Well-being in residency: Effects on relationships with patients, interactions with colleagues, performance, and motivation

Objective: Previous studies about resident well-being have focused on negative aspects of well-being. We conducted this study to explore residents' conceptions of well-being and how it affects their work. Methods: One investigator conducted semi-structured interviews with residents at two hospitals during February-June 2005. Through random sampling stratified by program and gender, we invited 49 residents from internal medicine, psychiatry, surgery, emergency medicine, anesthesia, obstetrics/gynecology, and pediatrics. Using an editing analysis style, three investigators independently coded transcripts. Results: 26 residents participated in 45-min interviews. Residents acknowledged that well-being affected four elements of their work: relationships with patients, interactions with colleagues, performance, and motivation. Residents described higher quality discussions with patients when their well-being was high and inappropriate exchanges when well-being was low. Residents attributed conflict with colleagues to lower states of well-being. Residents felt they had improved decision-making when their well-being was higher. Residents' motivation in their daily work and career varied with fluctuating well-being. Five residents initially denied that their well-being affects their work, voicing concerns that this would be unprofessional. Conclusions: Most residents felt that both high and low levels of well-being affected their work, particularly their work relationships. Practice implications: The educational and patient care goals of residency training may be enhanced through interventions that promote resident well-being.