September 25, 2025
2 min read
Key takeaways:
- Resident physicians who remain at the institution where they trained may continue to be perceived as students.
- This perception may negatively affect physician identity formation and retention.
CHICAGO — Institutions that struggle to retain physicians after residency may benefit from encouraging attending physicians and staffers to view new graduates as emerging independent practitioners rather than as students.
How institutions perceive and treat residents after graduation has consequences for both professional identity and retention, according to Jennie An, a recent graduate of Saint James School of Medicine in St. Vincent and Grenadines, who spoke during the Women in Medicine Summit.
“If new attendings continue to be seen as students, it undermines their sense of legitimacy. It often pushes them to leave the institution they trained at [despite] great packages for keeping residents after training,” An told Healio. “Programs that intentionally recognize residents as emerging professionals, rather than learners, through mentorship, role clarity, inclusive culture, things like that, are oftentimes more successful in retaining residents after they’re finishing training.”
An said the study was prompted by the experiences of some of the residents she worked with in a sub-internship.
“From the outside, the institution looked really well functioning,” An said. “But a common theme among the fourth-year residents was, ‘I can’t wait to stop being treated as a student. I’m tired of being micromanaged. I don’t want to stay here.’ Even though they had a good retention package for after training … they still wanted to leave.”
To explore this, An and colleagues conducted a systematic literature review that included 57 studies, published through May 2025, that examined career development, retention and identity formation of resident physicians in the United States.
A central conclusion was that new attendings who remain at the institution where they trained may continue to be treated as students in the eyes of their colleagues and institutional leadership. This perception can lead to job dissatisfaction, burnout and the desire to leave. The association was greater for women and residents from underrepresented groups.
“The implication here is physicians need to validate the feelings of these residents. What these residents are feeling is just not in their heads, they’re documented and impactful, as we’ve seen through the systemic review,” An said. “[Institutions] need to build a structure that affirms the transition to being an attending.”
An said she hopes to research possible solutions.
“I don’t think the problem is inevitable,” she said. “I think institutions are more than equipped to change it. And I don’t think medicine can function without teamwork, a healthy work-dynamic environment and overall good mental health. And those, honestly, depend on physicians feeling valued as professionals, no matter where they are in their career.”
For more information:
Jennie An can be reached at janhw5@mail.sjsm.org.
Sources/Disclosures
Source:
An J, et al. Should I stay or should I go? A systematic review of how perceived student status after residency influences physician retention and professional identity formation. Presented at: Women in Medicine Summit; Sept. 18-20, 2025; Chicago.
Disclosures:
An reports no relevant financial disclosures.
