Exploring Presenteeism in Obstetrics and Gynecology Residency

To examine the rates of and reasons for presenteeism amongst obstetrics and gynecology (OBGYN) residents and program directors (PDs).

A national survey regarding presenteeism was administered to OBGYN residents and PDs. Sociodemographic data and residency program characteristics were collected from both groups. A Z test of independent proportions was used to investigate differences in reported presenteeism between residents and PDs. Bivariate analyses were performed to examine key outcomes of interest by sociodemographic and program characteristics. Kappa coefficients were calculated to assess agreement in program culture support for resident versus attending absence when unfit for duty. Multivariable linear regression analyses were performed to examine effects of hypothesized predictors of PD job satisfaction.

A greater proportion of residents (51.3%) compared to PDs (21.2%) reported presenteeism (p < 0.001). The most common reasons reported by residents for presenteeism were concerns about forcing colleagues to cover (83.1%) and responsibility to care for patients (11.3%); while for PDs, they were responsibility to care for patients (35.6%) and residency administrative responsibilities (35.6%). In the resident survey, we found significant differences in rates of presenteeism by geographic region (p < 0.001), program type (p = 0.003), and training year (p = 0.001). We also found significant differences in program culture support for resident/attending/fellow leaves of absence when unfit for work by geographic region (p < 0.001). Lastly, we found significant differences in expectations for residents to "pay back" covered shifts during sick leave by geographic region (p < 0.001), and training year (p = 0.014). In the PD survey, we found significant differences in availability of emergency childcare by program size (p < 0.001) and program type (p = 0.003). We observed fair agreement between ratings of program culture support for resident versus attending absence when unfit for work (κ = 0.259, p <0.001). In adjusted analyses, we observed a negative effect of PD presenteeism (p = 0.044) and a positive effect of program culture support for attending absence (p = 0.007) on PD job satisfaction.

Presenteeism was reported by a greater proportion of residents compared to PDs. A supportive culture for attending absence positively correlated with PD job satisfaction, whereas PD presenteeism had a detrimental effect. These findings suggest that institutional policies and support systems may have a critical impact on mitigating presenteeism and enhancing job satisfaction within residency programs, highlighting the need for targeted interventions to foster a supportive work environment for both residents and PDs.