Wellness Initiatives During Orthopaedic Surgery Residency: A Survey of Residents and Program Directors

Area of Science:

• Medical Education
• Physician Well-being
• Orthopaedic Surgery

Background:

• The Accreditation Council of Graduate Medical Education (ACGME) revised program requirements in 2017 to enhance physician well-being.
• Limited guidance exists for implementing wellness curricula and understanding resident preferences.
• This study addresses the need to explore perspectives on wellness strategies and implementation barriers in orthopaedic surgery residency programs.

Purpose of the Study:

• To explore orthopaedic surgery residents' and program directors' (PDs) perspectives on wellness strategies.
• To identify barriers to implementing wellness programs in residency.
• To understand resident and PD preferences for wellness initiatives.

Main Methods:

• A 12-question online survey was distributed to 16 PDs and 197 orthopaedic surgery residents between January and March 2023.
• The survey assessed counseling access, confidentiality, program emphasis on wellness, hindrances, and potential improvements using a 5-point Likert scale.
• Descriptive statistics and free-response answers were used to analyze the data.

Main Results:

• While all PDs reported training residents on counseling access, 26% of residents were unaware; confidentiality was a concern for 60% of residents but assured by 93% of PDs.
• PDs rated wellness emphasis higher (88%) than residents (69%); both groups found social activities helpful and supported wellness days, though resident-reported impact was mixed.
• Residents cited lack of time (59%) and program attitudes (39%) as major hindrances, while PDs noted uninteresting programming and time constraints.

Conclusions:

• Improving resident wellness necessitates clear communication, a supportive culture, and incorporating resident input through schedule adjustments or protected time.
• PDs must ensure residents are aware of and trust available counseling and confidentiality.
• While wellness days are favored, their effectiveness varies, indicating a complex but crucial need to prioritize resident well-being in orthopaedic surgery.