P. N. Chotai1, P. Marincola Smith1, J. L. Padgett1, S. K. Geevarghese1, K. P. Terhune1 1Vanderbilt University Medical Center,Department Of General Surgery,Nashville, TN, USA
Introduction:
Surgical residents are at risk of burnout, depression, and poor compliance with health maintenance guidelines. We surveyed our trainees to understand their physical and mental health, compliance to age-appropriate health guidelines and self reported barriers to achieving that compliance. We implemented resident well-being initiatives (RWI) within our program and re-surveyed the resident cohort as a follow-up to gauge impact of our initiatives.
Methods:
General surgery residents at a large university-affiliated program were invited to participate in a 34-question, anonymous survey examining factors that affect physical and mental health, including self-reported work hours, compliance with age-appropriate health guidelines, and current diet and exercise habits, as well as barriers to achieving resident well-being. Based on the pilot data, areas of improvement were identified. With support from program leadership, a resident run resident well-being committee (RWC) was put together and various RWI were impleneted over the next 12 months. Examples of these RWI included quarterly RWC meetings to brainstorm ideas and oversee progress, encourage and facilitate periodic health maintenance visits, spreading awareness about the resilience resources within the program, and introduction of a resident pairing system. Same survey was repeated 12 months after RWI. Both years' survey data were compared to identify trends in residents' compliance and barriers to achieving health maintenance guidelines as well as self-care.
Results:
In the one-year follow-up survey, sixty-one percent of residents participated compared to 71% the previous year (42% female, both years). Following implementation of RWI, compliance with recommended primary care physician (PCP), dentist and vision visits was 42% (previously 25%), 45% (previously 23.5%), and 48% (previously 42%), respectively. Only 62.5% residents felt that they did not focus enough on their health compared to 80% prior to RWI. Following RWI, barriers to health maintenance visits were reported as a lack of time by 60.4% (previously 80%), schedule unpredictability by 73% (previously 76%), appointment availability by 42% (previously 67%) and difficulty getting time off of work by 42% residents.
Conclusion:
Resident well-being initiatives have a potential to improve residents' compliance to health maintenance visits, self-care as well as overcome the most common barriers to achieving resident well-being in a surgery residency education program. Multi-institutional collaborations with focus on encouraging resident participation and further optimizing the functioning of such initiatives, with support provided by program leadership, may be one of the few ways to tackle resident burn-out in a surgical residency program.