Valentine Bour

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.

Introduction: A decline in intentions to pursue careers in academic medicine (AM) has been observed, despite their importance for healthcare systems and scientific advancement. Persistent gender disparities further highlight the need to understand the factors shaping these career choices. Methods: This cross-sectional online survey study examined factors associated with AM career intentions among 1,641 french medical residents (63% women) who completed an online survey assessing individual (e.g. self-efficacy, professional interest), contextual (e.g. mentorship, perceived stress), and background variables (e.g. residency year, research experience). Regression analyses identified factors, while mediation and moderation analyses explored gender-related mechanisms. Results: Consistent with prior research, interest in research, prior research training (MSc/PhD), and mentorship were associated with academic medicine career intentions. Additional factors included work-related expectations (higher work centrality, stimulation, and lower conformity/autonomy) and intrapreneurial self-capital. Gender differences were partly explained by research-related factors (57.06%) and work centrality (15.61%), with no moderating effects observed. Discussion: Promoting AM careers requires enhancing early research exposure, providing structured mentorship, and fostering organizational flexibility to accommodate diverse professional goals. Strengthening supportive environments (especially for women) by improving mentorship access and workplace safety could sustain engagement and promote equity in academic medicine.

Objectives: Academic medical careers remain marked by persistent gender inequalities, despite the growing feminisation of the medical workforce. The objective of this study was to examine whether gender differences exist in key individual and institutional determinants of academic medical career aspirations among medical residents, including research motivation, mentoring, work centrality, self-efficacy, perceived discrimination and stress. Design: This was a national cross-sectional online survey. Setting: Multicentre study conducted across 36 medical schools in France. Participants: A total of 1570 medical residents (997 women and 573 men) voluntarily participated between November 2022 and February 2023. All participants completed validated self-report questionnaires. There were no exclusion criteria beyond being enrolled in a French residency programme. Primary and secondary outcome measures: Attitudes towards research (interest, motivation, significance) were measured using the Scale of Attitudes towards Research. Mentoring was assessed with the Mentor–Mentee Perception Questionnaire, work centrality with Hirschfeld and Feild’s scale, self-efficacy with the General Self-Efficacy Scale, perceived discrimination with the Sexual Harassment and Discrimination Experiences of Academic Medical Faculty instrument and stress with the Perceived Stress Scale. Gender differences were analysed using t-tests or χ² tests with Holm-Bonferroni corrections for multiple comparisons. Results: Compared with men, women reported lower research motivation (mean (SD) 21.0 (5.5) vs 22.8 (5.5); p _adj =0.011), lower research interest (27.1 (5.5) vs 28.1 (5.7); p _adj =0.011), lower work centrality (26.7 (7.0) vs 28.2 (8.1); p _adj =0.011) and lower self-efficacy (28.3 (5.2) vs 29.9 (5.0); p _adj =0.011). Women were less likely to report having a mentor (38.5% vs 44.5%; p _adj =0.02). They also reported substantially higher levels of experienced gender discrimination (22.8% vs 3.8%; p _adj =0.005), sexual harassment (57.7% vs 18.2%; p _adj =0.005) and perceived stress (8.48 (3.29) vs 7.27 (3.43); p _adj =0.011) Conclusions: Gender differences were observed across several individual and institutional factors associated with academic medical career aspirations. Reduced access to mentoring and greater exposure to discrimination and stress among women may contribute to lower research motivation and self-efficacy. These findings highlight the need for institutional strategies addressing mentoring, workplace culture and equity to support gender parity in academic medicine. Registration: OSF preregistration for this study is available at https://osf.io/9yseq/?view_only=1c72743f542b402ba67beed6908e597d