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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023
| Contributor Information
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Residency can seem like a crash course in survival. How well are today's residents bearing up with that test? This report is based on a Medscape survey of residents about the personal and professional stresses of residency and how well they maintain a healthy personal life.
In this report, gender is based on how physicians self-identified in our survey.
Some totals in this presentation do not equal 100% because of rounding.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Over the past 5 years, obtaining clinical knowledge has always topped the list when Medscape asked new doctors about the biggest rewards from residency. Starting with this year's report, being good at the job moved distinctly ahead of patient relationships in residents' esteem.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
As they were with the biggest benefits from residency, respondents have been consistent over the past 5 years of our survey in identifying the biggest challenges. Work-life balance, time pressures, and fear of failure (three factors that seem somewhat intertwined) have always topped the list.
In our 2018 report, the pressures of developing clinical skills were fourth on residents' challenge list at around 11%.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
There's a ray of hope for residents here. The share of residents who lamented how they rarely or never find time for socializing dipped to 31% from 36% in last year's report.
Also, residents less frequently told Medscape that a personal relationship had failed due to the time constraints of residency (54% did this year; 66% did in last year's report).
"I've had a good social life without lost or failed relationships," said a fourth-year from Virginia.
Still, respondents told a number of less positive tales: "My marriage fell apart at the beginning of residency," a fourth-year in Nevada shared. "It's hard to have a social life and work 80 hours a week, witnessing human trauma on a daily basis."
"I've had to make many sacrifices in regard to my work in order to have kids in residency, and I have no time for a social life outside that," a fourth-year in California also shared.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
With more time passing since exam changes were implemented, residents less often described residency as harder from a testing standpoint. In last year's report, more respondents characterized their journey to residency as more difficult than it was for their predecessors.
"There is less pressure now on the Step 1 score, and it is much easier financially and logistically to apply to residency with online interviews," a fourth-year from Massachusetts told Medscape.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Perhaps in a sign that stressful times can breed teamwork and cooperation, residents about as often said their relationships with attendings and nurses improved during the pandemic as described it as worsening.
"My relationship with the nurses is very good," a sixth-year in Colorado told Medscape.
Still, many residents were less than complimentary of their professional relationships. "The training of junior nurses needs to improve, as it does not compare to pre-COVID standards," a fourth-year in New York argued. "Nurses have attitudes with residents a lot of times or do orders late," another respondent complained.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
On the one hand, residents often complained about some situation involving attendings. On the other hand, 2 in 3 of them said that they were satisfied with attendings' behavior toward and treatment of residents. And 86% of them said that they get an appropriate level of supervision from attendings.
"The attending stepped up to shield the trainees from COVID exposure," one resident recalled.
"Attendings have very little power in the hospital but are the easiest targets as reimbursements go down but documentation and case requirements increase," a fifth-year from New York added.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
As a core principle, residency is about learning. But ensuring and evaluating learning opportunities can be a tricky proposition, given the way medical school programs are operated.
"During residency training, learners have to work largely on their own to master a large body of new information from disparate sources," the American College of Surgeons notes. "Perhaps 95 percent of what is learned during surgical training is acquired in the clinical setting or at home."
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
In looking back at their efforts during COVID, residents slightly less often said that the experience made them feel less appreciated as medical professionals than in last year's report (43%).
They also slightly less frequently described themselves as worried for the medical profession's future than they did 1 year earlier (28%).
Otherwise, attitudes expressed in this survey question were fairly stable.
Respondents to this question could choose more than one.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
More than one third of residents reported that their work-life balance was somewhat worse or much worse than they expected.
Residents aged 30-39 years said that their issues with balancing professional and personal lives were more problematic (40% chose "somewhat worse" or "much worse") than did those aged 29 or younger. Those aged 40 or older had it better (32%).
"I expected it [work-life balance] to be very challenging and I haven't been wrong," said Tyler Ramsey, a PGY-2 internal medicine resident at Mountain Area Health Education Center in Asheville, North Carolina.
"I've never been an individual to plan ahead, but you have to in residency. It's been a little better than expected, once you utilize this."
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Male residents were likelier to say they devoted enough attention to their personal health and wellness "most of the time" than were their female counterparts (26% v 18%).
"I've lost multiple close, long-term friendships given little personal time and days off," said a resident in Springfield, Illinois.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Talking with family members as a way to relieve stress and getting enough sleep were also the top two reasons in last year's report.
Some other stress-relievers that residents cited less often included reading, meditating, playing video games, watching or playing sports, and cooking.
"The best way I manage my wellness it to make sure I am physically active and work out as often as I can. It is also important to keep up with daily life activities such as cleaning and doing laundry," Ramsey noted.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
There was some improvement over last year's report, when 73% of residents who could use such a workplace program chose not to do so. Although programs are widely available, residents are not taking advantage (ironically perhaps because they are too busy or stressed).
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
In last year's report, 55% of respondents equated better compensation during residency with alleviating their burnout.
Managing burnout is important; one study found that resident burnout affected their health and emotional well-being as well as patient care, clinical decision-making, and the number of medical errors they make.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Around half of residents surveyed said that they felt depressed at least sometimes. Respondents aged 40 years or older were likeliest to report that they always felt depressed related to their residency.
In addition, 16% of residents told Medscape that they had suicidal thoughts but have not attempted suicide; 1% had attempted suicide.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Though nearly 3 in 10 respondents reported experiencing workplace misconduct during their residency, 44% of them said that they had witnessed sexual abuse, harassment, or misconduct.
When asked if they reported misconduct to a supervisor, 33% said yes, up from 26% in last year's report.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Female residents slightly more often than their male counterparts (6% vs 2%) told Medscape that they worried about a bad mistake. Fear trends upward with age, from 1% of those younger than 29 years to 12% of those aged 40 years or older.
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Twenty-six percent of respondents also said that the pandemic made them reconsider their decision to go into medicine. Fifteen percent told Medscape that they reconsidered their choice of specialty due to COVID-19.
Some alternative careers that residents considered included law, finance, dentistry, journalism, pharma, tech, engineering, cooking, and carpentry.
"I think that everyone who has pursued medicine has questioned it at some point along their past," Ramsey shared.
"However, each time that thought crosses my mind, I think about some of those special moments where I impacted that certain patient and changed their life. It's a privilege."
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
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Sometimes Optimistic, Sometimes Struggling: Medscape Residents Lifestyle & Happiness Report 2023
Jon McKenna; Jennifer Nelson | October 17, 2023 | Contributor Information
Nurse practitioners continue to fight overwork, stress, depression, and burnout. They're coping slightly better than during pandemic times but are still facing many challenges.Medscape Features Slideshows, Aug 2023
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Jon McKenna
Senior Editor, Reports, Medscape Business of Medicine
Jennifer Nelson
Features Editor, Medscape Business of Medicine
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