More than a third of resident and fellow physicians said they planned to stay with the organization where they had trained after graduation, AMA-exclusive analysis of survey data showed, with nearly half of those in internal medicine residency training saying they intended to do so.
Based on survey responses from more than 3,000 resident and fellow physicians across 20 states and 29 organizations, the AMA National Resident Comparison Report is exclusive data to the AMA and the Organizational Biopsy. The report reflects 2025 trends on five key performance indicators—job satisfaction, job stress, burnout, intent to leave and feeling valued—as well as additional analysis of drivers and key findings. Download the national resident companion report (email required to access) for a selection of data from the complete National Comparison Report.
The Organizational Biopsy ® offers health systems valuable insights into the well-being of the physicians in their organizations, and the AMA report allows them to compare their trends with national results.
In 2025, 38.6% of residents and fellows reported they either definitely would or were likely to stay in their organization after the end of their training, an increase of 5.3 percentage points from 2024. Of the resident and fellow physicians surveyed, 13.5% said they “definitely” planned to stay in their training organization after graduation, 25.1% called it “likely,” 27.7% said there was a “moderate” chance they would do so, 19.1% said there was a “slight” chance and 14.7% said there was “none” that they would stay.
Differences seen by specialty, program year
Of the residents and fellows surveyed, those in internal medicine were more likely to say they would stay with their organizations after graduation, with 49.4% saying they “definitely” or “likely” planned to do so.
The specialty with the lowest intent to stay after graduation was anesthesiology, with 27.5% saying they intended to do so. The physician specialties in the report by highest intent to stay numbers, were:
- Internal medicine—49.4%.
- Emergency medicine—43.2%.
- Pediatric medicine—41.9%.
- Radiology—39.8%.
- Psychiatry—38%.
- Obstetrics and gynecology—35.8%.
- Family medicine—34.1%.
- General surgery—31%.
The intent to stay with a training organization post-graduation varied by program year, with physicians in the following stages of their training saying they either definitely would or were likely to stay:
- PGY-1—40%.
- PGY-2—36.7%.
- PGY-3—34.2%.
- PGY-4—32%.
- PGY-5—28.8%.
- Fellows—48.9%.
“The variation we see across program years reminds us that retention is shaped by the cumulative experience physicians have throughout training,” said Heather Farley, MD, MHCDS, the AMA’s vice president of professional satisfaction. “Organizations that invest early in culture, support, and workflow improvement may be better positioned to retain physicians long term.”
In the survey, residents and fellows also were asked what might persuade them to stay at their current organization after training. The percentages of respondents who listed a resource that might help, with more than one choice allowed, were:
- Higher compensation—55.6%.
- Consistent staffing—38.2%.
- Enhanced workflow efficiency—37.3%.
- Less documentation/work outside of work—35.2%.
- Better ability to help patients—31.9%.
Taking the long view
By exploring the reasons physicians leave their roles and adapting their culture to make it a place residents and fellows want to stay, organizations that are part of the AMA Health System Member Program are tackling turnover and retention on multiple fronts.
The environment at a physician’s workplace matters to turnover, but people create the environment. At Sutter Health in Northern California, leaders know that compensation is one of the factors physicians need, but so is well-being. They’re leveraging technology like ambient listening to remove the obstacles to seamless patient care.
“If we provide the environment that allows the physicians to enjoy practicing at the top of their license, focus on what they do, provide them with the career path that allows them to continually grow and learn, you will provide that opportunity to have someone join and build a career,” said Todd Smith, MD, an orthopaedic surgeon in Modesto, California, and chief physician executive for Sutter Health.
To attract and retain the physicians at Bayhealth in Central Delaware, leaders have found that it helps to start early in their career. As Delaware currently has no medical schools in the state, Bayhealth partners with nearby institutions on yearlong clinical rotations. Then, during both those rotations and Bayhealth’s residency programs, they can showcase their commitment to helping new physicians flourish.
“We want somebody to be here a long time. One of the ways to do that is give them retirement benefits, making sure that we're generous in that respect,” John Fink, MD, MSHQS, Bayhealth’s vice president for quality and medical affairs, said in an interview. And “helping them understand that this is a good place to work and a good place to live for the long run.”
Every healthcare employer has challenges baked in, issues that can range from tough-to-fill roles to locations in more remote areas. Even though Ochsner Health sits in Louisiana and is often in the path of hurricanes, they’ve maintained a turnover rate well below the national average. How?
They implement policies that keep physicians at the forefront, offering child care, scheduling vacations up front to encourage people to take PTO and bringing physicians in on important systems-wide decisions.
“We’re dedicated to being visible and accessible, fostering collaboration and innovation across our teams,” said Robert Hart, MD, Ochsner's chief physician executive. “This commitment to engagement and professional growth empowers our team members to excel every day across our system."
The AMA has resources to serve as a collaborator in addressing the factors that cause resident burnout and stress, including the AMA Joy in Medicine® Health System Recognition Program, which empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive, and the AMA STEPS Forward® toolkit, “Resident and Fellow Well-Being.”
Time will yield more sophisticated results
There were, however, important considerations in assessing data from residents and fellows, who make up a relatively small percentage of physicians as a whole in the country. Accreditation Council for Graduate Medical Education data shows 167,083 active residents and fellows, while the Association of American Medical Colleges estimates more than 1 million active physicians in the U.S.
The AMA has offered the resident and fellow well-being survey since 2021, and some of the questions were added in 2023. Organizations also were not required to use all available questions, nor were respondents required to answer them all.
The topic of resident and fellow well-being, therefore, needs to be further explored. Dr. Farley encouraged more organizations with residency and fellowship training programs to take in part in the AMA’s organizational well-being assessment (PDF) work or email [email protected] for more information.
“Our insights will deepen as participation grows and measurement becomes more consistent over time—bringing greater clarity to the unique needs of physicians in training,” Dr. Farley said.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine.
