In a nationwide longitudinal analysis of 707,934 US physicians using Medicare data from 2013 to 2023, female physicians had a higher likelihood of leaving clinical practice than male physicians across all ages, specialties, and practice settings. The adjusted likelihood of attrition was 1.43 for female vs male physicians, with consistent findings in both rural and urban settings and across specialty groups. Among physicians who left practice, female physicians exited at significantly younger ages, with a median of 49 years compared with 64 years for male physicians.