By:Tonya Hamlin
Date: October 21, 2025
Congratulations! You’ve received your first physician job offer. You’ve spent a decade (or more) preparing for this moment, so expectations are understandably high. After years of living off loans and a resident’s salary, you finally hold the promise of a six-figure salary and a signing bonus big enough to erase an impressive amount of student debt.
It feels good — and it should. All of those zeroes are validating, but there is much more to consider before you sign on the dotted line. I’ve been helping physicians navigate job searches for a while now — first, as an in-house physician recruiter for a Texas hospital system and now, as Regional Vice President of Recruitment at Jackson Physician Search. If there’s one piece of advice I wish every early-career physician would take to heart, it’s this: the biggest offer doesn’t always lead to the happiest career.
It’s more than a platitude. The research continues to affirm this truth. According to a new study from Jackson Physician Search and MGMA, “From Contract to Connection: How Authentic Relationships Foster Early-Career Loyalty and Retention,” more than half (59%) of physician respondents reported leaving their first job within three years. For most, the cause had nothing to do with compensation. Our past research found that compensation was the primary factor in first-physician job decisions; however, first-job tenure continues to shrink. So while it may sound trite, it certainly seems to be true: Money can’t buy happiness.
So what is causing physicians to leave their first jobs? The Jackson Physician Search and MGMA report delves into exactly this. And while the report is written for an audience of administrators hoping to improve retention, it holds lessons for physicians too. Keep reading for a look at why physicians are leaving their jobs and how you can avoid being another statistic.
The Expectation Gap
Understanding why physicians leave their first jobs (and what will make them stay) is key to closing what the report calls the expectations gap. In the study, 69% of administrators said they expect new physicians to stay at least six years, but as I noted earlier, 59% of respondents moved on within just three years. And 27% said they considered leaving in the first year!
These stats are not all that surprising. When a physician accepts a role primarily because the offer looks great on paper, but the culture, leadership style, or support system doesn’t align, the cracks start showing fast. The excitement of a high salary fades quickly when you’re working in an environment that doesn’t feel like a fit.
I can recall several instances where a physician chose the higher offer, only to regret it later. One such example is memorialized on the Jackson Physician Search website. In that story, the physician returned to his original recruiter, who helped him find his way back to the employer he should have chosen initially. However, it’s not always so easy to correct the mistake.
So, if compensation isn’t the deciding factor, what should be?
Leadership, Culture, Autonomy
According to the research, leadership issues (45%) and organizational culture (39%) were the top reasons physicians gave for leaving their first jobs. This aligns with past research, which cites “practice ownership/governance model” as the top reason for leaving. The overarching theme is that how the practice/group/department is run will directly influence how happy you are in your job. It is critical that you get a clear sense of leadership style and culture during the recruitment process.
Also tied up with leadership and culture is physician autonomy. Does leadership grant physicians the freedom to do what is best for their patients, or are physicians bound to protocols that limit their autonomy?
Evaluating a potential employer in these areas is a must, but doing so effectively is easier said than done. So how can physicians evaluate employers in these areas?
What “Fit” Really Looks Like
One reason physicians may opt to follow the money is that it is the most objective method of comparison. Factors such as culture, leadership styles, and physician autonomy are more challenging to quantify and compare.
We’ve previously written about how to evaluate culture during the physician interview, and my colleague Neal Waters offers excellent advice on evaluating physician autonomy with a potential employer. I’ll add here a few things that I tell candidates to look for during interviews and site visits:
- Watch how people interact. Don’t just listen to what they profess to be true, but observe to see if what they say matches what they do. Do the physicians and staff seem to genuinely like each other? Is there laughter in the hallways, or tension? You can learn more in a five-minute observation than in a two-hour meeting.
- Ask about decision-making. How are clinical protocols set? How much voice do physicians have in operations or scheduling?
- Look for signs of mentorship. Is there a structured onboarding plan? Will someone help you navigate your first year, or are you expected to figure it out alone?
- Listen to your gut. If you see red flags or something just feels off — like leadership is dodging your questions or the team dynamic feels strained — trust that instinct.
The best time to identify culture issues is before you start, not three months in!
Hold Out for Happiness
You’ve worked too hard to land in a job that doesn’t support you, but physicians need more than competitive compensation. The best offer isn’t the one that pays the most — it’s the one that fits your values, supports your growth, and lets you practice medicine the way you envisioned when you started this journey. Because when those things are in place, the money feels just right — and so does everything else.
Wherever you are in your physician career, the recruitment team at Jackson Physician Search can help you identify your priorities and find an opportunity that meets your needs. Reach out today to learn more or search physician jobs online now.
Head to the Career Resource Center for more physician job search tips. Here, you will find a checklist of job search documents, physician interview etiquette, physician compensation considerations, and more. Most importantly, reach out to a Jackson Physician Search recruitment team member. We look forward to learning more about you and guiding you through your physician job search.
This article provided by Jackson Physician Search