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Retention of Clinical Faculty Physicians under the Geographic Full-Time Commitment: Challenges and Policy Options
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Ehsan Zarei    , Lida Shams , Masoud Arianfar * |
| Department of Health Services Management, Faculty of Health and Safety, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran , arianfar@sbmu.ac.ir |
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Abstract: (20 Views) |
Clinical academic physicians play a pivotal role in ensuring the quality of medical education, delivering specialized clinical services, and advancing health equity. However, recent field evidence indicates that the current implementation of the “Geographic Full-Time” (GFT) scheme has been associated with rising dissatisfaction and increased turnover intentions, potentially undermining educational–clinical productivity and equitable access to specialized care. This rapid policy review identifies key determinants of retention, including the public–private income gap, deficiencies in the provider payment system and delays in performance-based payments, excessive workload and professional burnout, weak regulatory oversight of dual practice, and insufficient place-based incentives. In an inflationary context characterized by declining real income, restrictive policies without adequate financial compensation and effective governance mechanisms face a heightened risk of reduced organizational commitment and workforce attrition. Based on comparative policy analysis, three strategic options are proposed: (1) strengthening the Geographic Full-Time model through meaningful and sustainable financial and non-financial incentives; (2) permitting regulated dual practice with mandatory disclosure, clearly defined time caps, and institutional revenue-sharing arrangements; and (3) implementing targeted, specialty- and region-based contractual models to address critical workforce shortages. The comparative assessment suggests that each option entails trade-offs in terms of effectiveness, fiscal sustainability, equity, and implementation feasibility, and reliance on any single approach carries substantial risk. Accordingly, the preferred policy recommendation is the adoption of a comprehensive, integrated policy package.
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| Keywords: Geographic Full-Time Commitment, Retention of Clinical Faculty Physicians, Health Workforce Policy |
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Type of Study: Policy Brief |
Subject:
medicine, paraclinic
Received: 2025/12/22 | Revised: 2026/02/18 | Accepted: 2026/02/18
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