Cornerstones of career satisfaction in medicine.
OBJECTIVE
To establish a reliable and concise measure of career satisfaction that covers all 4 of its dimensions and to document higher dimensions of satisfaction among the major medical specialties and across varying patterns of clinical practice.


METHODS
In 2004, we conducted a stratified, cross-sectional survey of physicians in Canada. Of the eligible population, 2810 physicians (56.7%) responded. We checked response bias and found it was negligible. Responding physicians completed a 17-item measure of career satisfaction along with a detailed breakdown of clinical, academic, and administrative duties. We used confirmatory factor analysis to verify the existence of the hypothesized dimensions of higher-order satisfaction. We then used Scheffe's tests to document differences in the levels of all satisfaction dimensions, both among specializations and by clinical practice profile.


RESULTS
Factor analysis revealed 4 reliable dimensions of satisfaction: personal (alpha = 0.85), professional (alpha = 0.78), inherent (alpha = 0.70), and performance (alpha = 0.75). Inherent satisfaction with medicine as a career was the most important dimension for all specializations and for all patterns of practice. The addition of administrative duties without a reduction of clinical duties compromised personal, professional, and performance dimensions of career satisfaction. Academic duties contributed significantly to most physicians' overall, inherent, and performance satisfaction.


CONCLUSIONS
Distinguishing higher-order dimensions of satisfaction from basic ones is a groundbreaking finding because addressing higher-order dimensions supports self-actualization and superior performance of duties.
Lepnurm
Rein
R
MERCURi Group, University of Saskatchewan, Saskatoon. R.Lepnurm@usask.ca
Danielson
Danton
D
Dobson
Roy
R
Keegan
David
D
D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004282:Documentation; D006801:Humans; D007588:Job Satisfaction; D019555:Physician-Nurse Relations; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires