2022 residency report: How happy are today's young physicians?
Key Takeaways
Medscape’s 2022 survey of residents reveals the state of residents’ well-being in 2022.
Results indicate that residents' experiences are about the same as, or slightly better than, in previous years.
Doctors from all age groups can review the findings to understand how residency is changing.
Residency in 2022 was a trial for many physician trainees because of the COVID-19 pandemic. But overall, residents’ experiences appear to be consistent with previous years, or improving.
That’s according to Medscape’s 2022 Residents Lifestyle & Happiness Report, which queried 1,376 US medical residents about work-life balance, relationships, and training during the COVID-19 pandemic. Their answers shed light on the ordeal of residency and the toll that it takes on young physicians.
Maintaining a social life
Do residents have few opportunities for extracurriculars? According to the report,[] 64% of residents indicated that they had time for a social life, at least sometimes. Among the respondents, 15% indicated that they were social most of the time, and 2% said they were always social. Medscape commented that the 2022 report was about level with data from 2021.
On the other end of the spectrum, 36% of residents said they rarely or never had time for a social life.
For 66% of this group, a lackluster social life caused relationships to fail. Fortunately, the results here showed some improvement over 2021, when 70% of residents indicated that their lack of a social life claimed a relationship.
Expectations vs reality
Like any ordeal, residency may require a bit of expectation management. And many residents in the Medscape survey indicated that the reality of residency was about the same as or better than they expected, in terms of work-life balance.
Overall, 61% of residents said that work-life balance was neither better nor worse, somewhat better, or much better than they expected. Thirty-nine percent said it was somewhat worse or much worse.
Further analysis revealed an interesting divide along gender lines: 44% of female residents, compared with 35% of male residents, said that their work-life balance was somewhat or much worse than they anticipated.
Regardless of expectations, 31% of residents said work-life balance was the biggest challenge they faced, followed by time pressures and demands on time (20%).
Self-care
Seasoned physicians know that surviving residency requires time to destress and decompress. According to the Medscape report, 75% of residents took this to heart and made self-care a priority at least sometimes. Interestingly, male residents indicated that they devoted time to self care at least sometimes in greater numbers than female residents: 77% compared with 72%.
This appears to be a positive development, when compared with a study published in 2020 in the Journal of the American College of Surgeons.[] Although that study included a smaller sample group (299) and focused only on residents in New England, it did reveal some illuminating insights.
A third of residents indicated that they had no self-care routine. This group was also less inclined to take advantage of preventative health services.
Additionally, 38% of residents who took a daily prescription did not have a self-care routine. Finally, about 66% of residents indicated that they had symptoms of depression, but these same residents were less likely to be receiving mental health care than residents without depression symptoms.
Comparing these two analyses, perhaps residents are now taking self-care a bit more seriously than they were in 2020.
Generational divide
Of course, the notion of self-care only recently became a part of the popular lexicon. The concept may have been foreign to senior attendings when they were residents.
Things were undeniably different for previous generations of residents. For one, the Step 1 exam is now pass-fail.[] And as of 2003, the Accreditation Council for Graduate Medical Education (ACGME) codified limits on duty hours for residents, capping them at 80 hours per week, averaged out over 4 weeks. The ACGME also now requires 10 hours of rest separating duty periods and places a 24-hour cap on continuous duty, among other stipulations.
Despite these changes, 40% of residents surveyed by Medscape said that residency was just as difficult as it was for their predecessors. Moreover, 45% said it was harder.
Regardless of work-hour differences, at least one study indicates that the work-hour reforms did not affect medical care across several domains. The study, published in 2019 in the BMJ, analyzed whether 30-day mortality, 30-day readmissions, and inpatient spending for Medicare beneficiaries changed after work-hour reforms took effect in 2003.[]
Researchers compared residents who concluded residency after 2006 with residents who wrapped up prior to 2006. Senior internists who did not experience the reforms during residency were the controls.
Across all three domains, the reforms were not associated with significant changes, when comparing data from before and after 2003.
The researchers provided one important caveat, however:
“Because hospital care is often the product of teamwork, the impact of any single physician in influencing patient outcomes and costs of care is muted by the effect of the team.”
Some positive notes
Despite the fact that residency has its undeniable challenges, the Medscape report does contain a number of bright spots. For example, nearly 80% of residents said that safety has improved when treating patients with COVID-19. And, 71% of residents said that the COVID-19 pandemic did not make them reconsider their decision to enter medicine. For 85%, the pandemic also did not make them reconsider their choice of specialty.
This is good news, as the US faces an ongoing physician shortage. Meeting future demand will require happy, healthy residents. And if the Medscape report is any indication, things appear to have stabilized, or to be trending in a positive direction.
What this means for you
Overall, while residency is undeniably challenging, the Medscape data seem to suggest that it hasn’t gotten any worse, and in fact may have improved for physicians-in-training.