Well-Being in Residency: A Systematic Review
Kristin S. Raj, MD
Citation: Kristin S. Raj (2016) Well-Being in Residency: A Systematic Review. Journal of Graduate Medical Education: December 2016, Vol. 8, No. 5, pp. 674-684.
Journal Club entry by: Karyn King, TUSM-MMC, M18
Summary:
The rates of physician burnout in the United States have been observed to be higher than those of the general population, in one study by Shanafelt et al (2012) burnout values were determined to be as high as 60% in certain specialties.1 Over the recent years, with increased concern for resident burnout, interventions to address resident wellness have been increasingly incorporated into graduate medical education curriculums across the United States. The objective of this well-being systematic review by Raj (2016) was to review the current literature on resident well-being and identify factors associated with well-being, identify interventions being used to address resident well-being, and provide goals for future resident well-being research. After a review of 26 articles that met inclusion criteria, the author found that several important well-being themes emerged including: sleep, coping mechanisms, resident autonomy, building of competence, and enhanced social relatedness. However, due to the fact that research on resident well-being is in its infancy and that there isn’t one widely accepted and validated tool for measuring resident wellbeing it is difficult to assess the efficacy of current interventions. The author believes that future work in the realm of resident well-being should focus on formation of a validated assessment tool so as to evaluate the broad array of interventions currently being implemented in residencies across the United States.
Discussion questions:
- What is it about graduate medical education as it stands currently that makes residency such a difficult and stressful time for residents?
- Did your residency have any interventions to promote well-being and if so, were they effective?
- Do you feel it is appropriate to put so much effort and funding into resident well-being if for many years residents have progressed through residency and into life as an attending physician without such interventions?
- If you were building a well-being assessment tool to evaluate resident well-being and the efficacy of well-being interventions what would this tool look like?
- Do you think it is fair to allocate well-being interventions differently across different residencies based on their generally reported levels of resident burnout?
- For example, psychiatry physicians report burnout rates of about 41% while emergency medicine physicians report burnout rates of >60%. Would it be fair to provide more interventions for emergency medicine physicians than their psychiatry colleagues?
For information on a virtual discussion of this article, please see: JGME-ALiEM Hot Topics in Medical Education: An Analysis of a Virtual Discussion on Resident Well-Being
Additional references:
- Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, West CP, Sloan J, Oreskovich MR. Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Arch Intern Med.2012;172(18):1377–1385. doi:10.1001/archinternmed.2012.3199