Identifying institutional factors in general surgery resident wellness and burnout

Background Effects of the institutional macrocosm on general surgery resident wellbeing have not been well studied. We sought to identify organizational factors that impact resident wellness and burnout. Methods Using a modified Delphi technique, an open-ended survey and two subsequent iterations were distributed to wellness stakeholders at two institutions to identify and stratify institutional factors in six burnout domains. Results Response rates for each survey round were 29/106 (27%), 30/46 (65%) and 21/30 (70%). Top factors identified in each domain were: • Workload: hours (60% respondents), advanced practice providers (53%) • Control: autonomy (77%), scheduling blocks/changes (43%) • Rewards: compensation (93%), vacation (83%) • Community: peer support (66%) and mentorship programs (59%) • Fairness: budget allocation (48%), resident union (48%) • Values: mentorship program (43%), institution type (40%) Conclusion A modified Delphi technique prioritized institutional wellness and burnout factors. Top factors identified were compensation, vacation time, and autonomy. These results can direct future scholarship of barriers/facilitators of resident wellbeing.