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Resident Stress Survey. Lija Joseph M.D. Boston University School of Medicine. Aim/Objective. Does stress exist among pathology residents? Discover the main sources of stress Residents Program Directors. Design. Approved by IRB Online Questionnaire
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Resident Stress Survey Lija Joseph M.D. Boston University School of Medicine
Aim/Objective • Does stress exist among pathology residents? • Discover the main sources of stress • Residents • Program Directors
Design • Approved by IRB • Online Questionnaire • Directed to residents via Program Directors • PRODS listserv • Question Selection • Literature review • Personal experience • final 20 questions out of a potential 100 • review from Office of Medical Education
Design • Sample questions Greatest stress Least stress • Work overload 5 4 3 2 1 • Faculty Bias 5 4 3 2 1 • Other 5 4 3 2 1 • Comment
Boston University School of Medicine Ball Memorial Hospital Cedar Sinai Medical Center Creighton University Duke University Indiana University LSUHSC-Shreveport Loyola University Medical Center Medical University of South Carolina Madigan Army Medical Center Mayo Clinic Medical College of Virginia Montefiore Medical Center/Albert Einstein College National Capital Consortium Naval Medical Center Northwestern Penn State Milton S Hershey Medical Center Scott and White Memorial Hospital St.Louis University Thomas Jefferson University Hospital Tufts-New England Medical Center Univ.of Arkansas for Medical Sciences Univ.of Alabama at Birmingham UC Davis Health System UTHSCSA UTMB-Galveston Univ.Hospital of Cleveland U-Mass Medical Center Univ.of Missouri- Columbia Univ. of North Carolina Hospital Univ.of Vermont Virginia Commonwealth University Participants
Results • 36 residency programs participated (23%) • All listed items were selected as a source of greatest stress (5) • Mean stress score (3.1-4.8) • Highest • Work Overload (4.8) and Variability in faculty expectations (4.5) • Lowest • Inattentive program co-ordinator (1.7)
Highest stressors (Residents) • Variability in faculty expectations (4.5) • Work overload (4.3) • A disorganized program (4.2) • Poor mentoring by faculty(4.2) • Faculty favoritism and bias (4.2)
Highest stressors (PRODS) • Work overload (4.8) • Variability in faculty expectations (4.6) • A disorganized program (4.5) • Inadequate supervision of residents (4.3) • Poor mentoring by faculty (4.1)
Stressors not included in questionnaire that were identified by respondents • Unprofessional faculty • “shouting” “lack of respect” “philosophy of learning by humiliation” “low priority of teaching” “Verbally abusive faculty” • Faculty stress passed on to residents • Poor support staff • Lack of autonomy • Too many conferences and presentations
Other “stressors” • Boards/RISE/Job • More of a concern for PRODS than residents • Family/Financial/Lack of fellowship opportunities • not frequent
Volunteered Comments • Residents • Excellent survey, programs should adapt the questions to address issues specific to a program • PRODS • Mostly supportive • Two disagree and state • “Stress is not "caused" by one or more extrinsic factors, but by how the individual reacts to / handles such situations.” “Look at stress management strategies”
Additional stressors identified by program directors • Poor orientation of roles and responsibilities (4.1) • Lack of a regular forum to discuss concerns (4.0) • Inadequate feedback from faculty (3.9) • Poor communication of evaluation criteria (3.8) • Insufficient support from peers (3.8)
Conclusions • Stress exists among pathology residents • PRODS are aware of major resident stressors • Work overload • Variability in faculty expectations • A disorganized program • Poor mentoring by faculty
Conclusions • Major Stressor for residents not well recognized by program directors • Faculty Favoritism/Bias
Acknowledgments • Peter Shaw Ph.D • Suzette Levinson Ph.D • John C. O’Hara B.S • Bruce Smoller M.D • Michael O’Brien M.D., M.P.H • Fred Silva M.D. • Teresa Cox M.D. • All my current and former residents