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Keith L. Martin | August 7, 2019 | Contributor Information
Being a resident comes with successes and challenges. More than 2200 residents in 30-plus specialties told Medscape about their enjoyment and frustration with training, their feelings of burnout and depression, and their anticipation about practicing medicine. All participants were enrolled in US medical resident programs. (Note: Label values in charts are rounded, but rankings and calculations are based on raw data to avoid rounding errors.)
Keith L. Martin | August 7, 2019 | Contributor Information
Gaining clinical knowledge and experience was named the most rewarding part of residency, no matter the year. Those in years 1 through 4 more often cited their relationships with other residents (61%) than those later in residency (55%). Those in years 5 through 8 cited being good at what they do (74%) more than those earlier in residency. "Caring for underserved and vulnerable people" and "knowing I'm doing good work to help patients" were some specific rewards noted by individual residents.
Keith L. Martin | August 7, 2019 | Contributor Information
Similar to the 2018 Medscape Residents Lifestyle & Happiness Report, work-life balance was named residents' greatest challenge. Dealing with time pressures was the second greatest challenge for the fourth straight year. Individual residents also noted "the amount of charting/paperwork," "dealing with staff and hospital administrative issues," and "just finding time to read/learn further" as daily issues.
Keith L. Martin | August 7, 2019 | Contributor Information
For the third year in a row, a good work schedule and reasonable call hours are the most important factors residents consider when looking for their first job as a physician. Starting salary ranked second and was more important to men (70%) than women (54%). Women also found a supportive organization/practice environment more important (63%) than men did (46%).
Keith L. Martin | August 7, 2019 | Contributor Information
About one quarter of residents say bullying is a problem in medical school. Women (68%) report higher rates of bullying than men do (58%), and those in their seventh and eighth years report bullying more often (69%) than those in their first and second years (58%).
Keith L. Martin | August 7, 2019 | Contributor Information
For the third straight year, residents point to attendings as the main source of bullying. Nurses are the second greatest source of bullying, with women (59%) more often reporting this behavior than men (48%). Chief residents, fellows, NPs, PAs, and program directors were also frequently noted as displaying bullying behavior in individual comments.
Keith L. Martin | August 7, 2019 | Contributor Information
More than two thirds of residents have seen a personal relationship suffer due to their lack of time for a social life. In fact, about half say they "sometimes" have time for something outside of work, about the same percentage as in 2018.
Keith L. Martin | August 7, 2019 | Contributor Information
While the majority of residents say they never experienced sexual abuse, harassment, or misconduct during their residency, there are clear variations by gender. Women report these experiences at their workplace more than men do.
Alexa Mieses, MD, a board-certified family physician and recent graduate of the Duke University School of Medicine family medicine residency program, called this data "troubling" and said there are various sources of the behavior. "I have personally been sexually harassed, not by supervisors or colleagues but by patients," she says. "While this is not an everyday occurrence, sexual harassment happens more commonly than anyone would like."
Keith L. Martin | August 7, 2019 | Contributor Information
Nearly two thirds (64%) of residents said that having a manageable work schedule and call hours would help them avoid burnout. Sufficient compensation and greater flexibility in schedule followed as top solutions to relieve on-the-job stress. Individual residents noted "less computer/EHR work," and "reducing administrative work" as other helpful avenues.
Keith L. Martin | August 7, 2019 | Contributor Information
Similar to results for the past 4 years, nearly 10% of residents report being depressed all or most of the time. In that same time span, this year's report marks the highest percentage (58%) of residents who say they are rarely or never depressed.
Keith L. Martin | August 7, 2019 | Contributor Information
Residents face a tough work-life balance and great on-the-job stress, but 85% of residents in our report say they have never felt suicidal nor attempted suicide. Still, 11% said they have, which is similar to last year's response.
Keith L. Martin | August 7, 2019 | Contributor Information
The majority of residents say there is still a stigma among peers when it comes to seeking help for mental health. Furthermore, women (70%) felt this way more so than men (63%).
Keith L. Martin | August 7, 2019 | Contributor Information
Many healthcare organizations, including hospitals, are becoming more proactive when it comes to addressing physician and staff stress. Nearly 60% of residents say their workplace has such a program in place to help.
Keith L. Martin | August 7, 2019 | Contributor Information
About 80% of residents say they rarely or sometimes have enough time to focus on their personal health and wellness. Mieses acknowledges the challenges of balancing long work hours with the "emotional tax" of caring for the sick and dying while also finding a healthy routine outside of work. "Having a good diet, sleep, and exercise routine before starting residency can make it easier to maintain the routine when the going gets tough," she says. "Leveraging social support whenever you can also protects against burnout."
Keith L. Martin | August 7, 2019 | Contributor Information
Whereas 44% of residents said their work-life balance is about what they expected, another 24% say it is better, including Mieses. "This is because it was not so great in medical school and I committed to change for residency," she says. "It is really easy to be consumed by the first years as a physician. When I wasn't at work, I was often talking or thinking about work. With each year that goes by, I become more comfortable as a physician and more balanced overall."
Keith L. Martin | August 7, 2019 | Contributor Information
The majority of residents say they are rarely or never too tired from long shifts to perform their job well. Mieses transitioned from a program that required 60-80 hours per week to one that was 40 hours or so, putting her in the "rarely" category herself. "However, imagine that most residency training is inpatient-focused and therefore residents have to endure month after month of long workweeks in the hospital. It may be more challenging to 'catch up' on sleep and wellness, and inhibit functioning," she says.
Keith L. Martin | August 7, 2019 | Contributor Information
Almost half of all residents said it would be desirable to be in a long-term relationship with another physician, similar to last year's results (49%) and those in 2017 (46%). Like in the 2018 report, second-year residents comprised the highest percentage.
Keith L. Martin | August 7, 2019 | Contributor Information
A large majority of residents are looking forward to their career as a physician. Only 10% of resident respondents are undecided, and 4% said they are not looking forward to it. This is similar to last year's results.
Keith L. Martin | August 7, 2019 | Contributor Information
Nearly half of residents said they sometimes have concerns about being a good physician. Mieses says that during her last few weeks of residency training, she felt she knew nothing at all. "This could not be further from the truth, but there is something very daunting about the idea of going off into the world for the first time without someone checking your work behind you," she says. "In reality, I learned a ton in medical school, residency, and by virtue of becoming board-certified."
Keith L. Martin | August 7, 2019 | Contributor Information
Forty-five percent of residents say they rarely or never fear making serious mistakes. Men (52%) feel this way more than women do (35%). Another 44% say they sometimes fear making a serious mistake, and 10% reported feeling this way all or most of the time.
Keith L. Martin | August 7, 2019 | Contributor Information
More than two thirds say they don't anticipate overspending their first year's salary, similar to last year's replies. Another 18% said they will overspend, whereas 15% said they aren't sure what they will do with their first professional income.
Medscape's report looks at how happy physicians are and why, as well as the state of their marriage and self-esteem, what cars they drive, how much time they spend on the Internet, and much more.Medscape Features Slideshows, January 2019
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Keith L. Martin
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Medscape Business of Medicine
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