BACKGROUND: While a great deal of research has brought attention to the issue of physician burnout in recent years, and resident physician burnout in particular, the topics of physician well-being, and by extension physician thriving, have been relatively understudied. Consequently, we propose a model of resident physician thriving. ObjectiveTo understand what factors contribute to a subjective sense of thriving among resident physicians. DESIGN: In this study, we conducted in-depth interviews from May 2020 through February 2021 with resident physicians to determine what factors have contributed to their sense of thriving in their careers as well as in their lives more generally. We used a snowball sampling technique to recruit participants. Validated instruments were used to quantify the participant's subjective level of job and life satisfaction as well as their level of career burnout. To derive our conclusions, we employed thematic content analysis using a grounded theory-based approach. PARTICIPANTS: Resident physicians in the internal medicine, pediatrics, and combined internal medicinepediatrics residency programs at a single universityaffiliated institution. APPROACH: We interviewed those residents with high life, career, and residency satisfaction who did not meet criteria for burnout to explore those factors that contribute to their sense of thriving. KEY RESULTS: Thirty-seven screening interviews were conducted. Twenty-four participants met criteria for life, career, and residency satisfaction while also not meeting criteria for burnout. The six key themes contributing to resident thriving that we identified during the course of our analysis included program leadership, learning climate, connectedness, joy in medicine, life balance, and intrinsic factors. CONCLUSIONS: This project proposes a model of resident thriving that can potentially inform program structure, culture, and values.

Objective: The COVID-19 pandemic has greatly impacted the residency experience, yet few qualitative studies have engaged residents for their perspectives. Our aim in this investigation was to better understand what effect the COVID-19 pandemic has had on resident learning climate and well-being and to determine how perspectives on the residency experience have changed over time. Methods: We conducted interviews from May 2020 through February 2021 with residents from the internal medicine, pediatrics, and internal medicine-pediatrics residency programs from a single, university-affiliated hospital. Validated instruments were used to quantify participants’ level of satisfaction and burnout.  A snowball sampling technique was used for recruitment. We employed thematic content analysis using a grounded theory-based approach. Results: Of the 56 residents invited to participate, 37 (66.1%) elected to do so. The first 15 interviews were completed between May 2020 and July 2020 (early COVID-19), with 22 interviews completed between December 2020 and February 2021 (late COVID-19). The residents interviewed during the late COVID-19 block were less likely to meet criteria for satisfaction (p<0.01) and thriving (p<0.05) and were more likely to endorse feeling burned out (p<0.002) compared to their peers in the early COVID-19 cohort. Four key themes emerged: changes to training and education, changes to well-being, changes to the practice of medicine, and changes to perspectives on residency. Conclusions: Residents described how the COVID-19 pandemic has contributed to a diminished sense of well-being as well as poorer clinical training. Further study should be done to determine what measures can be taken to help attenuate COVID-19-related burnout and educational compromise.