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

Law, Marcus MD, MBA, MEd; Lam, Michelle MD; Wu, Diana MD; Veinot, Paula MHSc; Mylopoulos, Maria PhD

doi: 10.1097/ACM.0000000000001711
Research Reports
AM Rounds Blog Post

Purpose 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.

Method 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.

Results 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be influenced by their evolving professional identity: Although personal relationships were important, being a doctor superseded them.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.

Conclusions 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.

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.

An AM Rounds blog post on this article is available at academicmedicineblog.org.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: This project received ethics approval from the University of Toronto Research Ethics Board (protocol reference no. 27575).

Previous presentations: Portions of this study were presented at the Canadian Conference on Medical Education (CCME), Vancouver, British Columbia, Canada, April 2015, and the International Conference on Residency Education, Ottawa, Ontario, Canada, September 2013.

Correspondence should be addressed to Marcus Law, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 3157, Toronto, ON M5S 1A8, Canada; telephone: (416) 978-4543; e-mail: marcus.law@utoronto.ca; Twitter: @lawmarcus.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

© 2017 by the Association of American Medical Colleges