Professor of Obstetrics and Gynecology, Division of Reproductive Endocrinlogy and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Division of Research, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Med Educ Online. 2021 Dec;26(1):1950107. doi: 10.1080/10872981.2021.1950107.
Physician well-being remains a critical topic with limited information concerning the impact of the progression of training and duty hours. To date, our knowledge and interventions have not adequately addressed these issues. We assessed differences in well-being across the USA: (1) between all post-graduate trainees and their academic core faculty; (2) between all obstetrics and gynecology trainees and their academic core faculty and (3) during the progression of training within obstetrics and gynecology (OB/GYN). A cross-sectional study analyzing responses to well-being questions included in the 2017-2018 Accreditation Council for Graduate Medical Education (ACGME) surveys given to all U.S. trainees and core faculty. More than 85% of all U.S. physician-trainees and faculty surveyed responded. Respondents included 128,443 trainees from all specialties combined, 5,206 OB/GYN residents and 799 OB/GYN subspecialty fellows. A total of 94,557 faculty from all specialties combined, 4,082 general OB/GYN faculty and 1,432 sub-specialty OB/GYN faculty responded. Trainees were more negative than faculty for the majority of questions for both all trainees combined and within OB/GYN when progressing from resident to subspecialty fellow to subspecialty faculty (p ≤ 0.05). Questions focusing on work satisfaction (e.g., pride in work) were more negative for residents compared to fellows and for fellows compared to faculty. In contrast to work satisfaction, responses to the question 'Felt the amount of work you were expected to complete in a day was reasonable' showed either no difference or higher scores for trainees compared to their faculty. Although an issue for all physicians, well-being impacts trainees more, and differently, than faculty and well-being improves during training from resident to fellow to faculty. Survey responses suggest that interventions should focus on workplace satisfaction over workplace environment areas and further limitations in duty hours are unlikely to improve physician well-being.
医生的幸福感仍然是一个关键话题，关于培训和工作时间进展对其的影响，我们的了解和干预措施有限。迄今为止，我们的知识和干预措施还没有充分解决这些问题。我们评估了美国各地的幸福感差异：（1）在所有研究生培训生与他们的学术核心教员之间；（2）在所有妇产科培训生与他们的学术核心教员之间；（3）在妇产科培训期间（OB/GYN）内。一项横断面研究分析了对 2017-2018 年研究生医学教育认证委员会 (ACGME) 调查中包括的幸福感问题的回答，这些调查是对所有美国培训生和核心教员进行的。超过 85%的接受调查的美国医师培训生和教员做出了回应。受访者包括来自所有专业的 128,443 名培训生、5,206 名妇产科住院医师和 799 名妇产科专业研究员。共有来自所有专业的 94,557 名教员、4,082 名普通妇产科教员和 1,432 名妇产科专业教员做出了回应。对于大多数问题，无论是所有培训生的综合问题，还是从住院医师到专业研究员再到专业教员的妇产科问题，培训生的回答都比教员更消极（p≤0.05）。与工作满意度相关的问题（例如，对工作的自豪感），住院医师的回答比研究员更消极，而研究员的回答比教员更消极。与工作满意度相反，对于“觉得一天内完成的工作量是合理的”这一问题的回答，培训生的回答要么与教员没有差异，要么分数更高。尽管这是所有医生的一个问题，但幸福感对培训生的影响比教员更大，也更不同，而且从住院医师到研究员再到教员，幸福感在培训过程中会提高。调查结果表明，干预措施应侧重于工作场所满意度，而进一步限制工作时间不太可能提高医生的幸福感。
