Family Medicine Residency Faculty: Inpatient Staffing, Satisfaction, and Turnover

Physician scheduling affects job satisfaction and retention. This study explores how family medicine residency inpatient staffing relates to core faculty retention and program director (PD) perception of faculty satisfaction with work-life integration.

A total of 280 family medicine residency PDs responded to the 2023 Council of Academic Family Medicine Education Research Alliance survey. We used the ꭓ2 test to explore associations among program demographics, inpatient staffing characteristics, faculty retention, and PD-reported faculty satisfaction with work-life integration. We measured associations among pairs of ordinal variables with Spearman's correlation.

In two-thirds (66%) of programs, faculty cover the inpatient service at least every 8 weeks, with 40% of programs reporting averages of 70 or more hours per inpatient week; nevertheless, most programs' faculty were perceived to be satisfied with less than 10% turnover. The number of hours per week was inversely associated with PD-reported faculty satisfaction (r=-0.21, P=.001). Faculty turnover was directly associated with community size (r=0.17, P=.01). Faculty turnover was more likely to be greater than 10% if the number of hours per inpatient week was more than 89 (odds ratio 12.4, P=.02). Faculty turnover, PD-reported faculty dissatisfaction, and plans to change inpatient staffing were all correlated (r>0.28, P<.0001).

Most family medicine residencies have core faculty cover the inpatient service at least once every 8 weeks, during which they work at least 60 hours per week. Longer hours are associated with lower perceived faculty satisfaction of work-life integration, with a threshold effect on faculty turnover. Family medicine residency programs must carefully balance the needs of residents, the community served, and faculty themselves.