Stahl, David

BACKGROUND: Burnout remains prevalent among anesthesiology residents. Contributing workplace factors include limited control over scheduling, unpredictable hours, critical patient care needs, and other residency challenges. The Family Anesthesia Experience (FAX) is a program designed to educate residents and their support persons on wellness and residency demands. The focus of this multisite study was to evaluate the impact of FAX on first year clinical anesthesiology (CA1, ie, PGY2s) residents’ wellness. METHODS: This was a prospective evaluation study involving 15 US anesthesiology residency programs, 13 of which completed FAX. CA1 wellness was evaluated through surveys assessing perceived stress as the primary outcome, with exploratory outcomes including burnout, depression, psychological wellness, and social support. Additionally, changes in support persons’ understanding and knowledge of residency demands were tracked over time. The study included a historical control group of 302 CA1s (2019-2021) who did not participate in FAX, and an intervention group of 88 CA1s that participated in FAX (2021-2022). Statistical analyses compared changes in metrics between groups using linear mixed models and generalized linear models. RESULTS: Significant reductions in perceived stress were observed in the intervention group at 6 months post-FAX (mean change = –2.14, 95% CI, –3.95 to –0.34; P = .021, effect size = 0.58) relative to the control group, but there was no sustained difference at 12 months. Compared to the control support persons, intervention support persons reported increased understanding of residency demands, with significant improvements at 6 (mean change = 2.80, 95% CI, 1.12–4.48; P = .001, effect size = 0.77) and 12 (mean change = 2.59, 95% CI, 0.12–5.05; P = .039, effect size = 0.71) months. Improvement in support persons’ understanding did not predict changes in CA1 wellness outcomes. First generation physician residents reported lower family support at baseline but showed significant improvements in family support at 6 months (mean change = 3.05 points; 95% CI, 0.25–5.84; P = .033; effect size = 1.23) compared to their non first generation peers. CONCLUSIONS: FAX participation was associated with reduced perceived stress in residents up to 6 months post-intervention. First generation physicians experienced greater improvements in perceived family support compared to their non first generation peers. Our findings suggest that resident wellness may be enhanced by engaging both residents and their support persons in an educational wellness program that outlines the professional expectations and demands of anesthesiology residency training.

BACKGROUND: Recent years have seen considerable growth and significant changes in the anesthesiology residency application process. Although the National Residency Match Program provides data on attributes of successfully matching applicants, it does not provide detailed characteristics of applicants’ research portfolio. This single-program retrospective analysis aims to characterize granular aspects of applicant research experiences to determine whether research involvement is linked to higher odds of matching. METHODS: Applications from interviewed United States allopathic (US-MD) and osteopathic (US-DO) applicants at a single anesthesiology residency program were analyzed for research experience. The primary outcome assessed was the association of any research experience with odds of ranked-to-match and the association of specific types of research experience with ranked-to-match. Secondary outcomes included the association of medical degree type (US-MD vs US-DO) or affiliation of medical school with an anesthesiology residency program to the number of research experiences, and the association of research experiences with the United States Medical Licensing Examination (USMLE) Step 1 score type (Pass/Fail vs Scored). RESULTS: Applicants with at least one research experience were more likely to be ranked-to-match than applicants without research experience (odds ratio [OR]: 2.16, 95% confidence interval [CI], [1.55–3.02], P < .001). Similar odds were demonstrated for applicants with at least one peer-reviewed publication compared to no peer-reviewed publications (OR: 2.25, 95% CI, [1.79–2.82], P < .001), and at least one anesthesiology-related research experience compared to no anesthesiology-related research experience (OR: 1.76, 95% CI, [1.36–2.26], P < .001. Applicants from US-MD schools were more likely to have research experience than those from US-DO schools ( P < .001); applicants from a medical school affiliated with an anesthesiology residency were more likely to have research experience than applicants from unaffiliated medical schools ( P < .001); and applicants with Pass/Fail USMLE Step 1 examinations were more likely than their Scored counterparts to report at least one research experience ( P < .001). CONCLUSIONS: Applicant research is associated with greater odds of being ranked-to-match in anesthesiology residency. Applicants from US-MD schools and schools affiliated with anesthesiology residency programs have significantly greater rates of reporting at least one research experience. There is a trend toward a higher incidence of reporting at least one research experience with the change of USMLE Step 1 policy toward a Pass/Fail examination.