Most residents (75%) in a new Medscape survey listed work/life balance as the top factor they will consider in choosing their first job as a physician. They prioritized having a good work schedule and reasonable call over starting salary (64%) and having a supportive organizational and practice environment (53%). Responses from more than 2200 residents in 30 specialties were included in the Medscape Residents Lifestyle & Happiness Report 2019. They answered questions about their joys and frustrations in training and their view of their future as doctors. Again this year, work/life balance was residents' biggest challenge. Thirty-one percent of residents in years 1-4 said it was their biggest difficulty (33% for those in years 5-8). The next biggest challenge was dealing with time pressures (20% in years 1-4; 22% in years 5-8), followed by debt (14% in years 1-4 and 13% in years 5-8 said it was their biggest challenge). For some, the imbalance was a surprise. Nearly a third (32%) said work/life balance was somewhat or much worse than they expected, while 24% said it was somewhat or much better. Forty-four percent said it was neither better nor worse. More than two-thirds (69%) of residents said they have had a personal relationship fail because they don't have time to lead the kind of social life they would like. Personal wellness time was elusive for some residents. Forty-six percent said they only sometimes have time for wellness and 34% said they rarely or never have time for that. Bullying, Harassment Continues Responses indicated that bullying and harassment persist to some degree in residency — particularly against women. Asked whether bullying was a problem in medical school, 4% said often; 20% said occasionally; 37% said rarely; and 39% said never. Women (68%) reported higher rates of bullying than men (58%). Additionally, 41% of women and 15% of men reported they personally had experienced either sexual abuse, or sexual harassment or misconduct during residency. As to the frequency, 1% of men and 2% of women said it was often; 3% of men and 12% of women said it was occasional; and 11% of women and 27% of men said it happened rarely. Asked whether they had reported the sexual harassment or abuse, only 18% of residents said yes. 11% Have Had Suicidal Thoughts The numbers of residents who have had suicidal thoughts rose slightly this year, to 11% from 10%, though no respondents said they had attempted suicide in either year. The numbers reporting depression have been fairly consistent for years. In this survey, 8% said they were depressed always or most of the time; 29% said they sometimes were; 58% said they were rarely or never depressed; and 5% preferred not to answer. Two-thirds of residents said in the survey that they somewhat or strongly agree there is a stigma around seeking help. Burnout When asked what would make the most difference in helping avoid burnout, the number-one answer by far from residents was a manageable work schedule and call hours (64%). The next most common answer was sufficient compensation to avoid financial stress (43%), followed by reasonable patient loads (40%). More workplaces are becoming proactive in helping residents reduce stress. In this year’s survey, 57% said their workplace has a program in place for stress reduction. For those who don't take advantage of such programs, reasons given included: "Good way to end up on [administration's] radar. No thanks!"; "Don't need now, but glad resources are there should I need them later"; "I have other ways to relieve stress"; "If I go it places burden on my colleagues [to cover for me]"; and "no time." Less Worry That More Work Hours Will Up Errors Controversy continues over the increase in work hours in 2017 that allowed for first-year residents to work 28 consecutive hours. But this year the number who said longer shift hours will lead to more errors was 35%, down from just more than half who answered that way in the 2017 survey. The vast majority of residents said they were optimistic about their careers: 86% said they were looking forward to being doctors, 10% were unsure, and 4% said they were not looking forward to starting their careers. The most rewarding aspect of residency for three-quarters of the respondents was the knowledge and experience they were gaining, followed closely by gratitude from and relationships with patients and "being very good at what I do." Source
