Changes in Resident Well-Being at One Institution Across a Decade of Progressive Work Hours Limitations

• Published in: Academic medicine Vol. 92; no. 10; pp. 1480 - 1484
• Main Authors: Krug, Michael F., Golob, Anna L., Wander, Pandora L., Wipf, Joyce E.
• Format: Journal Article
• Language: English
• Published: United States by the Association of American Medical Colleges 01-10-2017
• Subjects: Adult; Burnout, Professional; Chi-Square Distribution; Female; Humans; Internal Medicine - education; Internship and Residency; Male; Medical Staff, Hospital - psychology; Personnel Staffing and Scheduling - legislation & jurisprudence; Surveys and Questionnaires; Washington; Work Schedule Tolerance - psychology; Workload - psychology; Young Adult
• ISSN: 1040-2446; 1938-808X
• DOI: 10.1097/ACM.0000000000001675

PURPOSETo measure changes in markers of resident well-being over time as progressive work hours limitations (WHLs) were enforced, and to investigate resident perceptions of the 2011 WHLs.
METHODA survey study of internal medicine residents was conducted at the University of Washington’s multihospital residency program in 2012. The survey included validated well-being questionsthe Maslach Burnout Inventory, the two-question PRIME-MD depression screen, and career satisfaction questions. Chi-square tests were used to compare 2012 well-being questionnaire responses against nearly identical surveys conducted in 2001 and 2004 at the same institution. In addition, residents were asked to rate the impact of WHLs on resident well-being and education as well as patient care, and to state preferences for future WHLs.
RESULTSSignificantly different proportions of residents met burnout criteria across time, with fewer meeting criteria in 2012 than in 2001 (200176% [87/115]; 200464% [75/118]; 201261% [68/112]; P = .039). Depression screening results also differed across time, with fewer screening positive in 2012 than in 2004 (200145% [52/115]; 200455% [65/118]; 2012 [35/112]31%; P = .001). Residents, especially seniors, reported perceived negative impacts of WHLs on their well-being, education, and patient care. Most senior residents favored reverting to the pre-July 2011 system of WHLs. Interns were more divided.
CONCLUSIONSValidated measures of resident well-being changed across the three time points measured. Residents had the lowest rates of burnout and depression in 2012. Resident perceptions of the 2011 WHLs, however, were generally negative.