Wee Christopher E, Petrosky Jacob, Mientkiewicz Lauren, Liu Xiaobo, Patel Krishna K, Rothberg Michael B
From the Mayo Clinic, Rochester, Minnesota, University Hospitals Health System, Cleveland, Ohio, the Emergency Services Institute, Cleveland Clinic Foundation, Cleveland, Takeda Pharmaceuticals Company, Deerfield, Illinois, the Mid-America Heart Institute, University of Missouri-Kansas City, and the Cleveland Clinic Center for Value-Based Care Research, Cleveland.
South Med J. 2020 Feb;113(2):70-73. doi: 10.14423/SMJ.0000000000001061.
Previous studies have characterized the negative effects of graduate medical education on physicians; however, there is limited longitudinal data on how physicians' well-being changes during their training. This study aimed to demonstrate and quantify changes to trainees' wellness and health habits during the course of their first 2 years of graduate medical education.
A longitudinal survey study of postgraduate year 1 trainees at the Cleveland Clinic was administered at 3 time points: the initial survey during orientation week, a second survey at 1 year, and a final survey at 2 years.
Of the 170 trainees contacted, 59 (35%) completed the initial survey and 34 (58%) completed the first follow-up survey. Between the initial survey and the first follow-up survey, respondents reported that their health was worse than the prior year ( < 0.001). They also reported sleeping on average 1 hour less per night and exercising on average one fewer day per week. The number of individuals who reported not eating breakfast increased by 22%, whereas the number of individuals eating out at lunch more than doubled. Twenty-seven people completed the second follow-up survey. Between the first follow-up survey and the final survey, respondents gained on average 2.12 lb ( = 0.039). Breakfast, lunch, and sleeping habits persisted through the second follow-up survey.
Residents' health and wellness habits deteriorated during internship and did not improve in the second year of residency. Efforts to promote healthy habits in this population should be a priority.
以往研究已描述了毕业后医学教育对医生的负面影响；然而，关于医生在培训期间幸福感如何变化的纵向数据有限。本研究旨在展示并量化医学研究生教育头两年期间学员健康状况和健康习惯的变化。
对克利夫兰诊所一年级住院医师开展纵向调查研究，在3个时间点进行调查：入职周的初始调查、1年时的第二次调查以及2年时的最终调查。
在联系的170名学员中，59名（35%）完成了初始调查，34名（58%）完成了第一次随访调查。在初始调查和第一次随访调查之间，受访者报告称他们的健康状况比上一年更差（<0.001）。他们还报告平均每晚少睡1小时，每周平均少锻炼1天。报告不吃早餐的人数增加了22%，而午餐外出就餐的人数增加了一倍多。27人完成了第二次随访调查。在第一次随访调查和最终调查之间，受访者平均体重增加了2.12磅（=0.039）。早餐、午餐和睡眠习惯在第二次随访调查中持续存在。
住院医师实习期间的健康状况和健康习惯恶化，在住院医师培训的第二年没有改善。在这一人群中推广健康习惯的努力应成为优先事项。
