Factors Influencing Career Longevity in Pediatric Hospital Medicine

Pediatric hospital medicine (PHM) is a growing field recently approved by the American Board of Pediatrics as a subspecialty. Understanding factors associated with hospitalist retention is important for workforce planning. Our objective for this study was to examine the proportion of pediatric hospitalists who remained in PHM over a 5-year period and identify factors associated with retention.

We used 2012 and 2016 data from the American Academy of Pediatrics' Pediatrician Life and Career Experience Study. Retention was defined as being a self-reported hospitalist on both surveys. χ² tests were used to examine relationships between retention and variables within 3 categories: demographics, position-related factors, and factors related to stress and satisfaction. A multivariable logistic regression was used to further assess relationships between select factors and retention.

In 2012, 206 of 1804 survey respondents were hospitalists (11%); 180 of these 206 individuals responded again in 2016, and 122 (68%) remained hospitalists. In the multivariable analysis, individuals earning ≥$175 000 were more likely than those earning less (adjusted odds ratio [aOR] = 3.93; 95% confidence interval [CI]: 1.26-12.25) and those more satisfied with their job were more likely than those less satisfied (aOR = 3.28; 95% CI: 1.22-8.80) to remain hospitalists. Respondents with more concern about educational debt were less likely than those less concerned to remain hospitalists over 5 years (aOR = 0.42; 95% CI: 0.20-0.90).

Two-thirds of early- to mid-career hospitalists remained in PHM 5 years later. Financial factors and job satisfaction appear to play an important role in retention; consideration should be given to the impact of these factors on the PHM workforce.