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Keith L. Martin | October 22, 2021 | Contributor Information
Life as a resident can be tough. Long hours, scut work, and dealing with new personalities can all cause on-the-job stress. And that's without the immense pressure of a global pandemic.
But what about life outside of the medical workplace? That's not necessarily stress-free either. Balancing a social life, focusing on personal wellness, and thinking about future career options can all weigh on residents.
More than 1500 residents in 29-plus specialties told us about their hopes, their fears, and how COVID-19 has changed them personally and professionally.
(Note: Label values in charts are rounded, but rankings and calculations are based on raw data to avoid rounding errors.)
Keith L. Martin | October 22, 2021 | Contributor Information
Personal time continues to be a struggle for residents. More than one third of residents say they rarely or never have time to lead a satisfying social life, an increase from last year's report (27%). Furthermore, 7 in 10 residents who responded that they rarely, never, or sometimes have time for a personal life said that their personal relationships have suffered as a result.
Keith L. Martin | October 22, 2021 | Contributor Information
Four in 10 residents said the balance between their personal life and their healthcare profession is what they expected. The proportion of residents who reported that balance as being much worse than or somewhat worse than expected rose from last year's report (29%).
Amelia Breyre finished her emergency medicine residency in July 2020. For herself and many residents, she said, the financial strain of education debt and challenging work schedule often delay such life events as having children or buying a house like others in their age group. Add a global pandemic, and it's not hard to see a rise in negative outlook.
"Interns who started their training in the pandemic had a particularly challenging year balancing personal lives as many of them moved to new cities, started new jobs, and learned new systems, often without the traditional social support of a fellow co-intern or co-resident," said Breyre.
Keith L. Martin | October 22, 2021 | Contributor Information
Men (32%) are more likely than their female counterparts (26%) to say they are more appreciated as a medical professional (data not shown).
"This past year, working through COVID-19 surges, I have found the meaningfulness of the work incredibly career affirming but at the same time have felt pessimistic, replaceable, and unsupported by the healthcare system," said Breyre. "I hope that COVID-19 healthcare system challenges drive motivation for change and reform."
Keith L. Martin | October 22, 2021 | Contributor Information
Working long hours during a pandemic can form close bonds as well as fray nerves. Nearly 3 in 10 residents said professional relationships with attendings, nurses, and others worsened or improved. Among those who said relationships declined, the main reasons were much less social interaction on the job and outside of work, as well as the stress of daily patient care. "I haven't seen my co-residents in over a year," said one respondent.
Keith L. Martin | October 22, 2021 | Contributor Information
Although the large majority of residents overall said that COVID-19 has not made them reconsider medicine, more women than men (20% vs 14%) said the pandemic made them reconsider entering the field (data not shown).
Keith L. Martin | October 22, 2021 | Contributor Information
Women (43%) were more likely than men (36%) to have considered a different career choice during residency (data not shown). Responses regarding alternative careers varied from "literally anything else [other than physician]" to "something where you are given a little respect."
Keith L. Martin | October 22, 2021 | Contributor Information
Forty percent of women said that work schedule/call hours were a key factor, compared with 33% of men. A higher percentage of men than women (19% vs 11%) said that compensation was a key factor (data not shown).
Keith L. Martin | October 22, 2021 | Contributor Information
Similarly, residents are looking for better work and call hours to help them at their current work setting. Around two thirds said it would help ease burnout, with better compensation and schedule flexibility rounding out the top three ways to provide relief.
Keith L. Martin | October 22, 2021 | Contributor Information
Perhaps the combination of responding to the pandemic and an already difficult training environment is taking a toll on residents. One third say they rarely or never have time for their personal wellness, an increase from last year's report (25%). In this group, women (39%) more often replied that they "rarely" or "never" had time for personal wellness compared with men (29%) (data not shown).
Keith L. Martin | October 22, 2021 | Contributor Information
Similar to last year (57%), half of residents say they rarely or never feel depressed. Those replying "always" and "most of the time" rose from last year (7%).
Keith L. Martin | October 22, 2021 | Contributor Information
Similar to last year's findings, the majority of residents say they have not considered suicide. The proportion of those who had thoughts of suicide but did not act on them is also similar to last year's findings (11%).
Keith L. Martin | October 22, 2021 | Contributor Information
More than two thirds of residents somewhat or strongly agree that there is a stigma among peers in seeking help for their mental health. Women (30%) more often strongly agree that there is a stigma than do men (23%) (data not shown).
Cherie Fathy, a fourth-year ophthalmology resident, agrees that there are clear barriers to seeking mental health care. "It's not easy to access such care, and it requires some extra coordination. Appointments are also often during clinic time, making it difficult for us to make it to the appointments."
Keith L. Martin | October 22, 2021 | Contributor Information
Overall, 7 in 10 residents say they have never experienced sexual abuse, harassment, or misconduct at their workplace. Seven percent said this occurred "occasionally."
Keith L. Martin | October 22, 2021 | Contributor Information
Among the three quarters of residents who said that they did not report such behavior, the most common reasons were fear of retribution or retaliation; a feeling that nothing would be done; and that the perpetrator was a superior who had power over them and their future career.
Keith L. Martin | October 22, 2021 | Contributor Information
The value of clinical knowledge is the most rewarding part about residency, according to respondents, followed closely by the gratitude of and relationships with patients, and being good at their work.
"Despite the challenges, there are so many wonderful experiences I've had as a resident," said Breyre. "I've worked with some amazing colleagues, mentors, and friends. It's a true privilege and honor to be a physician and have the opportunity to be present, and help people on some of their worst days and some of their best. "
Keith L. Martin | October 22, 2021 | Contributor Information
As proven by previous data in this year's report, maintaining work-life balance remains the biggest challenge during residency.
"Balancing a busy residency with my personal life and wellness was difficult for me," said Fathy. "I was also stressed about the learning curve, especially early on, and always wanted to make sure that I was doing right by my patients."
Keith L. Martin | October 22, 2021 | Contributor Information
Larger percentages of residents choose positive methods of reducing stress, such as getting sleep and talking to others, rather than negative methods, such as eating junk food and binge eating. Women tend to turn to sleep (82%) to relieve stress at higher rates than men (71%). The same can be said for talking to others (82% of women vs 70% of men) (data not shown).
Among other replies from residents were such methods as listening to podcasts, cooking, journaling, going to church, and using antidepressants.
Keith L. Martin | October 22, 2021 | Contributor Information
Among the three quarters of residents not taking advantage of workplace support, the main reasons for not utilizing these services were a lack of time, not thinking they need to go, and not thinking the program is effective.
Keith L. Martin | October 22, 2021 | Contributor Information
Compared with female residents (32%), male residents (44%) more often replied that they "rarely" or "never" fear making a serious mistake (data not shown).
Keith L. Martin | October 22, 2021 | Contributor Information
Women (29%) more often replied that they had doubts about being a good physician "most of the time" or "always" compared with men (21%) (data not shown).
Medscape's Residents Salary & Debt Report 2021 explores how much residents earn, how much they owe, and how they've responded to the COVID-19 pandemic. Medscape Features Slideshow, Jul 2021
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Keith L. Martin
Editorial Director, Medscape Business of Medicine
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