Ha Gavin Q, Go Joseph T, Murayama Kenric M, Steinemann Susan
John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI.
Hawaii J Health Soc Welf. 2020 Mar 1;79(3):75-81.
Stressors during surgical residency training are common and can contribute to impaired technical performance, medical errors, health problems, physician burnout, and career turnover. This survey of general surgery recent graduates and chief residents examined threats to resident health and well-being. An electronic survey composed of multiple-choice, checkbox, dropdown, and open-ended questions was developed to determine the most stressful general surgery residency year, sources of the stress, and potential interventions to manage resident well-being. The survey was sent to five program directors across the United States to be forwarded to chief residents and recent graduates less than five years from graduation. Twenty-three residents and recent graduates responded to the survey. Seventy percent reported they "never" got enough sleep, and 39% reported they did not have a healthy lifestyle. Financial concerns were the most frequently cited source of stress. During post-graduate-years (PGY) 1 and 2, residents were most likely to fear hurting a patient or being "in over their head." In PGY-3, residents were most likely to consider leaving the residency program. The current findings suggest that each year of general surgery residency is linked with certain stressors, and no year is particularly stressful relative to the other years. There can be more research and efforts to focus on additional PGY-specific training and supervision, as well as added general measures to promote resident health and financial stability throughout all years. Regarding stress mitigation, residents may benefit from faculty, peer, and community interaction rather than from formal professional counseling.
外科住院医师培训期间的压力源很常见，可能导致技术操作受损、医疗失误、健康问题、医生职业倦怠和职业更替。这项针对普通外科应届毕业生和总住院医师的调查研究了对住院医师健康和福祉的威胁。设计了一项由多项选择题、复选框、下拉菜单和开放式问题组成的电子调查问卷，以确定普通外科住院医师培训中压力最大的年份、压力来源以及管理住院医师福祉的潜在干预措施。该调查问卷被发送给美国各地的五位项目主任，以便转发给总住院医师和毕业不到五年的应届毕业生。23名住院医师和应届毕业生回复了调查问卷。70%的人报告说他们“从未”获得足够的睡眠，39%的人报告说他们没有健康的生活方式。经济担忧是最常被提及的压力来源。在住院医师培训第1年和第2年，住院医师最有可能害怕伤害患者或“力不从心”。在住院医师培训第3年，住院医师最有可能考虑退出住院医师培训项目。目前的研究结果表明，普通外科住院医师培训的每一年都与特定的压力源相关，相对于其他年份，没有哪一年特别有压力。可以开展更多研究并做出努力，专注于额外的针对特定住院医师培训年份的培训和监督，以及在所有年份采取更多促进住院医师健康和经济稳定的一般措施。关于减轻压力，住院医师可能从与教员、同行和社区的互动中受益，而不是从正式的专业咨询中受益。
