Transitioning to practice can be both a thrilling and a stressful time for new physicians. They frequently are given more administrative and clinical responsibility while no longer having the formal structure of a residency or fellowship program to rely on.
That’s why system-level support is crucial. And when residents and fellows are looking for their first physician job, they need to make sure potential employers have hardwired systems in place to protect their well-being.
“That leap from residency or fellowship to your first job as an attending is certainly exciting, but it's also one of the most vulnerable transitions in our career,” said Heather Farley, MD, MHCDS, the AMA’s new vice president of professional satisfaction. “What many residents or fellows don't anticipate is how quickly that transition can become overwhelming, especially if you don't have a supportive health system or practice environment.”
Residents and fellows in the job hunt should balance the compensation in a job offer against the organization's culture and working environment. There are long-term impacts of your choice in first jobs, experts say, and discernment is crucial.
The AMA Joy in Medicine® Health System Recognition Program creates a framework for shoring up physician well-being. If an organization’s efforts line up with what experts know to be evidence-based and practical, it can show a commitment to preventing and treating burnout.
The burden of physician burnout
The transition to practice presents a key time for physicians when it comes to well-being, with Dr. Farley noting that “those first few years of practice can carry an elevated risk for burnout.”
There have been encouraging signs when it comes to physician burnout, but the hard work isn’t over.
“It's not all doom and gloom,” she said. “We're finally beginning to see some improvements in physician burnout levels overall across the population, especially at those systems that are investing in the well-being of their physicians and care teams.”
Physician burnout rates overall showed a drop in 2024 to 43.2%, down from 48.2% in 2023 and 53% in 2022, according to an exclusive AMA survey.
Nearly 18,000 responses from physicians across 43 states were received from more than 100 health systems and organizations that participated in the AMA Organizational Biopsy® last year. The AMA-exclusive data, which is not published anywhere else, reflects 2024 trends on six key performance indicators—job satisfaction, job stress, burnout, intent to leave an organization, feeling valued by an organization and total hours spent per week on work-related activities (known as “time spend”).
For physicians who are between one and five years out of residency or fellowship training, the burnout rate was 39.3%, according to the exclusive AMA data. Burnout ticks up for physicians further into their career before falling to 38.3% for doctors with 20 or more years in practice.
Where residents are concerned, the AMA National Resident Comparison Report offers responses from more than 3,600 resident physicians in the same six indicators.
According to the AMA data, residents reported lower burnout. Reported burnout among resident physicians dropped by 8 percentage points from the 2023 findings, to 34.5% in 2024. The 2024 reported burnout for practicing physicians came in at 43.2% in comparison. It is important to note that there is continued variation in reported burnout by resident gender, program year and specialty.
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.
Green flags you should look for
The right first job—one that’s well-aligned with your values and needs—will set the tone for a long, sustainable and fulfilling career as a physician. There are some characteristics shared among organizations committed to staving off burnout.
Dr. Farley said health care organizations where well-being is routinely measured “take action on what they're learning.” That means prioritizing adequate care-team staffing, mentoring, documentation assistance and “workflows that enable our physicians to work at the top of their license.”
“Those systems that are more successful at this actively cultivate a sense of community and belonging,” she added. “They provide access to confidential mental health support and peer support, and they listen to their physicians. They empower the physician voice and engage them in improvement efforts.”
Another way to check an organization’s commitment is through their participation in the AMA’s Joy in Medicine program, which recognizes organizations at the gold, silver and bronze levels based on their progress.
“For residents in their job search, Joy in Medicine recognition offers a public signal that the organization is committed to workforce well-being, not just in words, but in actually demonstrating measurable system change. It’s a useful way to gauge a potential employer's investment in physician well-being and professional satisfaction,” Dr. Farley said.
Through their ongoing efforts to reduce physician burnout and enhance well-being, 109 hospitals, health systems and medical groups are being honored this year by the Joy in Medicine Program. These organizations join a strong cohort of organizations from 2024, bringing the currently recognized total to 164 organizations, which represents 449,058 physicians. Each health system is recognized for a two-year period.
The 2025 recognition represents the outstanding efforts these organizations have initiated to address the systemic causes of physician burnout in six domains: assessment, commitment, efficiency of practice environment, teamwork, leadership and support.
At the same time, recognition isn’t a stamp of perfection, Dr. Farley added.
It also doesn’t mean that “every physician there is happy. But it means the system is trying, they're making progress, and they've committed to transparency, measurement and improvement,” she said.
Doing your homework on the job hunt
Early-career physicians “may experience a gap between their personal values and the system's realities,” Dr. Farley said, adding that we “sometimes hear about early-career physicians experiencing moral distress when they feel like they can't do the right thing for their patients because of system constraints. And sometimes they feel like a cog in the wheel when they don't have a sense of voice or agency to actually impact their environment.”
Residents looking for their first physician jobs can use tools like the AMA STEPS Forward® toolkits to prepare for interviews, finding questions to ask health care organizations and learning about where the trouble spots often lie.
Have they looked for ways to reduce regulatory burdens? Have they leveraged team-based care as one way to take the sting out of the EHR? And, crucially, have they created a culture that values the well-being of physicians and other health professionals?
Above all, don’t let a big salary blind you to conditions that you soon may find untenable. You aren’t applying for limited residency slots this time—the power resides with you.
“This can't be left to chance,” Dr. Farley said, adding that it’s essential that job seekers “do that homework and that digging and choose a system where physician professional satisfaction and well-being are a priority, where they're hardwired into the system's culture and the operations of the organization.”
