Original Article

Medical Resident Perceptions of Distress during Training

Authors: Simone A. Bernstein, MD, MHPE, Janice L. Hanson, PhD, EdS, MH, Emily A. Slat, MD, PhD, Jennifer G. Duncan, MD

Abstract

Objectives: This study used a qualitative research approach to grounded theory to identify factors that contributed to resident distress during 2021–2022 in multiple different specialties and at different postgraduate years of residency. By better understanding these contributors to distress, the aim was to inform the design of optimal interventions to reduce burnout and other emotional distress.

Methods: The residents enrolled in this study completed a demographic survey and semistructured interview. Interviews were recorded and transcribed. Data analysis included developing codes inductively, grouping codes into categories, and describing themes. Recruitment continued until data analysis indicated theoretical saturation/sufficiency had been reached. A qualitative research approach to grounded theory was used to identify themes and relationships among themes to better understand how the sources of distress affected the trainees of various specialties and postgraduate levels of training.

Results: Thirty-three participants (15 medical-based, 9 hospital-based, and 9 surgical-based residents) participated in interviews between 2021 and 2022. Seven themes described sources of distress and potential ameliorating factors: workload, support and community, culture, resident outlook, institutional resources, work-life balance, and coronavirus disease 2019. The grounded theory highlights that these factors can collectively influence work-life balance and distress.

Conclusions: The findings of the grounded theory qualitative analysis were used to examine ways to better mitigate the sources of distress that the residents enrolled in this study described. As institutions strive to diminish distress among residents, they can consider opportunities to assess environmental factors and design targeted interventions for their institutions or programs.

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