Journal of General Internal Medicine

, Volume 27, Issue 2, pp 147–152

Career Satisfaction in Primary Care: A Comparison of International and US Medical Graduates

  • Peggy G. Chen
  • Leslie A. Curry
  • Marcella Nunez-Smith
  • Elizabeth H. Bradley
  • Mayur M. Desai
Original Research

DOI: 10.1007/s11606-011-1832-4

Cite this article as:
Chen, P.G., Curry, L.A., Nunez-Smith, M. et al. J GEN INTERN MED (2012) 27: 147. doi:10.1007/s11606-011-1832-4

ABSTRACT

BACKGROUND

International medical graduates (IMGs) have substantial representation among primary care physicians in the USA and consistently report lower career satisfaction compared with US medical graduates (USMGs). Low career satisfaction has adverse consequences on physician recruitment and retention.

OBJECTIVE

This study aims to identify factors that may account for or explain lower rates of career satisfaction in IMGs compared with USMGs.

DESIGN

Using data from the 2008 Health Tracking Physician Survey, a nationally representative survey, we examined the association between IMG status and career satisfaction among primary care physicians. We used multivariable logistic regression modeling to adjust for a broad range of potential explanatory factors and physician characteristics.

PARTICIPANTS

The study participants comprise primary care physicians who reported at least 20 h a week of direct patient care activities (N = 1,890).

MAIN MEASURES

The main measures include respondents’ overall satisfaction with their careers in medicine.

KEY RESULTS

IMGs were statistically significantly less likely than USMGs to report career satisfaction (75.7% vs. 82.3%; p = 0.005). This difference persisted after adjusting for physician characteristics and variables describing the practice environment (adjusted odds ratio = 0.62; 95% confidence interval, 0.43–0.90). Pediatricians (vs. internists) and those who earned $200,001–250,000 (vs. <$100,000) or >$250,000 were more likely to report career satisfaction, while solo practitioners and those who reported being unable to provide high-quality patient care were less likely to report career satisfaction.

CONCLUSIONS

After adjusting for a number of variables previously shown to have an impact on career satisfaction, we were unable to identify additional factors that could account for or explain differences in career satisfaction between IMGs and USMGs. In light of the central role of IMGs in primary care, the potential impact of poorer satisfaction among IMGs may be substantial. Improved understanding of the causes of this differential satisfaction is important to appropriately support the primary care physician workforce.

KEY WORDS

workforce primary care physician satisfaction 

Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Peggy G. Chen
    • 1
  • Leslie A. Curry
    • 1
    • 2
    • 5
  • Marcella Nunez-Smith
    • 2
    • 3
  • Elizabeth H. Bradley
    • 1
    • 5
  • Mayur M. Desai
    • 2
    • 4
  1. 1.Division of Health Policy and AdministrationYale School of Public HealthNew HavenUSA
  2. 2.Robert Wood Johnson Foundation Clinical Scholars ProgramYale School of MedicineNew HavenUSA
  3. 3.Section of General Internal MedicineYale School of MedicineNew HavenUSA
  4. 4.Division of Chronic Disease EpidemiologyYale School of Public HealthNew HavenUSA
  5. 5.Global Health Leadership InstituteYale UniversityNew HavenUSA

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