The chipping away of a resident's resiliency

Residents have many lines of accountability.  First, their employer (and that may vary by time of day, building, and rotation) has high expectations of the volume and quality of patient care that they will provide.  Second, their program has high expectations for their training, education, and development of competencies.  Finally, their family has high expectations of whatever time is left over after meeting these other demands.  

I didn't mention the self. On purpose.  Most residents, particularly first year residents, rapidly sacrifice their personal life in hopes the sacrifice will be time limited and well worth the cost. 

So what is the price of meeting all of these demands? In a study of american family medicine residents it seems very high.

A group of family physicians published a study of 168 first year family practice residents in the USA, reporting that they all started their training in pretty good emotional and physical shape.  However, as the year progressed, 23% met criteria for depression, 14% met criteria for high emotional burnout, and 24% demonstrated relevant symptoms of depersonalization.  

Depersonalization also emerged as a relevant risk factor for use of medication for sleep, mood, and anxiety amongst residents, and this risk was higher if the resident was female.

And using alcohol to cope?  The higher the use of alcohol the more severe the levels of perceived stress, symptoms of burnout and feelings of depression.  So much for thinking a few extra mixer parties would take the edge off...

The authors recommended that restful sleep and exercise were associated with more positive well being in residents, so efforts looking at resident duty hours are important as are principles of promoting healthy weight, nutrition, and fitness amongst trainees.

How does your program help new residents stay well?  On July 1, 2014 Canada will welcome several thousand new first year residents.  Wouldn't it be great if we could help ensure 24% of them do not become depressed or depersonalized?