Hospital medicine is a dynamic and essential field, yet sustaining a long-term career within it presents unique challenges. Inspired by narrative accounts from internists recently published in the Society of General Internal Medicine’s SGIM Forum newsletter1,2, the authors led an interactive session discussing career lessons at SHM Converge 2025. The audience, representing hospitalists from various career stages across the country, responded to prompts that explored their experiences throughout their careers. The responses reveal recurring themes—financial planning, work-life balance, finding fulfillment, and evolving definitions of success. These insights align with existing literature, offering a roadmap for fostering career longevity in hospital medicine.
Early Career: Setting yourself up for success
In the very initial stages of your career, the focus should be on establishing clinical excellence. A study by Kotwal et al suggests the key core competencies required for clinical excellence are: communicating effectively, having superior clinical judgement, appreciating collaboration, being organized and efficient, connecting with patients, being professional and humanistic, and understanding the need for professional growth.3 This is also a time for early career professionals to explore different interests and find their passions, which will help sustain longevity. Mentoring can help with both aspects; newer hospitalists should be proactive about seeking mentorship. Equally important to establishing your career path is being proactive about financial management. One respondent advised, “Start planning for retirement ASAP.” This sentiment is echoed in a study on pediatric hospital medicine, which found that higher earnings and job satisfaction significantly increased the likelihood of remaining in the field over five years.4 Conversely, concerns about educational debt were associated with decreased retention.
Mid-Career: Navigating work-life balance
Mid-career professionals frequently grapple with balancing professional responsibilities with their personal lives. A respondent shared a pressure they experience is, “Family versus career. Cutting back hours to be with family.” Literature supports this tension, identifying low satisfaction with personal and family time, as well as limited control over work schedules, as significant predictors of burnout among academic hospitalists.5 This is also a time when it becomes increasingly important to focus on well-being and prioritize self-care. Remember, self-care is not selfish.
Adaptability: A key to navigating change
Adaptability emerges as a crucial trait across all career stages. Respondents highlighted strategies such as “Keeping an open mind” and “Leaning in to peer support (give and get).” These approaches are vital in a field characterized by rapid changes and high demands. The Society of Hospital Medicine’s Career Satisfaction Toolkit underscores the importance of supportive work environments and mentorship in promoting adaptability and career satisfaction.5
Redefining success over time
Perceptions of success evolve throughout a hospitalist’s career. Early on, success may be defined by clinical competence and financial stability. Over time, it shifts towards achieving work-life balance and personal fulfillment. As one respondent noted, “Fulfillment in life, not just job.” Recognizing and supporting this evolution is essential for retaining experienced hospitalists.
Conclusion
Hospital medicine emerged as a distinct field in the 1990s. We are now experiencing the first set of retirements from those who have dedicated their careers to hospital medicine. The insights from our survey, corroborated by existing research, highlight the multifaceted nature of career longevity in hospital medicine. Establishing clinical excellence, addressing financial security, supporting personal fulfillment, promoting work-life balance, fostering adaptability, and acknowledging evolving definitions of success are pivotal. By aligning institutional support with these factors, we can enhance job satisfaction and reduce burnout, ensuring a resilient hospitalist workforce.
Dr. Puri
Dr. Puri is a practicing board-certified hospitalist, immediate past president of the medical staff for Alta Bates Summit Medical Center, and executive medical director of people and culture for Sutter East Bay Medical Group in Oakland, Calif.
Dr. Gupta
Dr. Gupta is an academic hospitalist and the associate director of the division of hospital medicine at the University of South Florida. She is also the assistant dean for faculty development.
References
1. Society of General Internal Medicine Forum. 2024; 47(12). SGIM website https://www.sgim.org/wp-content/uploads/2024/12/2024-SGIM-DecemberWEB.pdf.
2. Society of General Internal Medicine Forum. 2024; 47(11). SGIM website https://www.sgim.org/wp-content/uploads/2024/10/2024-SGIM-NovemberFINALWeb.pdf.
3. Kotwal S, et al. Defining Clinical Excellence in Hospital Medicine: A Qualitative Study. J Contin Educ Health Prof. 2017;37(1):3-8. doi: 10.1097/CEH.0000000000000145. PMID: 28252466.
4. House S, et al. Factors Influencing Career Longevity in Pediatric Hospital Medicine. Hosp Pediatr. 2019;9(12):983-988. doi: 10.1542/hpeds.2019-0151.
5. Hinami K, et al. Job characteristics, satisfaction, and burnout across hospitalist practice models. J Hosp Med. 2012;7(5):402-10. doi: 10.1002/jhm.1907.