• Neda Ratanawongsa, Scott M Wright, and Joseph A Carrese.
• Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. neda@jhmi.edu
• Med Educ. 2007 Mar 1;41(3):273-80.

ContextPrevious quantitative studies about doctor well-being have focused primarily on negative well-being, such as burnout. We conducted this study to understand residents' perspectives on well-being.MethodsWe conducted 45-minute interviews with residents from 9 residencies at 2 academic hospitals in Baltimore, Maryland. From February to June 2005, we approached 49 residents through random sampling stratified by programme and gender. The semi-structured instrument elicited descriptions of well-being in residency and factors related to its promotion or reduction. Using an editing analysis style, investigators independently coded transcripts, agreeing on the coding template and its application.ResultsThe 26 participating residents came from internal medicine (3 programmes), psychiatry, surgery, emergency medicine, anaesthesia, obstetrics and gynaecology, and paediatrics. Six themes emerged: balance among multiple domains; professional development and temporary imbalance; professional satisfaction and accomplishment; maintaining a sense of self; stressors and coping strategies, and the role of residency programmes. Residents described well-being as a balance among multiple domains, including professional development, relationships, and physical and mental health. They viewed residency as a time for temporary imbalance, during which they invested in professional development at the expense of other domains. Some residents described feeling a 'loss of self'. Residents revealed strategies for coping with stressors and endorsed ways in which training programmes helped to enhance their well-being.ConclusionsResident well-being was closely connected to professional development and required varying degrees of self-sacrifice with a re-balancing of personal priorities. These findings should be considered by training programmes that are interested in enhancing resident well-being.

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