Table 1 Summary of study characteristics and research focus
From: Physicians’ intention to leave direct patient care: an integrative review
Author, year, country | Sample | Medical speciality | Design | Career phase | Research focus/question |
|---|---|---|---|---|---|
Bornschein et al. 2006 [21], Germany | Inpatient and outpatient care physicians in Munich 59% male Age: <35 = 1163 36–45 = 815 46–55 = 321 56+ = 136 Mean age: 38 | Different specialities | N = 5,461/2,450 (RR 47%) Employed physicians Cross-sectional, Quantitative | All career stages | Assess the extent to which the German law on working hours is actually implemented in employed physicians |
Davidson et al. 1998 [12], UK | Physicians qualified in the NHS in 1977 Mid 40s | Different specialities | N = 3,135/2,398 (RR 78.1%) Cross-sectional, Quantitative | Mid-career | Determine the career destinations by 1995 of physicians who qualified in 1977 |
Davidson et al. 2001 [29], UK | Physicians qualified in the NHS in 1974 Mean age: 48 | Different specialities | N = 2,217/1,717 (RR 77.4%) Cross-sectional, Quantitative (open question) | Mid-career | Systematic information about retirement intentions and factors that influence them |
Estryn-Behar et al. 2011 [23], France | French hospital physicians and emergency physicians 57.5% and 62.4% male Age: <35 = 8.2% and 25% 35–44 = 33.8% and 47% 45–54 = 34.5% and 23.5% 55+ = 23.6% and 4.5% | Different specialities of French physicians and emergency physicians | N = 3,196 (RR 66%) from this a representative sample (N = 1,924) was randomly selected and compared to 538 emergency physicians Cross-sectional, Quantitative | All career phases | Analysis of working conditions, satisfaction and health on ITL and burnout for French physicians with separate analysis for emergency physicians |
Estryn-Behar et al. 2011 [28], France | French hospital physicians 57.5% male Age: <35 = 8.2% 35–44 = 33.8% 45–54 = 34.5% 55+ = 23.6% | Different specialities | N = 3,196 (RR 66%) from this a representative sample (N = 1,924) was randomly selected Cross-sectional, Quantitative | All career phases | Analysis of the risk factors for burnout and intention to leave the profession according to gender |
Fuss et al. 2008 [30], Germany | Physicians from two university hospitals in North Rhine-Westphalia 60.1% male Age: <34 = 126 35–44 = 98 45–54 = 44 55+ = 21 Mean age: 38.3 | Different specialties | N = 761/296 (RR 38.9%) Cross-sectional, Quantitative | All career phases | Investigation of predictors for work interfering with family conflict |
Goldacre et al. 1999 [37], UK | All physicians who qualified in the UK in 1996 and 1993 About 50% male Age: NS (junior physicians) | All specialties | In 1996, N = 3809/2926 (RR 76.8%) Longitudinal – comparison of 1996 and 1993 graduates Quantitative | Early career | To report the career intentions 1 year after qualification of physicians who qualified in the UK in 1996 |
Hann et al. 2010 [2], UK | Family physicians Male: NS Aged 50 and below | Family physicians | N = 2,000/1,174 (RR 67%) Longitudinal (5 years) – Secondary analysis, Quantitative | Mid-career | Does a family physician’s stated intention to leave his/her job predict whether or not he/she actually does leave? |
Heponiemi et al. 2009 [27], Finland | Random sample of physicians 40.8% male Aged 25 to 65 Mean age: 45.9 | All specialties | N = 5,000/2,841 (RR 57%) Final sample: 2650 Cross-sectional, Quantitative | All career phases | Examine whether job control moderates the association between stress indicators and intention to change profession |
von dem Knesebeck et al. 2010 [31], Germany | Hospital physicians working in surgical fields 60.2% male Age: NS (920 residents and 391 consultants/senior physicians) | Surgery, gynaecology and obstetrics | N = 3,648/1,311 (RR 53%) Nationwide survey Cross-sectional, Quantitative | All career phases | Analyses of psychosocial stress in the workplace with the aid of the demand–control model, the effort–reward imbalance model and selected additional indicators |
Moss et al. 2004 [20], UK | Graduates in 1999 at the end of the first postgraduate year <50% men Age of junior physicians: NS | Graduates from all medical schools | N = 4,221/2,727 (RR 64.6%) Analysed physicians = 1,326 Cross-sectional, Quantitative (open question) | Early career | Study reasons why junior physicians trained in UK consider leaving UK medicine |
Ochsmann 2012 [24], Germany | Junior physicians in Bavaria in their first or second postgraduate year 42% men Mean age: 28.9 | Different specialities | N = 1,494/792 (RR 53%) Analysed physicians = 637 Cross-sectional, Quantitative | Early career | Examine the association between workplace factors and thinking about leaving clinical care using a gender-stratified approach |
Pachulicz et al. 2008 [26], US | Emergency physicians that completed residency in 1979,1984, 1988 and 1993 Over 80% men Age at 2004: primarily over the age of 45 with 6% over 65 | Emergency physicians | 1,269 participants in 2004 Longitudinal – three waves, Quantitative ITL was measured in 2004 (T3) | Mid-and late career | Objective and subjective career successes were hypothesized to mediate the relationships between socio-demographic variables, human capital indices, individual difference variables and organizational sponsorship as inputs and intention to leave medicine as the output variable |
Rittenhouse et al. 2004 [33], US | Specialist physicians practising in large urban counties in California 89.8% male Age: <55 years = 62.8%, 55–64 years = 27.3% 65+ years = 9.9% | Different specialities | N = 1,492/978 (RR 66%) Longitudinal (3 years), Quantitative | All career phases | To validate physicians’ self-reported intention to leave clinical practice and the Masterfile practice status variable as measures of physician attrition and to determine predictors of ITL and actual departure from clinical practice |
Scott et al. 2006 [25], UK | Representative sample of English and Scottish GPs 68% male Age in %: <35 = 0.14 35–39 = 0.19 40–44 = 0.21 45–49 = 0.18 50–54 = 0.17 55–59 = 0.09 60+ = 0.02 | General practitioners | N = 4,421/2,781 (RR 62.9%) 1,968 questionnaires were available for analysis (44%). Cross-sectional, Quantitative | All career phases | Clarify the relationships between ITL, overall job satisfaction, domains of job satisfaction and personal and job characteristics by using a structural recursive model |
Sibbald et al. 2003 [22], UK | Random sample general practitioner principals Male = 68.7% in 1998 and 70.6% in 2001 Age 1998 (2001): ≤35 = 113 (151) 36–40 = 187 (242) 41–45 = 195 (275) 46–50 = 125 (208) 51–55 = 102 (194) 56–60 = 53 (76) 61–65 = 15 (13) Mean age: 43.75 (44.35) | General practitioners | Sample 1998: 2,064/974 (RR 47%) Sample 2001: 2,000/1,332 (RR 67%) Final sample 790 in 1998 and 1,159 in 2001 Longitudinal, Quantitative | All career phases | Measure GPs’ intentions to quit direct patient care, to assess changes between 1998 and 2000 and to investigate associated factors, notably job satisfaction |
Williams et al. 2001 [32], US | Clinically active physicians working in patient care in office or hospital settings aged <57 years 66.7% male Mean age: 43.7 | Different specialities | N = 5,704/2,325 (adjusted RR 52%) Final sample 1,735 Cross-sectional, Quantitative | All career phases | Analysing a conceptual model of physician stress that explores its relationship with job satisfaction, physical and mental health and four types of withdraw intentions |