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Conflicts of Interest Statement D.L. reports funding by a postdoctoral fellowship from the Society for Immunotherapy of Cancers which is funded in part by an educational grant from Bristol-Meyers Squibb (BMS). BMS has had no input into the conception, conduct, or reporting of the submitted work. D.C. has received consulting (GSK, Lilly, Boston Pharmaceuticals) and travel/speaking (Merck) support, outside the scope of the present work. G.M.B. had sponsored research agreements with Takeda Oncology, Palleon Pharmaceuticals, Olink Proteomics, which were not used to support this work. She served as a speaker for Novartis and on scientific advisory boards for Nektar Therapeutics and Novartis and consults for Merck, all of which are outside the scope of this work. P.K.B has consulted

ImportanceRetaining female physicians in the academic health care workforce is necessary to serve the needs of sociodemographically diverse patient populations.ObjectiveTo investigate differences in rates of leaving academia between male and female physicians.Design, Setting, and ParticipantsThis cohort study used Care Compare data from the Centers for Medicare & Medicaid Services for all physicians who billed Medicare from teaching hospitals from March 2014 to December 2019, excluding physicians who retired during the study period. Data were analyzed from November 11, 2021, to May 24, 2022.ExposurePhysician gender.Main Outcome and MeasuresThe primary outcome was leaving academia, which was defined as not billing Medicare from a teaching hospital for more than 1 year. Multivariable logistic regression was conducted adjusting for physician characteristics and region of the country.ResultsThere were 294 963 physicians analyzed (69.5% male). The overall attrition rate from academia was 34.2% after 5 years (38.3% for female physicians and 32.4% for male physicians). Female physicians had higher attrition rates than their male counterparts across every career stage (time since medical school graduation: <15 years, 40.5% vs 34.8%; 15-29 years, 36.4% vs 30.3%; ≥30 years, 38.5% vs 33.3%). On adjusted analysis, female physicians were more likely to leave academia than were their male counterparts (odds ratio, 1.25; 95% CI, 1.23-1.28).Conclusions and RelevanceIn this cohort study, female physicians were more likely to leave academia than were male physicians at all career stages. The findings suggest that diversity, equity, and inclusion efforts should address attrition issues in addition to recruiting more female physicians into academic medicine.