a On a Likert scale of 1–5.
6.2.1 Gender and Career Satisfaction
It has been shown that women in general have a greater job satisfaction than men in the United States and United Kingdom, where it is suggested that women's job expectations are generally lower (Bender et al. 2005; Clark 1997; Sousa‐Poza and Sousa‐Poza 2000). That said, the gender influence on career satisfaction must vary in the context of the sector and subdiscipline being examined. For example, Bender and Heywood (2006) reported that among economists working in academia, females were less satisfied than their male counterparts. The negative relationship between age and career satisfaction is less for females than males. And except for impaired vision, there is less reported influence of disabilities on job satisfaction among women. Income appears to play no role in the career satisfaction of female academics (Bender and Heywood 2006). The impact of race on career satisfaction among academic is also less strong among females than among males.
6.3 Career Satisfaction in Medicine
The career satisfaction of physicians has important implications for the delivery of quality medical care. It has been reported for years that physicians who are satisfied with their careers provide better overall healthcare and have more appeased patients compared to physicians dissatisfied with their careers. Satisfied physicians are more likely to stay in their practice, thus enhancing patient continuity – which is an important component of healthcare quality. In contrast, dissatisfaction among physicians can lead to increased rates of medical errors related to job stress, and dissatisfied physicians are more likely to leave the healthcare profession (Lichtenstein 1984; Landon et al. 2003; Landon et al. 2006). Therefore, satisfaction may be considered an indirect measure of patient outcomes. Although the overall level of satisfaction among physicians in the United States has been consistently reported around 80%, there is a noticeable variation of satisfaction levels among different medical specialties.
6.3.1 Career Satisfaction in Primary Care Physicians
Primary care physicians (including family medicine, internal medicine, pediatrics, and general practice specialists) consistently rank in the bottom tier of satisfaction reports (Leigh et al. 2002; Leigh et al. 2009; Duffy and Richard 2006; Katerndahl et al. 2009). While primary care is a cornerstone for developing a cost‐effective, high‐quality healthcare system that reduces health disparities, there is a growing shortage of primary care physicians. In parallel to these findings, the interest in primary care among graduating medical students has also declined (Pugno et al. 2006).
The career satisfaction of primary care physicians has thus become the subject of studies that reveal some interesting trends and raise important questions regarding this medical specialty. In a survey conducted in 2006, it was found that more than 50% of primary care physicians considered themselves “second‐class citizens” compared with surgical and diagnostic specialists (Physicians Practice 2007). In addition, almost two‐thirds of primary care physicians reported that they would choose another field if they could start their careers over. Approximately 39% of the 508 primary care physicians said they would become surgical or diagnostic specialists, and approximately 22% said they would not choose medicine as a career. The only explanation for this situation seems to be career dissatisfaction. In a separate study, Katerndahl et al. (2009) found that doctors who worked more hours per week, more weeks per year, and who maintained solo practices reported significantly lower satisfaction than other physicians – all of these characteristics commonly defined primary caregivers. The results of this study suggested a consistent association between perceived autonomy and career satisfaction.
Deshpande and DeMello (2010) published an analysis to further examine factors that influence career satisfaction of three types of primary care physicians, specifically internal medicine physicians, family/general medicine practitioners, and pediatricians. This study illuminated another issue: malpractice lawsuits. According to the results of this survey, the threat of malpractice lawsuits significantly lowered career satisfaction. On the other hand, quality patient interaction and high incomes significantly increased career satisfaction reported by primary care physicians. With all of these influencing factors considered, pediatricians had the highest overall career satisfaction among the group. The authors suggested that steps like giving adequate time for interaction with patients, reducing potential threats of malpractice lawsuits, and improving income may contribute to increased career satisfaction among primary care physicians (Deshpande and DeMello 2010).
6.3.2 Clinical Specialties and Career Satisfaction
There is a huge range of interests and aptitudes among physicians, which influences their choices from a diverse field of specialties including primary care, surgery, psychiatry, public health, and more. Goldacre et al. (2012) conducted a study on doctors who considered but did not pursue specific clinical specialties as careers. Graduates in 2002, 2005, and 2008 from all UK medical schools were included in the study one year after qualification. According to the results of this study, 2573 of 9155 respondents (28%) had seriously considered, but not pursued, a specialty field. The issue of “work‐life balance” was the single‐most common factor, particularly for women, in not pursuing a specialty. Competition for positions, difficult examinations, stressful working conditions, and poor training were reported as minor concerns. Unusual work hours – deemed unsocial hours – and excessive on‐call hours were suggested to be more important determining factors in exclusion of certain specialties by the doctors. However, in some specialties, working unusual or excessive hours are unavoidable. It should be considered by workforce planners, health service administrators, and senior medical professionals that the intensity of working hours will dissuade some doctors from specializing. The study concluded that any approach to policy changes must address the imperatives of service needed, the importance of continuity of patient care, and the quality of training and learning experiences for doctors (Goldacre et al. 2012).
In a different study by Leigh et al. (2002), career satisfaction across 33 specialties among 12 474 US physicians was analyzed. It was suggested that geriatric internal medicine, neonatal‐perinatal medicine, dermatology, and pediatrics were all significantly more satisfying than family medicine. The researchers noted a nonlinear relationship between age, income, and satisfaction among surveyed physicians. Increased work hours were found to be associated with dissatisfaction reported by all specialties. A follow‐up study published by Leigh et al. (2009) supported the original findings and established a trend: Doctors who practice family medicine reported less job satisfaction than their peers.
6.3.3 Demographic Determinants of Career Satisfaction Among Medical Graduates
Demographic characteristics also seem to be an important determinant for career satisfaction in the healthcare field. For example, international medical school graduates have substantial representation among primary care physicians in the United States and consistently report lower career satisfaction compared with US medical school graduates (Morris et al. 2006). Chen et al. (2012) reported that career satisfaction among primary care physicians was 75.7%; but when US medical graduates were singled out, 82.3% expressed career satisfaction. This statistically significant difference persisted even after adjusting for a broad range of potential explanatory factors, including personal characteristics and variables related