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Finding and accepting their first job after medical school and residency is a major transition for new physicians. It’s also often a temporary one. In less than 3 years, nearly 6 in 10 doctors will have left their first positions for proverbial greener pastures, according to a survey conducted by Jackson Physician Search and the Medical Group Management Association.
What drives that trend, and what are new physicians looking for in a first job? Doctors share the factors they weigh when deciding whether to take a job or leave one.
Surprising (or Not?) Statistics
The Jackson survey found that 13% of new physicians left their first job within 12 months, and more than a quarter considered leaving that job during that year. By 2 years, nearly 40% of physicians had considered leaving. Yet 7 in 10 administrators expect newly hired physicians to stay 6 years or more, so there’s a disconnect between administrators’ expectations and reality.
About Medscape Data
Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, the Medscape Employed Physicians Report 2025 found that:
- About 48% of surveyed physicians said their employer’s rules didn’t make sense for doctors.
- Only 10% of surveyed doctors said that their collaboration with management was very effective.
- About 13% of doctors surveyed said their autonomy was satisfactory at work.
The Challenge of Assessing a Position
Steven Girdler, MD, knows that many new doctors pull up stakes in their first year or 2 of practice. “It was something that was talked about during training and during the residency process. I think it’s accurate and well known — especially in orthopedics,” said Girdler, fellowship-trained orthopedic surgeon at DISC in Newport Beach and Marina del Rey, California, in his second year of practice.
“Jobs are so hard to assess, and there are so many factors to consider,” he added. “You go through 10 years of training as a surgeon to get your skillset and be able to provide patient care, but the training we get to assess jobs is kind of deficient.” New doctors must consider factors including practice size, culture, compensation, and administrative support, which is difficult to do from the outside. (If you’re a doctor considering a new position, have both a lawyer and a colleague read your contract to check for red flags.)
The Search for Camaraderie
Girdler prioritized several factors, including location, income, and camaraderie, when looking for his first position. “I looked at who would be there to support me and help me along…having physician colleagues was a huge factor,” he said. “I work very closely with three or four surgeons on a day-by-day basis.”
Kayla Street, MD, had similar priorities. “My main priority was finding a practice that provided mentorship as a new graduate,” said Street, Ob-Gyn in Houston, who started her first position in September 2025. “The group I chose had several Ob-Gyns, with half of the group being more seasoned. I [knew] I could do cases with them, and that they’d be available to me.”
Culture Matters
Street also wanted a practice with a collaborative, family-friendly culture. “As someone who is very involved with the American College of Obstetricians and Gynecologists outside of work, I wanted to be part of a practice that found evidence-based medicine and advocacy very important,” she said.
Culture also mattered to Ray Lorenzoni, MD, who considered several jobs before choosing his current practice. “I had rotated through the same hospitals and was familiar with the group and the institutions they work in,” said Lorenzoni, pediatric cardiologist who practices in Hartford, Connecticut. “There was a certain amount of comfort, so when I made the leap with a medium-sized program, I trusted the people I was getting into bed with.”
Lorenzoni also likes the more relaxed pace of a smaller practice. “There’s a much more community feel and underlying ethos of ‘do what’s best for the patient,’” he added. “We all get along really well and work well when trying to solve complex physical problems. There’s an element of trust and responsibility to your coworker that maybe doesn’t exist when people are more siloed.”
Make the Transition an Easier One
Another factor new docs value is the level of practical support they receive as they begin their careers. For example, new doctors typically don’t know how to code or bill. “I came in with minimal knowledge [of that], and this group has been very helpful in providing that guidance,” said Street.
In addition to having access to a coding specialist, Street was paired with a seasoned nurse to help with clinic flow. “I knew I needed to order this test for the patient, and I talked with my nurse about how I needed to place it and who to call to move it up the chain,” she said. Having access to seasoned staff and colleagues and being able to ask questions of them is invaluable — and makes doctors more efficient and confident in their skills.
The Question of Compensation
Compensation is another factor that doctors consider when deciding to take a new position, and it can vary widely depending on the type of position and the structure of the organization. For example, in a private practice setting, the doctor may be paid a base salary that drops over time or start with no salary and be responsible for building a practice. Salaries can also vary widely. For example, Lorenzoni had competing similar offers that differed by 25%. And well-known institutions may offer less compensation than lesser-known ones, banking on “cachet.”
What Physicians Really Value
Compensation is not necessarily the primary driver for new doctors. When asked about the reasons for leaving their first job, “leadership/administration issues” (45%) and “organizational culture” (39%) both ranked higher than compensation (36%). Other significant factors included work-life balance (34%), career advancement opportunities (18%), geographic preference (17%), lack of mentorship (9%), and governance structure (9%).
Laurel Barr, MD, emergency physician in Powell, Ohio, left her first job after just 1 year and says this is common among emergency room doctors. “There are a lot of reasons, like culture issues that you might not be able to pick apart during the interview,” said Barr, who finished her residency in 2014. “At my first job, I had some difficulty addressing some nursing deficiencies…then the small group was sold to a large staffing firm, and the administration changed. There was no way I could deliver optimal patient care, so I left.”
Keeping New Doctors Engaged
What can administrators do to help retain new physicians? Stay connected with the doctors and make sure that you are responding to their needs, Barr said. “Administration needs to actually address patient care concerns in a way that matters — quickly and efficiently.”
“There are nonmonetary ways to keep people interested and engaged,” said Lorenzoni. “Support your new graduates to be faster and more efficient. Doctors — even mid-career physicians — are still looking for mentorship.”
While early-career doctors may value different aspects of practice, a common thread is that the people you work with matter. “What keeps a person at a given institution is familiarity with their colleagues,” said Lorenzoni. “What keeps people at an institution is having the interpersonal relationships…that interpersonal connection and feeling of family is important — and is going to make me [and others] feel more valued and satisfied at work.”
Kelly K. James is a freelancer, content manager, and author of The Book That (Almost) Got Me Fired: How I (Barely) Survived a Year in Corporate America. She covers health or wellness, business or career, and psychology topics from her home in the Chicago suburbs.
