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Residents Express Emotional, Social and Physical Stress in the Clinical Learning Environment

 Purpose: To evaluate OBGYN residents’ perceptions of personal wellness in relation to their clinical learning environment

Background: Resident wellbeing is a significant issue affecting our future physicians’ abilities to fulfill their training potential.

Methods: The Council on Resident Education in OBGYN (CREOG) administered a voluntary, anonymous, six-item wellness survey.  One question asked about personal experience with mental health problems (burnout, depression, binge drinking, eating disorders or suicide attempt) and then provided a free text response for “other” issues.  The free text responses were reviewed and analyzed.  The ACOG IRB determined this survey exempt from review.  

Results: Of 5,061 residents, 4,099 completed the question on personal issues experienced in residency (81% RR), and 200 free text responses were submitted.  1593 residents (32%) endorsed clinical depression.  34 (0.8%) wrote in anxiety, although this was not a formal category.  The free text responses clustered into three categories: physical health (n=56), social concerns (n=34), and mood symptoms (n=115).  Symptoms of clinical depression comprised 5,992 responses, combining structured questions and free text responses.  18 (0.4%) had attempted suicide, and 18 additional residents wrote in suicide ideation or attempt, translating into almost 1% of our residents having contemplated or tried self-harm, likely related to work stress.

Discussions: Significant mood disorders and self-harm are under-recognized among OBGYN residents, even as they acknowledge these symptoms.  Programs must consider formal evaluations for depression, anxiety, and suicide risk, conduct thorough culture evaluations to ensure these symptoms are not being normalized, and tailor their interventions to provide accessible, confidential support services within the clinical learning environment.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Osteopathic Faculty, Residency Director, Residency Coordinator, Professionalism, Interpersonal & Communication Skills, GME, CME, Assessment, Team-Based Learning,

General Information


Intended
Audience
Student,Resident,Faculty,Osteopathic Faculty,Residency Director,Residency Coordinator,
Competencies
Addressed
Professionalism,Interpersonal & Communication Skills,
Educational
Continuum
GME,CME,
Educational
Focus
Assessment,Team-Based Learning,
Clinical Focus

Author Information

Erica Mahany, MD, University of Michigan Medical School; Margaret Dow, MD; Abigail Winkel, MD, MHPE; James Palmer, MD, MS; Helen Morgan, MD; Mark Woodland, MS, MD

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