Factors Affecting General Surgery Intern Wellness: A Qualitative Study

Abstract

Background:
Surgical training is demanding and presents numerous challenges to new interns including long working hours that can threaten their well-being. The factors affecting their well-being as reported by interns themselves, are however, poorly understood. This qualitative study aimed to determine the factors contributing to the wellness of general surgery interns, and identify potential areas that could benefit from intervention and policy reform.

Methods:
A comprehensive scoping review of the literature on resident wellness was initially performed, using "resident" and "wellness" as search criteria on PubMed, and encompassing articles published from 2013 onward. The results of this review were used for the development of an interview guide for in-person focus groups. General surgery interns at Indiana University participated in focus groups that were recorded and transcribed. Two coders coded the transcript independently to develop a code book. Thematic analysis was conducted using a constructivist grounded theory methodology to determine emergent themes.

Results:
Ten surgical interns participated in the focus groups. Qualitative analysis revealed five predominant themes that impact intern wellness: Lack of respect, inadequate facilities and resources, lack of fulfillment, work overload, and poor communication.

Conclusions:
The themes identified reveal numerous factors that impact intern wellness beyond working hours and pay and provide targets for interventions that can address them. Our results suggest that “one-size fits all” wellness solutions are unlikely to address the specific challenges faced by surgical trainees; multifaceted interventions are required to enhance intern well-being. Future research should focus on the development and implementation of targeted strategies to address these identified issues.