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J Gen Intern Med. 2018 May;33(5):705-709. doi: 10.1007/s11606-018-4367-0. Epub 2018 Mar 5.

Resident Preferences for Program Director Role in Wellness Management.

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University of South Carolina Greenville, Greenville, SC, USA.
Combined Internal Medicine and Pediatrics Residency, Greenville Health System/USC SOM Greenville, Greenville, SC, USA.
University of Kentucky Markey Cancer Center, Lexington, KY, USA.
Quality Management Department, Greenville Health System, Greenville, SC, USA.



Burnout and depression are prevalent among resident physicians, though the supportive role of the program director (PD) is not well defined.


To understand the residents' view of the residency program director's role in assessing and promoting resident wellness.


A single institution survey of all house staff was conducted in 2017. Rates of burnout and depression were identified via the 2-item Maslach Burnout Inventory (MBI) and the Patient Health Questionaire-2 (PHQ-2), respectively. Residents then qualified their preferences for various assistance services and for the role of their program directors in assisting them.


One-hundred sixty-one of 202 (79.7%) residents completed the survey. The rate of depression was 28%. Rates of emotional exhaustion and depersonalization (2-item MBI) were 44 and 62%, respectively. Only 4% of respondents had used the Employee Assistance Program (EAP) in the prior 12 months. Eighty-two percent of residents were in favor of PDs inquiring about wellness regardless of their job performance and only 1% of residents stated the PD should not inquire about wellness at all. Thirty-three percent of residents reported that they would be likely to contact EAP on their own if they felt unwell. Significantly more residents (62%) reported being more likely to contact EAP if recommended by their PD (33 vs 62%, p < 0.001%). Important perceived barriers to seeking assistance were lack of time (65%), lack of knowledge of how to contact EAP (41%), and concerns about appearing weak (35%).


Despite a high prevalence of burnout and depression, residents are unlikely to seek help on their own. Program directors have an important role in assessing and promoting the wellness of their residents. The majority of residents wants their PD to inquire about wellness and may be more likely to seek and receive help if recommended and facilitated by their PD.


burnout; depression; physician; resident; wellness

[Available on 2019-05-01]

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