To examine the effect of increases in payment for teaching on retention of primary care faculty, and to compare those faculty members' needs and rewards for teaching with objective data on retention.
In 2006-2007, the authors compared retention rates of primary care clerkship preceptors at Harvard Medical School (1997-2006) when their stipends were raised from $600 to $900 (in 2003) and to $2,500 (in 2004), and when faculty received payment directly versus indirectly. A survey was sent to all 404 present and past living preceptors, who were asked to rank-order six factors in terms of (1) how much they needed each to continue teaching, and (2) each factor's contribution to their satisfaction with teaching.
Retention rates varied from a high of 91% in 2006 to a low of 69% in 2000. Faculty were 2.66 times more likely (P < .0001) to return to teach in the highest pay period than the lowest, and faculty receiving direct payment were more likely to continue teaching than those receiving it indirectly. Only 8% of the 170 responding faculty ranked receiving the stipend as the most important factor in their continuing to teach; no one ranked it first as a source of satisfaction. However, 73% ranked having a good student first as a factor in continuing to teach; 82% ranked it first as a source of satisfaction.
Raising stipends was associated with increased retention, although faculty ranked stipend low in terms of what motivates them to continue teaching.