1424. Resident wellness: single institution experience in a neurosurgical residency and review of the literature

Authors: Zachary S. Hubbard, MD; Gibson Klapthor, BS; Jeffrey Wessell; Fraser Henderson Jr, MD; Alejandro Spiotta, MD (Charleston, SC)

Background: The Accreditation Council for Graduate Medical Education has six core competencies, part of which state is to equip trainees the necessary tools to maintain habits of lifelong well-being. Resident wellness is a challenge due to the high stress, emotionally isolating environment, and numerous work hours. The prevalence of burnout in neurosurgery is 56.7% overall and 36.5% in residents.

Objective: The purpose of this paper is to review the literature on resident wellness, with specific emphasis on various wellness interventions that have been employed in specialties including neurosurgery.

Methods: Two reviewers (ZH and GK) conducted a literature search in the MEDLINE, EMBASE, and Cochrane central registrar of Controlled Trial databases. All articles were published between 2000 and 2018, with English as the primary language. A combination of the following Medical Subject Headings terms were used to conduct the search: “resident,” “residency,” “wellness,” “well-being,” “intervention,” “initiative,” “program.” Two reviewers (ZH and GK) independently performed each step in the study selection process.

Results: There were over 400 manuscripts identified by the initial search. 28 manuscripts were included in the review. Seven of the studies met the criteria for resident wellness intervention. 222 resident physicians were involved in the various interventions. Statistically significant improvements were observed in “grit”, exercise, sleep, stress, anxiety, quality of life, depersonalization, sense of personal achievement. Wellness interventions did not improve rates of burnout, depression, alcohol consumption, presenteeism, or negative affect.

Conclusion: Wellness interventions have the ability to positively affect various aspects of well being. Despite the success of wellness programs, they have failed to prove significant changes in burnout or depression. Moving forward, analysis of specific aspects of wellness programs will prove useful in constructing the most efficacious wellness interventions for medical and surgical residents.