The aim of the study was to (1) assess differences in how male and female general surgery
residents utilize duty-hour regulations and experience aspects of burnout
and psychological well-being
, and (2) to explore reasons why these differing experiences exist.
There may be differences in how women and men enter, experience, and leave residency programs.
A total of 7395 residents completed a survey (response rate = 99%). Logistic regression models were developed to examine the association between gender
and resident outcomes. Semistructured interviews were conducted with 42 faculty and 56 residents. Transcripts were analyzed thematically using a constant comparative approach.
Female residents reported more frequently staying in the hospital >28 hours or working >80 hours in a week (≥3 times in a month, P
< 0.001) and more frequently feeling fatigued and burned out from their work (P
< 0.001), but less frequently “treating patients as impersonal objects” or “not caring what happens” to them (P
< 0.001). Women reported more often having experienced many aspects of poor psychological well-being
such as feeling unhappy and depressed or thinking of themselves as worthless (P
< 0.01). In adjusted analyses, associations remained significant. Themes identified in the qualitative analysis as possible contributory factors to gender
differences include a lack of female mentorship/leadership, dual-role responsibilities, gender
blindness, and differing pressures and approaches to patient care.
Female residents report working more, experiencing certain aspects of burnout
more frequently, and having poorer psychological well-being
. Qualitative themes provide insights into possible cultural and programmatic shifts to address the concerns for female residents.