Residency Wellness: A Historical Narrative Review.

Area of Science:

• Medical Education
• Public Health
• Healthcare Systems

Background:

• Medical residency training in the U.S. has undergone significant evolution alongside medical advancements.
• These changes, while enhancing training, have introduced challenges impacting resident wellness.
• Resident well-being is paramount for quality patient care and the overall healthcare system.

Purpose of the Study:

• To provide a historical overview of medical residency training in the U.S.
• To examine the evolution of resident wellness and associated challenges.
• To synthesize current understanding of factors affecting resident well-being.

Main Methods:

• A narrative review methodology was employed.
• An exhaustive literature search was conducted across major academic databases (PubMed, Web of Science, Google Scholar) on January 25, 2024.
• Relevant articles were selected and synthesized thematically.

Main Results:

• The review identified 57 relevant publications detailing the transition from apprenticeship to formalized residency programs.
• Key developments include the Flexner Report's impact, the rise of modern programs, and the increasing recognition of burnout.
• Policy shifts, technological integration, and the COVID-19 pandemic have further influenced residency training and resident wellness.

Conclusions:

• Residency burnout has been a persistent and growing concern since the 1970s, intensified by modern medical and technological advancements and global events.
• Despite increased awareness, effective interventions to combat burnout and promote resident wellness are still needed.
• Further research is essential to develop adaptive strategies and interventions tailored to the evolving needs of residents.