Transplant Infectious Disease Physician Workforce: A National Survey of Practice Structure, Compensation, and Job Satisfaction.

BACKGROUND: Transplant Infectious Diseases (TID) is a growing, clinically complex subspecialty essential to transplant and oncology programs, yet the practice structure, compensation, and professional experience of TID physicians in the United States remain poorly characterized. METHODS: The IDSA Immunocompromised Host Community of Practice Leadership Group conducted a cross-sectional survey of U.S.- based TID physicians. RESULTS: A total of 184 physicians responded to the survey (86% adult, 13% pediatric; 94% academic). Adult TID physicians worked a median of 17 weeks (IQR 12-24) plus 8 (IQR 6-12)weekends per year on inpatient service, along with 1.5 half day clinics (IQR 1-2) outpatient. Physicians reported that a median of 67% of their non-clinical duties were not supported with FTE. Median base salary for adult TID physicians in an academic setting was $235,000 (IQR $205,000-$274,000), and $205,000 (IQR $183,000-$235,000) for pediatrics. Only 5% of junior faculty felt comfortable negotiating compensation. Forty-nine percent of respondents felt undercompensated, though 78.7% were satisfied or very satisfied with their job. CONCLUSIONS: This first national characterization of the TID workforce reveals substantial compensation inequity and unfunded non-clinical work alongside high job satisfaction and strong collegial value. Policy mandates, FTE protections, compensation transparency, and negotiation training are needed to sustain this workforce.