Motivation and barriers to physicians' academic career in gastroenterology in France

BACKGROUND: The decline in residents' interest in academic career, as well as high rates of dissatisfaction and intention to leave among academic physicians, have been reported in various medical specialties. Academic motivation remains underexplored among residents and university hospital faculty staff, particularly in gastroenterology, where the private sector is highly developed. OBJECTIVE: We aimed at investigating (i) motivational drivers and potential barriers to academic career decidedness in gastroenterology residents, and (ii) professional achievement and challenges experienced by academic physicians in gastroenterology in France. DESIGN: We conducted a descriptive cross-sectional quantitative study by distributing structured online questionnaires to all French gastroenterology residents and university hospital faculty staff between June 2024 and November 2024. Factors associated with academic motivation and perceived difficulties in career progression were identified by regression analysis. RESULTS: Seventy-five graduate physicians and 136 medical residents participated. A large proportion of gastroenterology residents (36.0%) declared considering the academic career, with a significant underrepresentation of female residents. The only differential barriers between females and males to academic decidedness were the lack of self-confidence in scientific skill for females and the insufficient salary for male residents. The academic motivation of university hospital faculty staff was lower in women and in early- and mid-career physicians. Decreased academic motivation was associated with poor confidence in scientific skill, no or few mentors, increased time dedicated to clinical activity, and perception of gender inequities in career advancement, reported by 57.6% of female physicians. Maintaining work-family balance was a major challenge for all. CONCLUSIONS: This study suggests the need to improve exposure to research among medical trainees, with a specific focus on women, to enhance the appeal of their academic career. In tenured and non-tenured university hospital faculty staff, mentoring development, workload adjustment including protected time for research, and combating gender inequities are major challenges for improving academic gastroenterology.