Behind the mask of academic anesthesia: exploring why anesthesiologists in Belgium choose to pursue a career at a university hospital, or not

Background and Goal of Study: The Anesthesia departments
of Belgian university hospitals are facing challenges in attracting
and retaining skilled and ambitious professionals.
This study aimed to identify the factors impacting Belgian anesthesiologist‘s decisions to work in a university or non-university
hospital.
Materials and Methods: We distributed mixed-method surveys
in both Dutch and French to department heads of the 7 Belgian
university hospitals, board-certified anesthesiologists working in
university and non-university hospitals, and anesthesiologists in
training.
The quantitative data underwent analysis using Excel 365 through
descriptive statistics, while qualitative data underwent categorization by two independent individuals, enabling the examination
of differences between different groups.
Results and Discussion: 239 individuals participated in the survey: 5 department heads, 161 board-certified anesthesiologists,
and 73 trainees. 56.8% were men, 43.2% women. 76.1% live in
Flanders, 9.8% in Wallonia, 13.7% in Brussels, and 0.4% elsewhere. The average age was 41 years.
The net promotor score (NPS) for current job satisfaction was -19
for those working in university hospitals and +27 for those working in non-university hospitals. Regarding the likelihood of recommending a career in academic anesthesia, the NPS stands at -24
for university hospital employees, -87 for non-university hospital
employees, and -73 for trainees.
The primary motivations for seeking employment at a university
hospital include engaging in challenging clinical work, the opportunity to train future colleagues, personal growth, access to
cutting-edge technology, and performing research. Conversely,
those employed in non-university hospitals are primarily driven
by factors such as work culture, work-life balance, remuneration
packages, personal growth, and challenging clinical work in making their career choices.
Hygiene factors are the main reasons for not pursuing an academic career: a substantial salary disparity, toxic work culture,
insufficient time for non-clinical activities like teaching and research, and the abundance of policies and rules that hinder organizational agility.
Conclusion(s): Job satisfaction among anesthesiologists in Belgian university hospitals is notably low, and pursuing a career in
academic anesthesia rarely endorsed. Policymakers should prioritize addressing hygiene factors to proactively mitigate job dissatisfaction.