Academic medicine career intentions among medical residents: a social cognitive career theory approach

BACKGROUND: Academic medicine (AM) careers combine research, teaching, and patient care, yet their attractiveness has declined in recent years, particularly among women, who remain underrepresented in this field. Previous research highlights the central role of interest in research, but the cognitive and contextual processes underlying academic career intentions during residency remain insufficiently understood. Social Cognitive Career Theory (SCCT) provides a relevant framework for examining how individual cognitions and learning experiences jointly shape career intentions. METHODS: This cross-sectional study included 1,570 French medical residents who completed an online questionnaire. Guided by the SCCT framework, we examined the relationships between learning experiences (academic satisfaction and perceived stress), self-efficacy, outcome expectations (operationalized through work centrality), professional interest in research, and intention to pursue a career in academic medicine. Hierarchical ordinal regression models were used to predict AM career intention, and structural equation modeling was conducted to investigate the formation of professional interest in research. Gender and prior research experiences (master's or PhD) were examined as moderating factors. RESULTS: Overall, residents reported low intention to pursue a career in academic medicine, with women expressing significantly lower intentions than men. Professional interest in research emerged as the strongest predictor of AM career intention, followed by research experiences and mentorship. Outcome expectations, measured through work centrality, also contributed significantly to career intentions. Structural equation modeling supported key assumptions of SCCT: perceived stress was negatively associated with self-efficacy, academic satisfaction was positively associated with outcome expectations, and work centrality played a central role in shaping professional interest in research. Gender differences in career intentions were largely explained by disparities in learning experiences and research opportunities rather than by differences in outcome expectations. Moderation analyses suggested gender-specific patterns at advanced levels of research involvement. CONCLUSIONS: These findings support the relevance of SCCT for understanding academic medicine career intentions and highlight the central role of professional interest in research and contextual learning experiences. Promoting positive learning environments, providing early and structured research exposure, and ensuring access to mentorship may represent key levers for fostering academic career engagement and addressing gender disparities in academic medicine.