1.67–7.17), performance feedback (women aOR 1.88, 95% CI 1.23–3.14), the availability of postgraduate training possibilities (men aOR 4.74, 95% CI 1.53–14.69), overtime (women aOR 1.82, 95% CI 1.02–3.25), weekend duty (men aOR: 3.58, 95% CI 1.86–6.88), and the medical specialty were found to be significant predictors for thinking about leaving clinical practice for both men and women.

Conclusions: Workplace factors predict the wish for leaving clinical care for junior doctors. Male and female junior doctors seem to have different priorities in the workplace, which should be addressed in order to retain them in patient care.

Dr. Ochsmann is occupational physician and researcher, Institute of Occupational and Social Medicine, Medical Faculty, RWTH (Rheinisch-Westfälische Technische Hochschule) Aachen University, Germany, and project manager, Institute of Occupational, Social, and Environmental Medicine, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.

Correspondence should be addressed to Dr. Ochsmann, Institute of Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, D-52074 Aachen, Germany; telephone: (0049) 241-80-85488; fax: (0049) 241-80-82587; e-mail:

First published online November 18, 2011

© 2012 Association of American Medical Colleges