Developing a Framework for Career Fulfillment in Academic Anesthesiology: Findings from a Single-institution Focus Group Study

Background: Since anesthesiologists report the highest intent to leave academic practice of all specialties, understanding the factors driving attrition is essential to maintaining a robust academic workforce. This study aims to explore how academic anesthesiology faculty at various stages of life define and navigate meaningful, sustainable careers in the context of growing clinical, academic, and personal demands and to identify individual-level strategies for long-term career satisfaction in academic anesthesiology. Methods: Virtual focus groups with faculty representing a range of clinical subspecialties, academic interests, and career stages and practicing across six diverse clinical sites within an academic anesthesiology department were conducted. Six focus groups were stratified by both career stage and self-identified gender (early-career, midcareer, and established-career men and women). Three additional focus groups involved participants who self-selected into one of the following groups: underrepresented in medicine, parents, and researchers. Due to scheduling constraints, two separate focus groups were held for the established-career men, whereas all other groups were conducted in a single session. Focus groups were audio-recorded, transcribed, and deidentified before performing an inductive thematic analysis. Results: Five themes were identified: (1) forming a professional identity through use of a “purposeful yes”; (2) understanding one’s professional motivators; (3) integrating work and life; (4) progressing along a career arc; and (5) overcoming impostor phenomenon. Each theme corresponds to one or more questions that can assist faculty members in defining their professional goals, priorities, and values. These questions form the basis of a conceptual framework offered as a practical tool for strategically shaping one’s professional efforts, building a mentorship team, and periodically reevaluating progress toward goals. Conclusions: In this study, five themes were synthesized into a series of guiding questions that form the basis of a conceptual framework for advancing career fulfillment and retention in academic anesthesiology. Use of a purposeful yes guided by personal values and motivations allows an individual to strategically shape his or her efforts toward a desirable and sustainable career pathway.