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Acad Med. 2017 Nov;92(11):1601-1606. doi: 10.1097/ACM.0000000000001711.

Changes in Personal Relationships During Residency and Their Effects on Resident Wellness: A Qualitative Study.

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M. Law is associate professor of family medicine and director of Foundations, MD Program, University of Toronto, as well as director of medical education, Michael Garron Hospital, Toronto, Ontario, Canada. M. Lam is a family physician, Hamilton, Ontario, Canada. D. Wu is a family physician, Toronto, Ontario, Canada. P. Veinot is an independent research consultant, Toronto, Ontario, Canada. M. Mylopoulos is assistant professor, Faculty of Medicine, and scientist, Wilson Centre, University of Toronto, Toronto, Ontario, Canada.



Residency poses challenges for residents' personal relationships. Research suggests residents rely on family and friends for support during their training. The authors explored the impact of residency demands on residents' personal relationships and the effects changes in those relationships could have on their wellness.


The authors used a constructivist grounded theory approach. In 2012-2014, they conducted semistructured interviews with a purposive and theoretical sample of 16 Canadian residents from various specialties and training levels. Data analysis occurred concurrently with data collection, allowing authors to use a constant comparative approach to explore emergent themes. Transcripts were coded; codes were organized into categories and then themes to develop a substantive theory.


Residents perceived their relationships to be influenced by their evolving professional identity: Although personal relationships were important, being a doctor superseded them. Participants suggested they were forced to adapt their personal relationships, which resulted in the evolution of a hierarchy of relationships that was reinforced by the work-life imbalance imposed by their training. This poor work-life balance seemed to result in relationship issues and diminish residents' wellness. Participants applied coping mechanisms to manage the conflict arising from the adaptation and protect their relationships. To minimize the effects of identity dissonance, some gravitated toward relationships with others who shared their professional identity or sought social comparison as affirmation.


Erosion of personal relationships could affect resident wellness and lead to burnout. Educators must consider how educational programs impact relationships and the subsequent effects on resident wellness.

[Indexed for MEDLINE]
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