Examining Early Career Pediatrician Characteristics, Sacrifices, and Satisfaction

Published:January 18, 2023DOI:



      Explore relationships between pediatrician characteristics, sacrifices made for career, and career and life satisfaction.


      Surveys of early career pediatricians (ECPs) who recently graduated residency (2016-18), as part of the AAP Pediatrician Life and Career Experience Study (PLACES) were administered in 2019. Logistic regression analyzed association of pediatrician characteristics with personal sacrifices (a lot vs some or no sacrifices) made for one's career and whether career was worth the sacrifices made to become a physician, and association of characteristics and sacrifices with overall career and life satisfaction.


      Of 918 ECPs in the cohort, 90% responded to the 2019 survey. 77% agreed their career was worth the sacrifices and 40% reported they made a lot of personal sacrifices for their career. In multivariable analysis, female sex was associated with lower odds of viewing career as worth the sacrifices made [adjusted odds ratio-aOR 0.45, 95% Confidence Interval-CI 0.28-0.71], a higher odds of delaying starting a family [aOR 2.25, CI 1.32-3.86] and making sacrifices in having children for career [aOR 2.60, CI 1.48-4.58]. Those in fellowship training also reported making more sacrifices related to having children for their career [aOR 1.73, CI 1.08-2.78]. ECPs who reported making a lot of sacrifices for their career were less likely to be satisfied with their overall career and life.


      Most ECPs believe their sacrifices to become a pediatrician were worth it. Female pediatricians were less likely to feel personal sacrifices were worth it and reported more sacrifices related to having children.


      American Academy of Pediatrics ((AAP)), Pediatrician Life and Career Experience Study ((PLACES)), early career pediatrician ((ECP)), adjusted Odds Ratio ((aOR)), confidence interval ((CI))
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Tawfik DS
        • Shanafelt TD
        • Dyrbye LN
        • et al.
        Personal and professional factors associated with work-life integration among US physicians.
        JAMA Netw Open. 2021; (Published online May 3,)
        • Schrijver I
        • Brady KJS
        • Trockel M.
        An exploration of key issues and potential solutions that impact physician wellbeing and professional fulfillment at an academic center.
        PeerJ. 2016; 4: e1783
        • Webber S
        • Babal JC
        • Shadman KA
        • Coller RJ
        • Moreno MA.
        Exploring academic pediatrician perspectives of factors impacting physician well-being.
        Acad Pediatr. 2020; 20: 833-839
        • Linzer M
        • Harwood E.
        Gendered expectations: do they contribute to high burnout among female physicians?.
        J Gen Intern Med. 2018; 33: 963-965
        • Ramas ME
        • Webber S
        • Braden AL
        • Goelz E
        • Linzer M
        • Farley H.
        Innovative wellness models to support advancement and retention among women physicians.
        Pediatrics. 2021; 148
        • Templeton K
        • Bernstein CA
        • Sukhera J
        • et al.
        Gender-based differences in burnout: issues faced by women physicians.
        NAM Perspect. 2019; (Published online May 30,)
        • Frintner MP
        • Sisk B
        • Byrne BJ
        • Freed GL
        • Starmer AJ
        • Olson LM.
        Gender differences in earnings of early- and midcareer pediatricians.
        Pediatrics. 2019; 144e20183955
        • Salles A
        • Awad M
        • Goldin L
        • et al.
        Estimating implicit and explicit gender bias among health care professionals and surgeons.
        JAMA Netw Open. 2019; 2e196545
        • Webber S
        • Nackers K
        • Kelly MM
        • et al.
        Gender-based linguistic analysis of pediatric clinical faculty evaluations.
        Acad Pediatr. 2021; (Published online December 17,S1876-2859(21)00624-0)
      1. Starmer AJ, Frintner MP, Matos K, Somberg C, Freed GL, Byrne BJ. Gender discrepancies related to pediatrician work-life balance and household responsibilities. Pediatrics. 144(4):e20182926.

        • Stentz NC
        • Griffith KA
        • Perkins E
        • Jones RD
        • Jagsi R.
        Fertility and childbearing among American female physicians.
        J Womens Health. 2016; 25: 1059-1065
        • Furnas HJ
        • Li AY
        • Garza RM
        • et al.
        An analysis of differences in the number of children for female and male plastic surgeons.
        Plast Reconstr Surg. 2019; 143: 315-326
        • Beckett L
        • Nettiksimmons J
        • Howell LP
        • Villablanca AC.
        Do family responsibilities and a clinical versus research faculty position affect satisfaction with career and work-life balance for medical school faculty?.
        J Womens Health 2002. 2015; 24: 471-480
        • Macy ML
        • Leslie LK
        • Boyer D
        • Van KD
        • Freed GL.
        Timing and stability of fellowship choices during pediatric residency: a longitudinal survey.
        J Pediatr. 2018; 198 (294-300.e1)
        • Powell WT
        • Dundon KMW
        • Frintner MP
        • Kornfeind K
        • Haftel HM.
        Parenthood, parental benefits, and career goals among pediatric residents: 2008 and 2019.
        Pediatrics. 2021; 148e2021052931
      2. Cull WL, Frintner MP. Experiences During Pediatric Subspecialty Fellowship Training. Presented at the April 2019 Pediatric Academic Societies Annual Meeting. Accessed March 17, 2022.

        • Frintner MP
        • Cull WL
        • Byrne BJ
        • et al.
        A longitudinal study of pediatricians early in their careers: PLACES.
        Pediatrics. 2015; 136: 370-380
      3. American Academy of Pediatrics Pediatrician Life and Career Experience Study (PLACES). Accessed June 2, 2022.

        • Williams ES
        • Konrad TR
        • Linzer M
        • et al.
        Refining the measurement of physician job satisfaction: results from the Physician Worklife Survey.
        Med Care. 1999; 37: 1140-1154
        • Linzer M
        • Konrad TR
        • Douglas J
        • et al.
        Managed care, time pressure, and physician job satisfaction: results from the Physician Worklife Study.
        J Gen Intern Med. 2000; 15: 441-450
      4. Institute for Social Research, Survey Research Center, University of Michigan. Panel Study of Income Dynamics.

      5. Bianchi SM, Robinson J. National Survey of Parents, 1999-2001: Version 2. Published online 2005. doi:10.3886/ICPSR04247.V2

        • Sierra T
        • Forbes J
        • Nelson M.
        Career regret among physician assistants: a comparative survey of primary and subspecialty care careers.
        Internet J Allied Health Sci Pract. 2019; 17 (Article 10)
        • Starmer AJ
        • Frintner MP
        • Freed GL.
        Work-life balance, burnout, and satisfaction of early career pediatricians.
        Pediatrics. 2016; 137e20153183
        • Katakam S
        • Frintner M
        • Pelaez-Velez C
        • Chakraborty R.
        Work experiences and satisfaction of International Medical School Graduates.
        Pediatrics. 2019; 143e20181953
        • Byrne BJ
        • Katakam SK
        • Frintner MP
        • Cull WL.
        Early career experiences of pediatricians pursuing or not pursuing fellowship training.
        Pediatrics. 2015; 136: 672-679
        • Bering J
        • Pflibsen L
        • Eno C
        • Radhakrishnan P.
        Deferred personal life decisions of women physicians.
        J Womens Health. 2018; 27: 584-589
        • Kin C
        • Yang R
        • Desai P
        • Mueller C
        • Girod S.
        Female trainees believe that having children will negatively impact their careers: results of a quantitative survey of trainees at an academic medical center.
        BMC Med Educ. 2018; 18: 260
        • Chesak SS
        • Yngve KC
        • Taylor JM
        • Voth ER
        • Bhagra A.
        Challenges and solutions for physician mothers: a critical review of the literature.
        Mayo Clin Proc. 2021; 96: 1578-1591
        • Behbehani S
        • Tulandi T.
        Obstetrical complications in pregnant medical and surgical residents.
        J Obstet Gynaecol Can. 2015; 37: 25-31
        • Carson SA
        • Kallen AN.
        Diagnosis and management of infertility: a review.
        JAMA. 2021; 326: 65-76
        • Lean SC
        • Derricott H
        • Jones RL
        • Heazell AEP.
        Advanced maternal age and adverse pregnancy outcomes: a systematic review and meta-analysis.
        PloS One. 2017; 12e0186287
        • Wilder JL
        • Pingree EW
        • Hark CM
        • et al.
        Pediatric trainees as parents: perspectives on parenthood from pediatric resident parents.
        Acad Pediatr. 2021; (Published online August)
      6. ABMS Announces Progressive Leave Policy for Residents and Fellows. American Board of Medical Specialties. Published July 13, 2020. Accessed December 2, 2021.

        • Krupat E
        • Pololi L
        • Schnell ER
        • Kern DE.
        Changing the culture of academic medicine: the C-Change learning action network and its impact at participating medical schools.
        Acad Med J Assoc Am Med Coll. 2013; 88: 1252-1258
        • Takagishi J
        • Garagozlo K
        The Council on Early Childhood and Section on Pediatric Trainees. Parental leave for residents and pediatric training programs.
        Pediatrics. 2022; 149e2021055988
        • Barger SD
        • Donoho CJ
        • Wayment HA.
        The relative contributions of race/ethnicity, socioeconomic status, health, and social relationships to life satisfaction in the United States.
        Qual Life Res. 2009; 18: 179-189
        • Marquine MJ
        • Maldonado Y
        • Zlatar Z
        • et al.
        Differences in life satisfaction among older community-dwelling Hispanics and non-Hispanic Whites.
        Aging Ment Health. 2015; 19: 978-988
        • Zhang W
        • Braun KL
        • Wu YY.
        The educational, racial and gender crossovers in life satisfaction: findings from the longitudinal Health and Retirement Study.
        Arch Gerontol Geriatr. 2017; 73: 60-68
      7. Gallup Inc. How Race and Income Relate to U.S. Adults’ Wellbeing. Published February 18, 2022. Accessed November 16, 2022.

        • Garcia LC
        • Shanafelt TD
        • West CP
        • et al.
        Burnout, depression, career satisfaction, and work-life integration by physician race/ethnicity.
        JAMA Netw Open. 2020; 3
        • Cull WL
        • Frintner MP
        • Starmer AJ
        • Leslie LK.
        Longitudinal analyses of pediatrician burnout.
        Acad Pediatr. 2019; 19: 256-262
      8. American Academy of Pediatrics. Research Update: AAP studies examine prevalence of burnout, strategies to reduce occurrence. AAP News. Accessed November 10, 2022.

        • Frintner MP
        • Leslie LK
        • Gottschlich EA
        • Starmer AJ
        • Cull WL.
        Changes in work characteristics and pediatrician satisfaction: 2012-2020.
        Pediatrics. 2022; 150e2021055146
        • Shanafelt TD
        • Noseworthy JH.
        Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout.
        Mayo Clin Proc. 2017; 92: 129-146