Eight of 24 (33%) neonatologists in Greater Hartford currently practice general pediatrics, an unreported high attrition rate. Demographic data and audio tape recorded interviews from open ended questions and qualitative responses to 22 statements from 23 of the 24 doctors were analyzed.

Of the 24 neonatologists, 15 practice neonatology (mean age 43 years), 8 practice general pediatrics (age 47 years), and one is a pediatric chairman. Excluding the pediatric chairman, attrition rates were higher in those who were not certified as compared to those with sub-board certification [6/8(75%) vs 2/15(13%)p <.01].

Fourteen (93%) of those remaining in neonatology had only full time neonatology positions, whereas all but one in general pediatrics had had part time neonatology careers (p <.001). Attrition rates also trended higher for men (age 46 years) than for women (age 43 years) [6/13(46%) vs 2/10 (20%)p=.19].

The practicing neonatologists were significantly more likely to believe neonatology required quick, difficult decision making, was a rewarding career and worth the long hours, late nights and time away from family. There were no significant differences in most attitudes concerning positive and negative aspects of neonatology as a career.

Reasons for attrition by the eight general pediatricians were: it was too hard to practice general pediatrics and neonatology at the same time and/or they never intended to practice full time neonatology (6), didn't “fit in” with the personalities of colleagues (1), and were depressed with the poor outcome of patients (1). Additional comments included missing well child and longitudinal care, problems with repetitive rounds, sick patients, an enclosed environment, less personal family life and inability to find a job without research requirements.