Medical Resident Wellness

Are physician residency’s arduous demands a relationship killer?

Brendan Murphy , Senior News Writer

Despite the heavy demands of graduate medical education, most neurosurgical residents’ significant others report high satisfaction with their relationships, according to the findings of a survey that allowed them to reflect on their experiences. 

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The findings do indicate, however, that most partners were dissatisfied with the level of work-life balance in their resident significant other’s career and reported that their physician partners showed signs of professional burnout.  

The study published in the Journal of Neurosurgery consisted of responses from 93 resident partners across 12 neurosurgical residency programs. More than eight in 10 respondents reported that they were satisfied with their relationships. Among the group that reported relationship dissatisfaction—16% of respondents—frustrations with work-life balance were more common, as was the likelihood of reporting a partner as having higher levels of burnout.

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Survey responses highlighted the demands of neurosurgical residency from a partner’s perspective. Over 80% of respondents said their partner regularly worked more than 80 hours per week. A majority said their partner took two or three days of call per week. 

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Illustration of resident looking at a diagnostic image

Those demands, and the fact that neurosurgery residents train for seven years, mean that survey respondents were assessing partnership with a physician in one of the most grueling specialty training programs.

Nevertheless, the findings are likely to be representative of the experiences of partners to resident physicians training in other specialties, said William Joseph Ares, MD, the study’s lead author.

“I’ve never met a resident who said, ‘I wish I was working more,’” said Dr. Ares, a neurosurgeon at NorthShore University HealthSystem in suburban Chicago. “They are not spending as much time as they want with their family.”

The study asked partners to answer the questions from the Maslach Burnout Inventory. In response to those queries, respondent data indicated that they perceived their resident partners were in the moderate or severe range of burnout in at least one of the three Maslach Burnout Inventory subscales—personal achievement, depersonalization and emotional exhaustion.

Those responses from significant others may provide a more revealing view of the realities on the ground, Dr. Ares said.

While many papers published in the research literature have found “that burnout wasn’t that bad in neurosurgery,” the picture changes when it is residents’ significant others who are weighing in.

“That’s what we found,” Dr. Ares said. “Partners were willing to point out that people were pretty burnt out and affected by the life in residency.”

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For generations, physicians have had a divorce rate higher than the national average, but among survey respondents there was very low interest in divorce. In identifying possible drivers for high relationship satisfaction, the study’s authors cited the value of support systems.

About one-third of respondents said that their partner’s residency program had some sort of institutional wellness program in which they could participate along with their resident physician significant other. Meanwhile, 22% were given the opportunity to participate in a partner-support system organized by the residency program. Two-thirds, however, said that they were active in some sort of informal partner-support network, one typically organized by their resident significant other.

Dr. Ares—who began dating and married his wife during his neurosurgical residency in Pittsburgh—said those activities and relationships can go a long way.

“As a resident, one of the things I found compelling was when there was a new partner of a resident, it was always open arms,” he said. “For the most part, spouses were very open and would say, ‘Hey, listen, this is not easy, but we’re all in this together and we come out on the other side.’

“You would walk into a room and see a spouse of a PGY-7 sitting with the spouse of a PGY-1,” Dr. Ares added. “That support system for us continues to exist well into our professional life. … It was vital for everyone to have healthy relationships and healthy professional lives.”