Mental Health Experiences, Resources, and Challenges in Post-Graduate Medical Education: A Case Study of Resident Physicians in Ontario

Abstract

Physician health is a growing issue, garnering recognition by virtue and for potential negative impact on patient care. The state of physician mental health is troubling with above average prevalence of burnout, depression, and suicidal ideation across career stages. Well-being in resident physicians requires special consideration, given their dual role as trainees and physicians.

The objectives of this study were to: (1) elucidate the mental health experiences of Ontario resident physicians, characterizing help-seeking behaviours in relation to awareness and utilization of available local and provincial services; and (2) generate knowledge that guides the development of resident-focused mental health services, informing wellness directives at the educational and organizational levels.

A provincially focused study included an environmental scan of physician health programs and services at six postgraduate faculties of medicine, as well as in-depth, experiential interviews with residents on key trends across different residency contexts, the specific circumstances facing Ontario residents, their help-seeking behaviours, and experiences with physician health services. A total of 40 interviews were conducted with resident physicians across the province of Ontario, from which a subset of 12 was selected for in-depth analysis.

This study found that resident physicians in Ontario were aware of resources for supporting their mental health but there were a number of challenges to seeking support. Barriers such as time, confidentiality, helpfulness, and impact on professional development and career trajectory were cited by participants. Factors that facilitated the use of resources included the accessibility and mode of delivery of services.

This research offers insight towards the development and dissemination of resident-specific services and wellness resources. Furthermore, the findings of this study inform strategies and interventions to improve physician well-being through medical education in the postgraduate setting in addition to health and wellness directives at the organizational level.