2018 Medscape Survey

U.S. Resident Physicians Express Frustration, Fulfillment

August 30, 2018 10:29 am News Staff

Physician well-being and physician burnout are important topics in today's high-stress health care environment. And the concern around those issues applies equally to physicians who've been taking care of patients for decades and the newest docs on the block -- resident physicians who endure several years of hardcore training in the specialty of their choice.

[young female physician in front of medical group]

That's why Medscape's 2018 iteration of its Residents Lifestyle & Happiness Report(www.medscape.com) is worth a look for anyone who'd like a quick assessment of these physicians' resilience in the trenches.

Key Findings

Resident responses to a key question in the survey show an important positive trend: In the 2018 report, 87 percent of respondents said they still looked forward to working as a doctor. That's an increase of two percentage points when compared to 2017 results.(www.medscape.com)

When it came to the biggest challenges they faced in residency, 33 percent of respondents who'd been training for one to four years put work-life balance at the top of their list, followed by

  • time constraints (17 percent),
  • fear of failure or a major mistake (15 percent),
  • developing clinical skills (10 percent),
  • debt (10 percent) and
  • dealing with stress (8 percent).
Story Highlights
  • Medscape's 2018 Residents Lifestyle & Happiness Report compiled responses from more than 1,900 U.S. residents training in more than two dozen medical specialties.
  • One key finding is that 87 percent of residents still look forward to their careers in medicine, an increase of two percentage points  compared to 2017 results.
  • Residents answered questions about facing challenges, maintaining wellness, and dealing with stress and burnout; they also identified the most rewarding aspects of their job.

In their responses, residents acknowledged the fatigue that comes with working long shifts. When asked if they were too tired to function well because of the workload, 5 percent answered that they were too tired always or most of the time, 34 percent said sometimes, and 61 percent said rarely or never.

Additionally, 65 percent rejected the notion that longer shifts lead to more errors.

Regarding questions about depression and suicide, one in 10 residents said they suffered from depression all or most of the time. Thirty-three percent were depressed some of the time, and 53 percent rarely or never; 4 percent didn't want to answer the question.

No residents said they had attempted suicide, but 10 percent said they had suicidal thoughts; 85 percent said they had never considered suicide. Again, 4 percent preferred not to answer the question.

When asked if there was a stigma against seeking help, 68 percent of residents somewhat or strongly agreed, 16 percent somewhat or strongly disagreed, and 16 percent of responses were neutral.

Several questions were related to maintaining wellness, and responses show this area needs improvement. The survey asked whether residents had enough time to pursue personal wellness, and 19 percent said they did always or most of the time. However, 46 percent said they had enough time only sometimes, and 35 percent said they rarely or never did.

Balancing their personal and professional lives also proved challenging for some residents. Twenty-five percent said that balance was somewhat or much better than they had expected, 32 percent said it was somewhat or much worse than anticipated, and 43 percent said it was about what they expected.

In a related question, 19 percent of residents said they had enough time to pursue a satisfying social life, but 49 percent said they did just some of the time, and 33 percent responded that they rarely or never did.

Significantly, 69 percent of residents said they had experienced failed personal relationships because of those time constraints.

Residents responded to several suggestions for avoiding burnout at work, including

  • a manageable work schedule or call hours (which 64 percent said would help),
  • sufficient compensation to avoid financial stress related to paying off debt and purchasing a home (41 percent),
  • reasonable patient loads (40 percent),
  • a flexible schedule (38 percent),
  • positive colleague attitudes (38 percent),
  • adequate support staff (34 percent),
  • sufficient paid vacation time (27 percent), and
  • educational and professional growth opportunities (12 percent).

Lastly, residents were not shy about sharing how they relieve stress. Write-in answers included these: have sex, pray, sleep, read, travel, spend time with their dog, indulge in food and drink, play with their child, hike, and run.

Additional Highlights

The 2018 survey showed that nearly half of all respondents, 49 percent, said they sometimes harbor doubts about whether they are a good doctor. Nineteen percent said they feel that way always or most of the time, and 32 percent said they rarely or never feel that doubt.

When it came to identifying the most rewarding part of their jobs, residents in years one to four responded in a number of ways that included

  • gaining clinical knowledge and experience (76 percent),
  • recognizing gratitude of and relationships with patients (69 percent),
  • being very good at their job (68 percent),
  • cultivating relationships with other residents (64 percent),
  • being proud to be a doctor (56 percent),
  • making the world a better place (46 percent) and
  • having the potential to make good money as a doctor (38 percent).

When it comes time to look for that first job, 75 percent of residents said the first thing they'd look at was work schedule and call hours. Salary and compensation came in second at 66 percent, followed by a supportive organizational and practice environment at 49 percent.

Residents also shared some thoughts on which facets of residency took them by surprise. Responses included "Working alone in high-stakes situations," "You can significantly affect patient outcomes," "The sense of isolation at times," "Patient relationships, cultural experiences," and "How much your body adapts to stress."

Methods, Demographics

The 2018 report represents a collection of responses from 1,916 residents training in more than two dozen medical specialty fields in the United States. The online survey, conducted April 6-23, took about 10 minutes to complete.

Of the respondents, 61 percent were men and 39 percent were women. Fifty-five percent of respondents were ages 30-34; 31 percent were ages 25-29; and 14 percent were between 35 and 49.

A whopping 71 percent of residents said they worked in a hospital setting. Other work settings were academic, research, military or government (13 percent); health care organization (7 percent); outpatient clinic (4 percent); office-based single-specialty group practice (2 percent); and office-based multispecialty group practice (1 percent). Two percent of respondents chose "Other."

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