Authors: Donovan A L et al.
Anesthesiology, December 26, 2025, 10.1097/ALN.0000000000005920
This qualitative study explored the factors that contribute to career fulfillment among academic anesthesiologists and sought to develop a practical framework to help physicians sustain meaningful careers within academic medicine. The work was motivated by growing evidence that anesthesiology has one of the highest rates of intent to leave academic practice among medical specialties.
Academic anesthesiology involves competing demands, including clinical responsibilities, research productivity, teaching commitments, and personal life obligations. These pressures have contributed to increasing attrition from academic departments, raising concerns about the future of mentorship, leadership development, and research productivity in the specialty.
To better understand the factors influencing career satisfaction, the investigators conducted a series of virtual focus groups involving faculty members from an academic anesthesiology department practicing across six clinical sites. Participants represented a range of subspecialties, career stages, and personal backgrounds.
The researchers organized six focus groups stratified by both gender and career stage, including early-career, mid-career, and established-career faculty. Additional focus groups were created for faculty who self-identified within specific interest groups, including individuals underrepresented in medicine, physician parents, and research-focused faculty. All sessions were recorded, transcribed, and analyzed using inductive thematic analysis to identify common themes.
Five major themes emerged from the discussions.
The first theme was forming a professional identity through the concept of a “purposeful yes.” Participants described the importance of intentionally choosing professional opportunities that align with personal values and long-term goals. Rather than accepting every opportunity presented, faculty emphasized the need to selectively commit to roles that contribute meaningfully to career development.
The second theme involved understanding one’s professional motivators. Participants reported that career satisfaction depends heavily on recognizing what drives personal fulfillment, whether that involves clinical excellence, research discovery, teaching, leadership, or service. Aligning work activities with these motivations was considered essential for long-term career sustainability.
The third theme focused on integrating work and life. Faculty emphasized the importance of balancing professional responsibilities with personal priorities, including family life, health, and community engagement. Participants highlighted that work–life integration, rather than strict work–life separation, is often necessary in academic medicine.
The fourth theme described the concept of progressing along a career arc. Participants noted that career priorities and opportunities evolve over time. Early-career faculty may focus on skill development and establishing academic credentials, while mid-career and senior faculty often shift toward mentorship, leadership, and shaping departmental culture.
The fifth theme addressed overcoming impostor phenomenon. Many participants described feelings of self-doubt despite objective success, particularly early in their careers. Mentorship, peer support, and institutional recognition were identified as key factors in helping physicians overcome these feelings and maintain confidence in their professional roles.
Based on these themes, the authors developed a conceptual framework designed to help academic anesthesiologists reflect on their goals and shape their professional activities strategically. The framework centers on a series of guiding questions that encourage faculty to clarify their motivations, evaluate opportunities, build mentorship networks, and periodically reassess their career direction.
The authors suggest that using a “purposeful yes” approach—accepting opportunities aligned with personal values while declining those that do not—can help physicians build sustainable and fulfilling careers. The framework also highlights the importance of mentorship teams, rather than relying on a single mentor, to provide diverse perspectives and guidance.
Overall, the study emphasizes that career fulfillment in academic anesthesiology requires intentional planning, alignment with personal values, and supportive institutional environments. Addressing these factors may help reduce faculty attrition and strengthen the academic anesthesiology workforce.
What You Should Know
Academic anesthesiology has one of the highest reported rates of intent to leave academic medicine.
Career satisfaction depends on aligning professional activities with personal values and motivations.
The concept of a “purposeful yes” encourages physicians to selectively pursue opportunities that support long-term goals.
Work–life integration and mentorship are critical factors in sustaining academic careers.
A structured framework of guiding questions may help faculty maintain career fulfillment and reduce attrition.
Key Points
Five major themes influencing academic anesthesiology career fulfillment were identified.
Intentional acceptance of professional opportunities (“purposeful yes”) helps guide career development.
Understanding personal motivators improves long-term job satisfaction.
Work–life integration plays a key role in sustainable careers.
Impostor phenomenon is common among academic physicians and can be mitigated through mentorship and support.
The study proposes a practical framework to help anesthesiology faculty plan and sustain fulfilling careers.
Thank you to Anesthesiology for allowing us to summarize this article.