While physicians are in residency and fellowship training, they are furthering their expertise in the practice of medicine, but they also are naturally looking forward to the time after graduation. An AMA-exclusive analysis of survey data shows that physicians in training are looking around at their organization with an eager eye, determining whether it is the kind of place they would like to start their professional careers.
The most commonly selected reason for staying was higher compensation, which was named by more than half of resident and fellow respondents. Compensation is clearly key in the resident and fellow decision-making process, and with good reason. Many physicians emerge from training with a weighty burden of educational debt—on average, $200,000 or more.
But there are a multitude of other factors physicians are weighing in their decision, and that examination is a process that takes all the years of training.
“Retention is shaped by the cumulative experience physicians have throughout training,” said Heather Farley, MD, MHCDS, the AMA’s group vice president of professional satisfaction and practice sustainability. “Organizations that invest early in culture, support and workflow improvement may be better positioned to retain physicians long term.”
If you are searching for your first physician job after residency, get your cheat sheet from the AMA now.
Data that shows how to retain
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, the AMA report showed.
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.
In the survey, residents and fellows were asked what might persuade them to stay at their current organization after their training ended. 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%.
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.” It is enduring material and designated by the AMA for a maximum of 0.25 AMA PRA Category 1 Credit™.
Giving residents a reason to stay
Those statistics are reflected at some health systems that see high retention among residents. At South Dakota-based Sanford Health, leaders have learned that nearly 40% of graduating physicians stay with the health system after their residency ends. The reasons why are manifold, but chiefly they appear to be getting an early look at the place where they feel they will flourish.
“We created a culture of wellness,” said Nessim Amin, MD, a neurologist at Sanford Health and program director of the University of South Dakota Sanford School of Medicine neurology residency program. “We value being busy—because during residency, you have to learn as much as you can—but not at the expense of being drained or burned out or affecting your mental health.”
Sanford Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Being a physician-led group leads to benefits that residents see during their training, Dr. Amin said.
“Even the administration understands our challenges and our potential,” he said. “They try to make things work for us, not just look at numbers and statistics. They know what a physician can bring to the table or to a healthcare system if we provide adequate support.”
Learn more on evaluating practice environments to match your priorities with the AMA STEPS Forward® toolkit, “What to Look for in Your First or Next Practice.” It is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™. Read up on AMA accreditation.
