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

In 2017, the Accreditation Council of Graduate Medical Education revised Common Program Requirements to better address well-being in residency and fellowship programs. These requirements emphasize 'psychological, emotional, and physical well-being' for physicians. Limited guidance exists on implementing wellness curricula and understanding residents' preferences. Our study explored orthopaedic surgery residents' and program directors' (PDs) perspectives on wellness strategies and barriers to program implementation.

A 12-question survey was distributed to 23 PDs and 616 residents, addressing counseling access, confidentiality, and program emphasis on wellness. A 5-point Likert scale was utilized to evaluate wellness program hindrances, structural changes that may offer wellness improvement, and perspectives on currently implemented programming. Free-response answers collected opinions and improvement suggestions. Descriptive statistics were used to analyze the data.

Responses were collected from an online survey between January 2023 and March 2023.

Our survey included 16 PDs (70%) and 197 (32%) residents.

Although 100% of PDs reported residents were trained in counseling access, 26% of residents were unaware. Residents cited confidentiality concerns (60%), while PDs assured confidentiality (93%). Wellness emphasis was rated higher by PDs (88%) than residents (69%). Both groups found social activities with or without attendings helpful. Both residents (63%) and PDs (63%) believed wellness days could improve well-being. However, only 43% of residents with wellness days reported a significant impact compared to 57% of PDs. Although residents reported that optional and mandated wellness days would be comparably beneficial for promoting wellness (3.92/5 and 3.74/5, respectively), PDs reported lower benefit from mandated days (3.56/5 vs. 2.38/5, respectively). Residents cited lack of time (59%) and program attitudes towards mental health (39%) as major hindrances, while PDs mentioned uninteresting programming, time constraints, and lack of ideas.

Improving resident wellness requires clear communication, a wellness-emphasizing culture, resident input, and participation through schedule adjustments or protected time. PDs should ensure residents understand counseling access and confidentiality. While both groups favor wellness days, their overall impact is mixed. While wellness in orthopaedic residencies remains complex, it should be prioritized.