The Pandemic Effect on Faculty Attrition at a School of Medicine.

Mentors at Academic Health Centers (AHC) are challenged by mentee attrition, with one in five physicians reporting an intent to leave in 2020. AHCs struggle with physician replacement costs, which are exorbitant. Data-driven efforts to mitigate attrition during the pandemic require an understanding of reasons to leave. This study compares characteristics of exiting faculty at the University of New Mexico School of Medicine (UNM SOM) two years before to two years after April 1, 2020. Demographic and reason to leave variables from exit interviews of 168 faculty that left UNM SOM between April 2018-to-March 2020 and 151 faculty that left between April 2020-to-March 2022 were compared. Exiting faculty were stratified into those resigning vs. retiring. Distributions of each variable were analyzed for statistically significant differences using a chi-square or Fisher's 2-sided exact test. The pandemic was associated with an approximately three-fold higher proportion of retirement contributing to total attrition than before (25.8% vs. 8.9%; p<0.001). Among those who resigned, the pandemic was associated with a higher proportion of physicians than before (84.3% vs. 72.8%; p=0.03). Hispanic faculty may be more likely to resign during the pandemic than before (p=0.06). Those who resigned during the pandemic may be significantly less likely to cite "inadequate adherence to FTE" or a "challenging work environment" (p= 0.048 and 0.053 respectively) but more likely to cite personal family matters (p=0.06) as reasons to leave than before the pandemic. The increased proportion of retirees during the pandemic presents challenges for AHCs by exacerbating the current shortage of mentors while providing leadership opportunities for those retained. Mentors need to be aware of the top reasons for faculty leaving (which have not materially changed during the pandemic): challenging work environment, personal/family matters, inadequate work-life balance, greater career opportunities, and inadequate salary.

A Qualitative Review of Comments by Faculty Who Cite Work-Life Balance as a Reason to Leave.

Despite growing evidence for the need for work-life balance (WLB) for faculty at academic health centers, mentors frequently do not know how to advise their mentees on this topic. WLB impacts job satisfaction and intent to stay, and physicians are particularly at risk. In this study, we explored exit survey comments of faculty of the University of New Mexico School of Medicine citing work-life balance as a reason to leave (WLB-ARTL). Between July 2017 and December 2020, 59 faculty provided open-ended survey responses related to reasons for leaving, what they liked and disliked about being faculty, mentorship, and more. Using a qualitative descriptive design, we analyzed open-ended responses using a systematic, iterative, thematic approach via NVIVO software. We classified themes using Shanafelt's drivers of engagement and burnout: workload/job demands; efficiency/ resources; meaning in work; culture/values; control/flexibility; social support/community at work; and work-life integration. While there were numerous quotes across all themes, we chose to summarize emergent codes with the most faculty representation and those that can most easily be addressed through mentorship: career development, culture and people, and hours and schedule (related to themes of meaning in work, culture and values, community at work, work-life integration, and control and flexibility). To improve faculty retention, institutional leaders should focus on developing mentors' career coaching and mentoring skills. Additional focus should be placed on training mentors to discuss and address WLB among their faculty mentees.