困難に直面する研修医と解決策の手がかり：医科教員の視点からの質的研究

During postgraduate medical education (PGME), individuals face both internal and external professional difficulties. This study examines the difficulties faced by medical residents, their consequences, and their coping strategies from the perspective of medical teachers. This phenomenological study, conducted during the 2024 to 2025 academic year, included 10 medical teachers (3 from Basic Sciences, 3 from Surgical Sciences, and 4 from Internal Sciences) from 3 medical faculties. Purposeful sampling with maximum variation was used to ensure diversity. Data were collected through semi-structured interviews were analyzed thematically. From the perspective of medical teachers, the difficulties encountered by residents during PGME were grouped into 7 themes: "curriculum," "medical teachers," "learners," "health system," "culture/climate," "specialization area," and "time/period." Intergenerational differences influenced perceptions of education and coping strategies, adding another dimension to the conceptualization of challenges. The consequences of these difficulties were identified as feelings of inadequacy and deterioration in well-being. Coping strategies primarily included individual efforts and external support. The study highlights that residents' difficulties arise from the complex interaction of educational, cultural, and systemic factors that shape PGME environments. While teachers often recognize these difficulties, they tend to frame them through personal or generational comparisons, reflecting limited pedagogical reflection. Sustainable improvement requires shifting from an individual resilience model to a relational and system-oriented approach that emphasizes empathy, reflective supervision, and psychological safety. Faculty development programs focused on mentoring, feedback literacy, and cultural awareness, together with institutional policies that balance service and education, are essential to foster humane, learning-centered environments. Such integrative strategies can enhance residents' well-being, strengthen teacher-learner relationships, and contribute to the long-term sustainability of PGME.