Physicians' Career Progression: Medical Student to Faculty

Scope of the literature

The 10 papers examine physicians’ career transitions at different stages. Five qualitative studies examine the internship experiences of Australian university graduates, transition experiences over time in South Africa, the attending physician role in Switzerland and Canada, and the retrospective career paths of South Korean physicians. Three cross-sectional surveys analyze career preparation among South Korean medical students, intentions to pursue academic medicine among French residents, and burnout among mid-career faculty in the United States. The remaining two papers are cohort studies that use United States data to track faculty appointments and subsequent career progression. The studies do not track the same individuals from student to faculty. Attending physicians’ responsibilities and qualification systems vary by country. These stages provide a framework for organizing the studies, with faculty positions representing one of several career paths.

Stage	Authors (Year)	Design and sample	Country
Medical student	Lee et al. (2022)	Cross-sectional online survey, 198 respondents from years 1–4 at a single medical school	South Korea
Student→intern	Sturman et al. (2017)	Qualitative descriptive study, interviews with 15 junior doctors	Primarily Australia, including North American practitioners
Student→intern	Pattinson et al. (2026)	7-month longitudinal qualitative study, 22 entry interviews, 20 audio diaries, 17 exit interviews	South Africa
Resident→attending	Roten et al. (2022)	Multicenter qualitative study, 35 clinicians across 12 hospitals	Switzerland
Senior resident→independent practice	Dunbar-Yaffe et al. (2022)	Collective case study, 20 interviews across 6 hospitals affiliated with a single university	Canada
Resident→intention to enter academic medicine	Deledalle et al. (2026)	Cross-sectional survey, 1,570 residents	France
Medical school admission→faculty appointment	Andriole & Jeffe (2012)	Retrospective national cohort, 66,889 medical school graduates	United States
Faculty career progression and retention	Carr et al. (2018)	17-year follow-up cohort, 1,273 faculty members at 24 medical schools	United States
Mid-career faculty burnout	Paradis et al. (2024)	Cross-sectional survey, 841 academic medicine practitioners among NIH K08 and K23 recipients	United States
Admission→specialty→workplace choice	Lee & Kim (2025)	Retrospective qualitative study, 10 physicians in the Daejeon, Sejong, and Chungcheongnam-do region	South Korea

Medical students: Career preparation and specialty choice

A survey at Seoul National University College of Medicine found that average career maturity scores, except for curiosity, increased with year of study. Most subfactors of specialty indecision showed no consistent decrease, while self-doubt increased. Career interest and self-doubt were positively correlated. The study compared students across years of study. The findings do not describe changes within the same students over time (Lee et al., 2022).

Scores on the career maturity and specialty indecision scales were correlated, although the scales captured different concerns. The authors proposed using both scales for individual career coaching. The findings reflect a small sample from one medical school, with few upper-year participants. The cross-cultural validity of the Korean version of the specialty indecision scale has yet to be tested (Lee et al., 2022).

Transition to internship

In interviews with Australian university graduates, the transition to internship was accompanied by physical and emotional exhaustion and decreased confidence. Participants felt prepared in terms of clinical knowledge and skills but reported being underprepared for administrative tasks, prioritization, frequent interruptions, and time pressure. They had to learn to communicate concisely, understand their position within the hospital hierarchy, and resolve conflicts. Education and support from near-peer colleagues were helpful. Participants were more hesitant to disclose health or personal problems than to seek help with patient care issues (Sturman et al., 2017).

In a longitudinal study in South Africa, professional identity was destabilized when participants were excluded from teams as students or failed to demonstrate competencies valued in the workplace as interns. Contributing to shared work and having that contribution acknowledged strengthened professional identity. The legitimacy of participation was repeatedly negotiated during the transition, and participants’ paths included regressions and detours (Pattinson et al., 2026).

Preparing for transition means having the resources to continually adjust participation and identity in a changing workplace. The authors call this ‘preparedness for transition.’ Observation extended only into early internship. The analysis did not distinguish between placement institutions or examine the effects of race and gender separately (Pattinson et al., 2026).

From resident to specialist: The process of becoming an attending

In a Swiss study of general internal medicine, new attending physicians faced challenges in understanding patients holistically and making decisions amid uncertainty. They also faced challenges in balancing patient safety with resident learning and leading multidisciplinary teams. Attendings took on responsibility for resolving conflicts and organizational problems. Few participants received regular, structured coaching, but those who did found it helpful (Roten et al., 2022).

The Junior Attending (JA) in Canada is an educational model in which senior residents take on attending responsibilities under supervision. Interview participants reported that working almost independently with access to supervisor support helped them build confidence. It also helped them handle non-clinical tasks and respond to clinical uncertainty. Participants viewed the experience favorably when goals and roles were clear, the supervisory relationship preserved JA autonomy, and they were recognized as team leaders (Dunbar-Yaffe et al., 2022).

Participants found the JA model useful for gaining experience with supervisory tasks and the research and clinical demands of teaching hospitals. Many did not consider it essential for all physicians. The JA study examined participants’ experiences; objective improvements in educational or patient care performance were outside its scope. The model’s potential to support the transition to practice is distinct from demonstrated outcomes (Dunbar-Yaffe et al., 2022).

Entry into academic medicine (faculty positions)

In a survey of French residents, academic medicine was treated as a career path combining research, education, and clinical practice. The proportion expressing a strong intention to enter academic medicine was 20.1% overall, 15.1% among women, and 28.8% among men. Vocational interest in research was the strongest predictor, and residents with research experience or mentoring also reported stronger intentions. When contextual variables were included, the predictive contribution of gender decreased. The authors noted differences in learning experiences and research opportunities (Deledalle et al., 2026).

The study applied social cognitive career theory. Self-efficacy was measured using a general scale rather than one specific to research. Work centrality served as the measure of outcome expectations. Mentoring was assessed only in terms of its presence or absence. These measures cannot explain which research experiences or mentoring relationships shaped intentions. The cross-sectional associations cannot be interpreted as actual appointments or causal effects (Deledalle et al., 2026).

In a United States cohort study examining actual appointments, 18.0% of 66,889 graduates had held a full-time faculty position by follow-up. Faculty appointments were more common among graduates who had attended a research-intensive medical school or participated in research during graduate medical education. Research experience of one year or more was among the strong predictors for both men and women. Women were more likely than men to receive appointments, but appointed women had less experience with medical school research electives and authorship than appointed men (Andriole & Jeffe, 2012).

Faculty career retention and attrition: Gender differences and mid-career faculty burnout

In a 17-year follow-up of a United States faculty cohort, women had lower odds of becoming full professors or remaining in academic medicine. With additional adjustment for baseline publication productivity, neither difference was statistically significant. Women’s odds of holding senior leadership positions remained lower after adjustment for productivity. Adjustment for productivity alone cannot explain differences in opportunities to build publication productivity or the causes of gender disparities (Carr et al., 2018).

Among NIH career development grant recipients who remained in academic medicine, work-related burnout rates were 40.8% for women and 23.0% for men. Women’s higher odds of burnout persisted after adjustment for covariates. Burnout was more common among respondents with long clinical hours, work hours above pre-pandemic levels, and recent experiences of workplace sexual harassment. It was less common among those who slept longer and reported a favorable organizational climate (Paradis et al., 2024).

The analysis included only individuals who remained in academic medicine. It cannot establish whether burnout caused attrition or describe the experiences of those who left. The sample’s restriction to early career grant recipients also limits generalizability (Paradis et al., 2024).

The South Korean context

In interviews with physicians in the Daejeon, Sejong, and Chungcheongnam-do region, medical school admission, specialty choice after graduation, and workplace choice after training emerged as major decision points. Interest, aptitude, and personality were commonly cited as factors in specialty choice. When choosing a workplace, participants considered suitable work, opportunities to work alongside mentors and desirable colleagues, work-life balance, compensation, and opportunities for growth. Research opportunities were cited as a reason for pursuing academic medicine. Experiences with colleagues and organizational culture during residency shaped career choices (Lee & Kim, 2025).

The study encompasses the career paths of faculty, employed physicians, clinic owners, and public officials. The data consist of 10 physicians’ recollections of past decisions in one region; policy effects were outside the scope of the analysis. A generational gap also separates current students from the participants. The student survey and these interviews cannot establish broader career trends in South Korea (Lee et al., 2022; Lee & Kim, 2025).

Commonalities across stages

Peer relationships for interns, autonomy and supervision for attendings, research experience and mentoring in entry into academic medicine, and mentors and role models in workplace selection in Korea vary in function and form (Sturman et al., 2017; Dunbar-Yaffe et al., 2022; Deledalle et al., 2026; Lee & Kim, 2025). Intentions to enter academic medicine in the French study and actual appointment histories and long-term retention in the US studies represent different outcomes (Deledalle et al., 2026; Andriole & Jeffe, 2012; Carr et al., 2018).

These experiences can also be understood through the workplace learning perspective used in HRD. An intern gaining recognition as a team member illustrates how workplace learning accompanies changing responsibilities. A new attending exercising judgment and making decisions under supervision similarly demonstrates how learning occurs alongside role changes (Pattinson et al., 2026; Dunbar-Yaffe et al., 2022). Beyond outcomes such as readiness at the point of transition or subsequent appointments (Roten et al., 2022; Lee et al., 2022), the scope and complexity of tasks can also be examined across a career.

References

• Andriole, D. A., & Jeffe, D. B. (2012). The road to an academic medicine career. Academic Medicine, 87(12), 1722–1733. https://doi.org/10.1097/ACM.0b013e318271e57b
• Carr, P. L., Raj, A., Kaplan, S. E., Terrin, N., Breeze, J. L., & Freund, K. M. (2018). Gender differences in academic medicine: Retention, rank, and leadership comparisons from the National Faculty Survey. Academic Medicine, 93(11), 1694–1699. https://doi.org/10.1097/ACM.0000000000002146
• Deledalle, A., Bour, V., Galharret, J.-M., Sarda, É., Gourraud, P.-A., Cohen, F., Lemarchand, P., & Congard, A. (2026). Academic medicine career intentions among medical residents: A social cognitive career theory approach. BMC Medical Education, 26(1), Article 1405. https://doi.org/10.1186/s12909-026-09740-4
• Dunbar-Yaffe, R., Wu, P. E., Kay, T., Mylopoulos, M., McDonald-Blumer, H., Gold, W. L., & Stroud, L. (2022). Understanding the influence of the junior attending role on transition to practice: A qualitative study. Journal of Graduate Medical Education, 14(1), 89–98. https://doi.org/10.4300/JGME-D-21-00728.1
• Lee, S.-Y., & Kim, J. L. (2025). Career paths and career choice factors of medical school graduates working in the Daejeon, Sejong, and Chungcheongnam-do region: A retrospective observational study. Korean Journal of Medical Education, 37(2), 105–118. https://doi.org/10.3946/kjme.2025.328
• Lee, S.-Y., Lee, M.-J., & Lee, S.-H. (2022). Analysis on students’ career preparation in one Korean medical school: Based on the relationship and trend between career maturity and specialty indecision. Journal of Korean Medical Science, 37(37), Article e277. https://doi.org/10.3346/jkms.2022.37.e277
• Paradis, K. C., Kerr, E. A., Griffith, K. A., Cutter, C. M., Feldman, E. L., Singer, K., Spector, N. D., Ubel, P. A., & Jagsi, R. (2024). Burnout among mid-career academic medical faculty. JAMA Network Open, 7(6), Article e2415593. https://doi.org/10.1001/jamanetworkopen.2024.15593
• Pattinson, S. R., Savelberg, H., & Atherley, A. (2026). ‘Like an infant … trying to run a marathon’: A longitudinal audio-diary study exploring the transition from medical school to internship. Medical Education, 60(10), 1130–1142. https://doi.org/10.1111/medu.70221
• Roten, C., Baumgartner, C., Mosimann, S., Martin, Y., Donzé, J., Nohl, F., Kraehenmann, S., Monti, M., Perrig, M., & Berendonk, C. (2022). Challenges in the transition from resident to attending physician in general internal medicine: A multicenter qualitative study. BMC Medical Education, 22(1), Article 336. https://doi.org/10.1186/s12909-022-03400-z
• Sturman, N., Tan, Z., & Turner, J. (2017). “A steep learning curve”: Junior doctor perspectives on the transition from medical student to the health-care workplace. BMC Medical Education, 17(1), Article 92. https://doi.org/10.1186/s12909-017-0931-2