Perspectives of female and under-represented physicians on well-being in medicine: a qualitative study from an academic medical centre in the USA.

Thematic analysis of interviews with female and URM physicians revealed four key themes affecting their careers and well-being.

• The four themes were: physician identity (URM, female, family), well-being in the workplace (emotional health, staffing burden, non-clinical responsibilities), barriers to accessing well-being resources (workplace environment, culture, overgeneralisation), and facilitators to well-being (physician camaraderie, leadership support).
• Semi-structured interviews were conducted with 30 physicians at an urban academic health system.
• Interviews were audio-recorded, transcribed and thematically analysed using a general inductive approach.
• Interview guides were informed by prior literature and constructs.

The study sample consisted predominantly of female physicians with substantial racial and ethnic diversity.

• 30 female or URM physicians were interviewed.
• 27 (90%) of participants were female.
• 14 (47%) identified as Black, Asian or multi-racial.
• Participants self-reported demographic information including sex, race, ethnicity and tenure.
• Participants were recruited via email from a large academic medical centre.

Physicians identified their intersecting identities as URM status, female gender, and family roles as influencing their experiences of well-being.

• Physician identity emerged as one of four key themes in the thematic analysis.
• Sub-themes within physician identity included URM identity, female identity, and family.
• Physicians discussed how their identities influenced their experiences of well-being in academic medicine.

Emotional health challenges, staffing burdens, and non-clinical administrative responsibilities were identified as contributors to stress and reduced well-being in the workplace.

• Well-being in the workplace was one of four key themes identified.
• Sub-themes included emotional health, staffing burden, and non-clinical responsibilities.
• Physicians highlighted these factors as contributing to stress in their academic medical careers.

Workplace culture, workplace environment, and overgeneralization of interventions were identified as barriers to accessing well-being resources.

• Barriers to accessing well-being resources constituted one of the four key themes.
• Sub-themes included workplace environment, culture, and overgeneralisation.
• Broad-based interventions that do not account for the specific needs of female and URM physicians were identified as a barrier.
• Workplace culture was described as impeding access to well-being resources.

Physician camaraderie and supportive leadership were identified as facilitators of well-being and access to well-being resources.

• Facilitators to well-being constituted one of the four key themes.
• Sub-themes included physician camaraderie and leadership support.
• Supportive leadership and camaraderie were identified as facilitators of access to well-being resources.

The authors conclude that tailored interventions, supportive leadership structures, and collaborative working cultures are crucial for sustaining a diverse physician workforce.

• Female and URM physicians face systemic challenges impacting their well-being and careers.
• Findings underscore the need to address systemic changes and specifically design programmes focused on promoting well-being and inclusivity of female and URM physicians.
• Academic physicians who are female and URM face inequities in the workplace and beyond.
• The authors note disproportionate effects on these individuals and overall workforce capacity.