Identifying Sources of Stress Across Years of General Surgery Residency

Stressors during surgical residency training are common and can contribute to impaired technical performance, medical errors, health problems, physician burnout, and career turnover. This survey of general surgery recent graduates and chief residents examined threats to resident health and well-being. An electronic survey composed of multiple-choice, checkbox, dropdown, and open-ended questions was developed to determine the most stressful general surgery residency year, sources of the stress, and potential interventions to manage resident well-being. The survey was sent to five program directors across the United States to be forwarded to chief residents and recent graduates less than five years from graduation. Twenty-three residents and recent graduates responded to the survey. Seventy percent reported they "never" got enough sleep, and 39% reported they did not have a healthy lifestyle. Financial concerns were the most frequently cited source of stress. During post-graduate-years (PGY) 1 and 2, residents were most likely to fear hurting a patient or being "in over their head." In PGY-3, residents were most likely to consider leaving the residency program. The current findings suggest that each year of general surgery residency is linked with certain stressors, and no year is particularly stressful relative to the other years. There can be more research and efforts to focus on additional PGY-specific training and supervision, as well as added general measures to promote resident health and financial stability throughout all years. Regarding stress mitigation, residents may benefit from faculty, peer, and community interaction rather than from formal professional counseling.