Changes in Personal Relationships During Residency and Their Effects on Resident Wellness: A Qualitative Study

Abstract

PurposeResidency poses challenges for residents’ personal relationships. Research suggests residents rely on family and friends for support during their training. The authors explored the impact of residency demands on residents’ personal relationships and the effects changes in those relationships could have on their wellness.MethodThe authors used a constructivist grounded theory approach. In 2012–2014, they conducted semistructured interviews with a purposive and theoretical sample of 16 Canadian residents from various specialties and training levels. Data analysis occurred concurrently with data collection, allowing authors to use a constant comparative approach to explore emergent themes. Transcripts were coded; codes were organized into categories and then themes to develop a substantive theory.ResultsResidents perceived their relationships to be influenced by their evolving professional identity: Although personal relationships were important, being a doctor superseded them. Participants suggested they were forced to adapt their personal relationships, which resulted in the evolution of a hierarchy of relationships that was reinforced by the work–life imbalance imposed by their training. This poor work–life balance seemed to result in relationship issues and diminish residents’ wellness. Participants applied coping mechanisms to manage the conflict arising from the adaptation and protect their relationships. To minimize the effects of identity dissonance, some gravitated toward relationships with others who shared their professional identity or sought social comparison as affirmation.ConclusionsErosion of personal relationships could affect resident wellness and lead to burnout. Educators must consider how educational programs impact relationships and the subsequent effects on resident wellness.

Natural history of burnout, stress, and fatigue in a pediatric resident cohort over three years

“…The factors associated with improvement or recovery in these realms remain to be identified. The strain and pressure of residency training might cause a cohort of residents to grow closer -few acquaintances outside of medicine are likely to understand what they are experiencing on a daily basis as their co-residents do [29]. In the months leading up to residency completion, PGY3 residents might also have more time to engage socially with each other, and they might try to solidify friendships prior to moving on to the next phase of their careers.…”

“…PGY1 schedules contained no 24-hour shifts and there were frequent periods of day/night shifts in place of some 24-hour calls during the PGY2 and PGY3 years. There is evidence that while sleep on night shifts is not significantly different from 24-hour calls, night shift schedules are associated with worse scores on measures of fatigue and burnout [29]. In addition, restricting work hours might diminish a resident's sense of purpose and patient 'ownership,' and the perception of clinical responsibility might decrease when involvement in each patient's care is time-limited by work rules.…”

The Use of Simulation to Improve Family Understanding and Support of Anesthesia Providers

“…Almost all (98%) respondents indicated that their spouse’s residency training contributed to at least one negative effect on their marriage. More recently, Law et al found that residents had difficulty explaining their job to those outside of medicine and felt that their family and friends needed to change their expectations of them as work-related obligations were frequently their first priority [ 4 ]. Non-anesthesia providers' understanding of the role of an anesthesia provider and the accompanied work-related demands may be even less than that of other medical subspecialties, as research showed that only 40% to 88% of patients knew that an anesthesiologist was a physician [ 5 ].…”

Challenges and the Future of Residency Education in the UAE After ACGME-I Accreditation

“…A qualitative study emphasized the need for more rigorous research on promoting well-being during residency. 5 However, data on this topic from Arab nations are scarce, and only one study has analyzed the patterns of burnout and depression among residents in the UAE. 6 This multicenter, cross-sectional study assessed burnout in residents in programs in Dubai and Abu Dhabi.…”

“…6 Supportive personal relationships help to maintain well-being and prevent depression, and these relationships are stronger in the Arab world. 6 Strengthening personal and family relationships while improving work-life balance has been suggested as a measure to markedly improve resident wellness, 5 and this strategy would be particularly effective in the UAE. Thus, international studies evaluating resident wellness-related measures are needed, including those that assess the impact of local context and the effect of ACGME-I accreditation.…”