Patient Safety and Quality

Quality of care and working conditions influence job satisfaction of surgical residents

Fewer medical students are interested in surgical residencies, and up to one-fifth of residents drop out of surgical residency programs. Surgical residencies are known for their grueling hours. However, a survey of 844 surgical residents from 52 hospitals found that resident job satisfaction was intricately linked to the perception that their patients are receiving high-quality care. In fact, staff and systems that enabled residents to care for patients were more influential on job satisfaction than the teaching skills of their attending physician, duty hours, fatigue, and other issues. Attending physicians' appreciation and openness to suggestions was also correlated positively with resident satisfaction.

Residents often perceived themselves as carrying the burden for shortfalls in staffing and systems of care at hospitals, note the study authors. In the 844 returned surveys, resident job satisfaction did not correlate with age, sex, or postgraduate year. Scut work (such as expediting operating room cleanup for the next patients and putting in peripheral intravenous lines) and excessive erroneous/unnecessary paging on services diminished resident satisfaction.

Resident educators are working hard to shift the focus from residents as employees to residents as students. The study findings suggest that for this shift to occur, hospitals will need more effective/efficient systems and staffing to relieve residents of the clinical care burden. Addressing systems, staffing, and attending physician issues that diminish resident satisfaction can increase the attractiveness of surgical residencies to medical students, conclude the researchers. The study was supported by the Agency for Healthcare Research and Quality (HS12029).

More details are in "Surgery resident working conditions and job satisfaction," by Daniel L. Davenport, Ph.D., William G. Henderson, Ph.D., Shomari Hogan, M.D., and others, in the August 2008 Surgery 144, pp. 332-338.

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