graduate medical education; medical education research; program director; resident wellness; survey; professional burnout; psychological burnout; psychological well-being


Medical Education | Social and Behavioral Sciences



This study evaluated wellness programs in a large hospital network to determine residency program directors’ (PDs) perspectives on their wellness programs' state, including wellness prioritization, frequency of wellness activities, and wellness’ influence on decision-making across organizational levels.


In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration’s ability to prioritize wellness, funding sources, and perceptions of resident wellness’ impact on decision-making.


Among 211 contacted programs, 148 surveys were completed (70.1%). The majority reported having wellness programs, committees, and funding. Fewer than 25% reported having a chief wellness officer. PDs perceived that fellow colleagues in their institution linked wellness to markers of institutional success to a greater extent than other available options (ie, Accreditation Council for Graduate Medical Education [ACGME] requirements, budgetary concerns, resident input, core faculty priorities, and education quality). Financial well-being was perceived as least connected to wellness. Perceptions of wellness were rated across 3 organizational levels: program, institution, and organization. Across all levels, ACGME requirements (31.0%-32.8%) and budgetary/financial concerns (21.9%-37.0%) were perceived as having the most significant influence on overall decision-making, whereas resident wellness was rated lower in influence (8.0%-12.2%). Most programs allowed residents to attend mental health appointments without using paid time off (87.9%) and while on duty (83.1%).


The frequency of wellness activities varied greatly across programs. PDs reported challenges making resident self-care and personal development a priority and perceived resident wellness as having limited importance to decision-making at higher levels.