Primary Care Fellowship Training and Career Satisfaction
Primary Care Fellowship Training and Career Satisfaction
Purpose This study was designed to measure the impact of primary care fellowship training on the subsequent happiness, career satisfaction and perceived stress levels of fellowship-trained physicians as compared to a general population of Family Medicine physicians in North Carolina.
Methods A written survey instrument was completed by fellowship graduates of the Brody School of Medicine (n=53) and general population of Family Medicine physicians in North Carolina (n=203) in 2011. The survey included general demographic and practice variables, and validated psychological scales on subjective happiness, satisfaction with life, and perceived stress.
Results Fellowship graduates (n=50), and non-fellowship graduates (n=203), exhibited similar levels of satisfaction with life (fellows=27.36 SD 5.45, FM physicians=26.91, SD 5.99 on a 5–35 scale), statistically higher levels of perceived stress (fellows=5.92, SD 3.03, FM physicians=4.98, SD 2.70 on a 0–16 scale), and significantly higher levels of subjective happiness (fellows=5.61SD 83, FM physician=4.75 SD 1.00 on a 1–7 scale). Female fellow response was significantly higher on the Satisfaction with Life and Subjective Happiness Scores, and lower on the Perceived Stress Scale. Male fellowship graduates presented with a reverse relationship, with higher perceived stress and lower satisfaction with life and subjective happiness.
Conclusions Fellowship training exhibited a positive psychological effect on the graduate respondents versus the general physician population. Scores on various well-being scales were higher than the general Family Medicine physician population as a whole, although stress levels were also higher. Female physicians seem to garner a much larger gain in satisfaction than male fellowship graduates, who score slightly worse than the general family medicine population on the satisfaction with life and Perceived Stress Scales.
Many studies have been performed to determine the general happiness or satisfaction of practicing physicians with their choice of specialty, practice location, work hours and income. These studies have identified various overarching themes on physician satisfaction and correlations to practice demographics, including the fact that most physicians have a high level of career satisfaction, especially when compared to their professional peers, such as attorneys and business professionals. It will be essential to determine educational and workforce development that produce satisfied and reliable physicians, so that those in the health professions can produce the next generation of the health workforce.
Researchers have often used the findings from measures of physician satisfaction to determine specific variables that lead to increased satisfaction and retention. In the past, research has identified the limited impact that salaries have on physician satisfaction and has instead found that many work environment and relational conditions of practice add to satisfaction in a much more meaningful manner. Key indicators of satisfaction often focus on relationships that practising physicians can build with their colleagues and patients, as well as important personal and family relationships.
Coupled with the available research on practice environment and happiness and career satisfaction, is research examining the relationship between higher levels of education and general happiness levels. Studies done in Spain and Asia have resulted in very similar findings on general populations. Cunado and Perez de Garcia found that increased levels of education impacted happiness through career and job stability and pay, but also through what they labelled as 'self-confidence' or 'self-estimation' from increased knowledge. In a like study on an Asian population, Chen found that income was a limited factor in happiness in general, while interpersonal networks and interaction with the 'wider world' had a much greater impact on general well-being.
In keeping with the focus of examining and predicting satisfaction and happiness based on relationships rather than more tangible rewards for the physician, several researchers have championed the idea of training future physicians with additional psychological coping strategies to manage the reality of modern practice, such as efforts to produce positive primed responses and provide life coaches. These efforts are increasingly important, as little evidence currently exists that traditional recruitment efforts successfully identify individuals best suited for the life of a practising physician. Fellowship training, with its particular focus, as well as the addition of specific professional development content, may engender increased coping skills on the participants.
Fellowship training as an educational experience has not been examined in an in-depth manner, but there have been multiple studies on its general impact. Studies have shown that fellowship training, particularly content that focuses on teaching and professional development, may increase well-being in participants. These studies also indicated that fellowship participants were more interested in non-clinical matters, such as research, teaching and leadership. This may be indicative of the general views espoused by other researchers on the role of a wider or more cosmopolitan view on the well-being of individuals.
Determining various practice, personal and educational characteristics that equate to increased levels of satisfaction for physician graduates is essential to creating a future physician workforce that will be challenged, but satisfied. The purpose of this study was to explore the relationship between fellowship training and its possible impact on happiness and satisfaction for practising physicians. This research question is based on the additional training received in the fellowship-trained cohort described in this study, which includes significant non-clinical academic, teaching, leadership and communication instruction for the students. With previous research considered, it is possible that fellowship training may provide an opportunity for practitioners to adopt a professional view that is more 'cosmopolitan' and inclusive, that may lead to higher career satisfaction and happiness and lower stress levels.
Abstract and Introduction
Abstract
Purpose This study was designed to measure the impact of primary care fellowship training on the subsequent happiness, career satisfaction and perceived stress levels of fellowship-trained physicians as compared to a general population of Family Medicine physicians in North Carolina.
Methods A written survey instrument was completed by fellowship graduates of the Brody School of Medicine (n=53) and general population of Family Medicine physicians in North Carolina (n=203) in 2011. The survey included general demographic and practice variables, and validated psychological scales on subjective happiness, satisfaction with life, and perceived stress.
Results Fellowship graduates (n=50), and non-fellowship graduates (n=203), exhibited similar levels of satisfaction with life (fellows=27.36 SD 5.45, FM physicians=26.91, SD 5.99 on a 5–35 scale), statistically higher levels of perceived stress (fellows=5.92, SD 3.03, FM physicians=4.98, SD 2.70 on a 0–16 scale), and significantly higher levels of subjective happiness (fellows=5.61SD 83, FM physician=4.75 SD 1.00 on a 1–7 scale). Female fellow response was significantly higher on the Satisfaction with Life and Subjective Happiness Scores, and lower on the Perceived Stress Scale. Male fellowship graduates presented with a reverse relationship, with higher perceived stress and lower satisfaction with life and subjective happiness.
Conclusions Fellowship training exhibited a positive psychological effect on the graduate respondents versus the general physician population. Scores on various well-being scales were higher than the general Family Medicine physician population as a whole, although stress levels were also higher. Female physicians seem to garner a much larger gain in satisfaction than male fellowship graduates, who score slightly worse than the general family medicine population on the satisfaction with life and Perceived Stress Scales.
Introduction
Many studies have been performed to determine the general happiness or satisfaction of practicing physicians with their choice of specialty, practice location, work hours and income. These studies have identified various overarching themes on physician satisfaction and correlations to practice demographics, including the fact that most physicians have a high level of career satisfaction, especially when compared to their professional peers, such as attorneys and business professionals. It will be essential to determine educational and workforce development that produce satisfied and reliable physicians, so that those in the health professions can produce the next generation of the health workforce.
Researchers have often used the findings from measures of physician satisfaction to determine specific variables that lead to increased satisfaction and retention. In the past, research has identified the limited impact that salaries have on physician satisfaction and has instead found that many work environment and relational conditions of practice add to satisfaction in a much more meaningful manner. Key indicators of satisfaction often focus on relationships that practising physicians can build with their colleagues and patients, as well as important personal and family relationships.
Coupled with the available research on practice environment and happiness and career satisfaction, is research examining the relationship between higher levels of education and general happiness levels. Studies done in Spain and Asia have resulted in very similar findings on general populations. Cunado and Perez de Garcia found that increased levels of education impacted happiness through career and job stability and pay, but also through what they labelled as 'self-confidence' or 'self-estimation' from increased knowledge. In a like study on an Asian population, Chen found that income was a limited factor in happiness in general, while interpersonal networks and interaction with the 'wider world' had a much greater impact on general well-being.
In keeping with the focus of examining and predicting satisfaction and happiness based on relationships rather than more tangible rewards for the physician, several researchers have championed the idea of training future physicians with additional psychological coping strategies to manage the reality of modern practice, such as efforts to produce positive primed responses and provide life coaches. These efforts are increasingly important, as little evidence currently exists that traditional recruitment efforts successfully identify individuals best suited for the life of a practising physician. Fellowship training, with its particular focus, as well as the addition of specific professional development content, may engender increased coping skills on the participants.
Fellowship training as an educational experience has not been examined in an in-depth manner, but there have been multiple studies on its general impact. Studies have shown that fellowship training, particularly content that focuses on teaching and professional development, may increase well-being in participants. These studies also indicated that fellowship participants were more interested in non-clinical matters, such as research, teaching and leadership. This may be indicative of the general views espoused by other researchers on the role of a wider or more cosmopolitan view on the well-being of individuals.
Determining various practice, personal and educational characteristics that equate to increased levels of satisfaction for physician graduates is essential to creating a future physician workforce that will be challenged, but satisfied. The purpose of this study was to explore the relationship between fellowship training and its possible impact on happiness and satisfaction for practising physicians. This research question is based on the additional training received in the fellowship-trained cohort described in this study, which includes significant non-clinical academic, teaching, leadership and communication instruction for the students. With previous research considered, it is possible that fellowship training may provide an opportunity for practitioners to adopt a professional view that is more 'cosmopolitan' and inclusive, that may lead to higher career satisfaction and happiness and lower stress levels.