P. Marincola Smith1, P. N. Chotai1, J. L. Padgett1, S. K. Geevarghese1, K. P. Terhune1 1Vanderbilt University Medical Center,Department Of General Surgery,Nashville, TN, USA
Introduction:
Surgical residents are at risk of burnout, depression, and poor compliance with health guidelines. We surveyed our trainees to understand their physical and mental health, and compared answers to age-appropriate health guidelines for the population at large.
Methods:
General surgery residents at a large university-affiliated program were invited to participate in a 34-question, anonymous survey examining factors that affect physical and mental health, including self-reported work hours, compliance with age-appropriate health guidelines, and current diet and exercise habits. Validated depression (PHQ9) and fatigue (Epworth Sleepiness Scale, ESS) scales as well as questions on perceived barriers to health and wellness were included. Data was analyzed using chi-square and Mann-Whitney U tests with SPSS software.
Results:
Seventy-two percent of residents participated (n=55, 42% female). Most worked an average 71-80 hours per week (78%) and reported an average of 5 hours of sleep or more per night (75%). Most had at least three hours of leisure time (76.5%) or physical activity (42%), and up to one hour for religious activities (73%) or community activities (80%), per week. Lack of time was the most common (94.5%) barrier to more physical activity. Compliance with recommended primary care physician (PCP), dentist and vision visits was 25%, 23.5% and 42%, respectively. Those who saw their PCP in the last year were more satisfied with their health (p=0.049). Among female residents, 78% complied with cervical cancer screening recommendations. The majority (80%) of residents felt they did not focus enough on health. Barriers to health maintenance visits were time (80%), schedule unpredictability (76%) and appointment availability (67%). Forty-nine percent were interested in participating in work-place wellness programs, including fitness classes(56%), massages(56%), sports teams(49%), ergonomic assessments(36%) and running programs(31%). Although most (71%) reported no mental health concerns, median PHQ9 score was 5 (“mild depression”), and 11% scored in the “moderately severe” or “severe” depression category. The median ESS was 14, corresponding to moderate excessive daytime sleepiness. ESS and PHQ9 scores were positively correlated (p≤0.0001). Male and female residents scored similarly on ESS(p=0.945) and PHQ9(p=0.056) scales. Significant differences in daytime sleepiness were noted among residents in different years of training(p=0.007). Perceived mental health problems correlated with higher scores on ESS(p=0.049) and PHQ9(p≤0.0001) scales.
Conclusion:
This single-center pilot survey identified barriers to resident wellness as well as opportunities for targeted intervention, a next intended step. Future multi-center collaborations are proposed to further promote wellness among surgical trainees. A specific target should be facilitating trainees’ abilities to meet age-appropriate health guidelines.