Drivers of Professional Satisfaction in Emergency Medicine Residency Training in the US

Physician wellness discussions often center on burnout and negative aspects of clinical practice. Less is known about what brings professional satisfaction to physicians, particularly among emergency medicine (EM) residents. Understanding drivers of professional satisfaction is important for the future of the specialty as they may influence residents' career decisions. This study aimed to identify drivers of professional satisfaction among a national cohort of EM residents.

We conducted a mixed methods study using a survey administered following the 2024 ABEM In-Training Examination to EM residents in ACGME-accredited programs. The single-item, free-text survey question asked: "List the top 3 drivers of your professional satisfaction in EM." Responses were linked to resident demographics, year in training, and program length. Using an exploratory, sequential mixed methods design, we developed a codebook via team-based thematic analysis. We subsequently quantified theme prevalence, summarized the top 10 themes, and compared the top 5 themes across strata by demographics and program characteristics.

3914 of 9820 eligible residents (39.9%) responded. Our team identified 41 unique themes from these responses. The top 10 drivers of professional satisfaction by frequency were: (1) EM community/team culture, (2) positive impact on patients, (3) work-life balance, (4) bedside patient interactions, (5) clinical variety, (6) shift work flexibility, (7) financial compensation, (8) opportunities for procedures, (9) EM clinical skill set, and (10) critical care opportunities. The most prevalent themes did not vary by resident demographics.

In a national cohort of EM residents, we identified a list of key drivers of professional satisfaction that clustered into a small number of highly prevalent themes. The most important factors were related to the people and culture of the program and making a positive impact on patients. These findings may inform strategies to strengthen EM resident professional fulfillment and support the future of the specialty.