Every academic year, I observe a new group of residents and fellows getting ready to graduate and begin their medical careers. The shift from a regulated training setting to a professional environment can be equally exhilarating and daunting. Although these emerging physicians are clinically competent, residency rarely prepares them to recognize and champion what they genuinely need to succeed in practice. This discrepancy is apparent in the statistics. A 2023 survey conducted by MGM & Jackson Physician Search indicates that early-career physicians are resigning from their initial positions within three years at rates higher than those of earlier cohorts. Fewer than half of administrators indicated that they retained over 75% of their new hires past three years, and 5% reported retaining none.

The consequences of early turnover are considerable:

1. **Financially:** Replacing a physician may incur costs between $500,000 and $1 million due to lost revenue and recruitment expenses.
2. **Personally:** Physicians and their families may experience unsettling disruptions due to job transitions, influencing home buying and community connections.
3. **Professionally:** Early job changes can sap confidence, leading to self-doubt, feelings of being a fraud, and burnout.

### Why Does This Occur?

#### Our Medical Training Focuses on Uniformity, Not Individuality
Residency often rewards conformity, with scant attention to personal priorities and career aspirations. This emphasis on “fitting in” frequently leaves physicians ill-prepared to pursue positions that align with their distinctive strengths.

#### Misaligned Priorities During Job Selection
Entry-level physicians may place salary above other considerations when selecting their first role, motivated by the prospect of substantial earnings following years of financial pressure. However, lucrative salaries do not guarantee retention; culture, mentorship, and opportunities for growth are far more critical elements.

#### Insufficient Support During Difficult Times
Launching a practice is a daunting task, necessitating support to navigate challenges. In the absence of mentorship and resources, young physicians often face significant hurdles.

#### Scarce Mentorship and Guidance
Senior physicians frequently lack the necessary time for meaningful mentoring. Without a structured support system, new physicians may ignore essential factors influencing long-term success.

### What Steps Can Be Taken?

To enhance the early-career experience and retention, training programs and professional organizations can implement numerous strategies:

– Assist young physicians in defining their priorities prior to job searching.
– Educate them to assess opportunities beyond just salary and prestige.
– Equip them with negotiation strategies for securing lasting resources.
– Create deliberate mentorship and coaching frameworks to support early-career physicians.

In the end, new physicians require careers that promote growth, well-being, and purpose. By addressing these shortcomings, we can improve retention, lower turnover rates, and enable newcomers to flourish.

*Sharon L. Stein is a surgeon and coach for physicians.*