See One, Do One, Improve One's Wellness: Resident Autonomy in US General Surgery Programs, A Mixed-methods Study.

Area of Science:

• Medical Education
• Resident Wellness
• Surgical Training

Background:

• Concerns exist regarding a potential decline in resident autonomy.
• Decreased autonomy may negatively impact resident competence and well-being.

Purpose of the Study:

• To investigate factors influencing resident perceptions of autonomy.
• To analyze the relationship between resident autonomy and overall wellness.

Main Methods:

• A cross-sectional survey was administered to residents post-ABSITE (American Board of Surgery In-Training Examination).
• Qualitative data were gathered through interviews and focus groups with residents and faculty across 15 programs.

Main Results:

• Over 7,000 residents participated, with 82.2% reporting appropriate autonomy.
• Appropriate autonomy was associated with reduced burnout, suicidality, and intent to leave the program.
• Factors positively correlating with autonomy included workload satisfaction, work-life balance, faculty engagement, camaraderie, and resource availability.
• Women reported lower levels of appropriate autonomy.

Conclusions:

• Resident autonomy is not an assumed outcome of training and often requires active cultivation.
• Equitable resource allocation is crucial for supporting resident educational growth and wellness.