Additional domains of experience may contribute in important ways to differences in career satisfaction between international and US graduates. These may include the impact of discrimination in the workplace, stresses of being an “outsider,” and lack of appropriate supportive structures in the workplace (Chen et al. 2011). Previous reports indicated that international medical graduates were more likely than US graduates to report experiences of discrimination in the workplace (Chen et al. 2010). Given the central role of international graduates in the US healthcare system, particularly for vulnerable populations, improved understanding of the causes of this differential satisfaction is important to appropriately support the healthcare workforce.
6.4 Research and the Physician‐Scientist
A challenge for the medical profession is to preserve the future of academic researchers in the next generation of physicians in a way that is compatible with their personal lives. There is an increasing number of clinicians who would prefer to work part‐time. Hoesli et al. (2013) conducted an exploratory survey to assess predictors for an academic career in a population of physicians working full‐time or part‐time in the northwestern part of Switzerland. These Swiss physicians were evaluated to determine the individual attitudes, influences, and motivations toward working part‐time. The results of this survey suggested that the opportunity to do research on the side was the most significant factor positively influencing the physicians' decisions to work part‐time in a clinical setting.
Whether practicing medicine full‐ or part‐time, physicians have always found it challenging to balance the demands of clinical care with the time required to perform research or publish their findings. Many physicians have also found it challenging to obtain the time they need to start and maintain a research program; one hurdle being the long lag in time between beginning a research career and receiving funding. Furthermore, it can be hard to cope with the career uncertainties related to the reliance on other grants for salary support (Nathan 1998). For these reasons, many clinicians have not been attracted to a career that combined clinical work with research.
With today's growing focus on the translation of basic science discoveries into clinical practices, and the increased need for comparative effectiveness research, the demand for physician‐scientists is likely to grow – as is the demand for new ideas and programs to increase the supply of physician‐scientists. Some universities have established various types of career development programs. However, the success of these programs to substantially increase the cadre of well‐trained physician‐scientists must address the problems that commonly deter physicians who might be interested in pursuing investigative careers.
6.5 Career Satisfaction and Productivity
The motivation for studying career satisfaction is, in part, the perception that higher satisfaction should be associated with greater productivity. Thus, if the determinants of career satisfaction are understood, researchers may be able to contribute to creating conditions or models that enhance productivity for a multitude of industries including academia. By example, managers concerned with maximizing the impact of their research and development teams are specifically interested in findings revealed by the aforementioned research (Kim and Oh 2002).
The opportunity to perform research remains the most important predictor for a successful academic career. At the University of Pittsburgh's Institute for Clinical Research Education (ICRE), The Research on Careers Workgroup, a development program, created a comprehensive theoretical model to address career success. The Workgroup's model, and consecutive submodels, would allow for the evaluation of personal factors (e.g. demographics, education, and the psychosocial milieu), organizational factors (e.g. financial resources, infrastructure, training, and mentoring), and the interplay between factors that contribute to career success. The authors have suggested that with this model, leaders of training programs could identify potential physician‐scientists and provide early opportunities for intervention – thus ensuring career success. The authors concluded that their model may serve as a highly flexible template for concise and testable analytic models used to develop a positive career trajectory for aspiring physician‐scientists (Rubio et al. 2011). However, demonstrating how these theoretical associations may apply to important questions related to career success is limited in scope.
6.6 Conclusions
Career satisfaction is an important issue that directly affects a person's productivity and quality of life. There are many determinants, which are all likely play a role in career satisfaction. The role of these determinants have been the subject of many studies; no single determinant seem to outweigh the others, especially since personal expectations regarding one's job cannot be objectively measured. While personal expectations are subject to change over time, continuous research is warranted to evaluate the job and workplace factors that are associated with low satisfaction and burnout, and can then be remedied through new programs and job redesign. Investigating determinants of career satisfaction is an important means for academic institutions not only to achieve better performance outcomes, but to improve the quality of working life.
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