TOPLINE:

A survey of 2711 emergency medicine (EM) residents in the US revealed that lifestyle (97.5%), location (88.7%), and professional fulfilment (87.7%) strongly influenced their career choices, with most residents planning community-based practice despite high burnout rates (72.4%).

METHODOLOGY:

• Researchers conducted a cross-sectional survey study of 2711 graduating residents (51.4% men; 54% White individuals) from Accreditation Council for Graduate Medical Education-accredited EM residency programs in 2023.
• Survey questions covered various career options, including fellowship, community practice, academics, and hybrid settings, with practice locations categorized as urban or rural.
• The primary outcomes were immediate postresidency career plans, intended practice setting, anticipated years of clinical practice, burnout (assessed using the abbreviated Copenhagen Burnout Inventory), and career decision factors.

TAKEAWAY:

• Residents anticipated practicing clinical EM for a mean of 22.4 years. Overall, 46.7% of residents planned community-based or hybrid practice, and 24.1% intended to work in rural settings. Lifestyle (97.5%), geographic location (88.7%), professional fulfilment (87.7%), and salary expectations (82.8%) were most frequently cited as major career factors.
• White individuals were more likely to choose rural settings than residents belonging to other racial and ethnic groups (odds ratio [OR], 1.76; 95% CI, 1.43-2.16). Additionally, female residents were more likely to prioritize professional fulfilment (OR, 1.73; 95% CI, 1.30-2.32) and less likely to prioritize salary (OR, 0.69; 95% CI, 0.54-0.87) than male residents.
• Residents reporting burnout anticipated practicing clinical EM 5.1 years longer (95% CI, 4.0-6.2) than those without burnout.

IN PRACTICE:

"These findings provide timely insights into the perspectives of the next generation of EPs [emergency physicians] and highlight important considerations for workforce planning and career sustainability initiatives in EM," the authors wrote.

SOURCE:

The study was led by Dave Lu, MD, MSCI, MBE, University of Washington School of Medicine, Seattle. It was published online on January 27, 2026, in JAMA Network Open.

LIMITATIONS:

Substantial missing data for certain variables may have affected the generalizability of subgroup analyses. The voluntary nature of participation could have introduced response and social desirability bias, particularly for self-reported measures of burnout, educational debt, and career intentions. The cross-sectional design captured career intentions at a single timepoint during residency, making it unclear how closely these intentions reflected actual postgraduation trajectories. Additionally, the observational nature of the study precluded causal inferences between resident characteristics and career decisions.

DISCLOSURES:

Funding information was not provided for the study. One author reported receiving a waived registration fee to the American College of Emergency Physicians Scientific Assembly for service as a research moderator.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.