Wellness Initiatives in Integrated Plastic and Reconstructive Surgery Residency Programs

Background: Recent surveys suggest 60% of plastic surgery (PRS) residents experience burnout. While some PRS residency programs have developed wellness programs to combat this, little is known about their structure and content. We sought to describe these residency wellness initiatives. Methods: An anonymous Qualtrics survey was sent to 88 integrated PRS programs. Respondents were program directors, associate program directors, and wellness officers. The survey focused on wellness content, program structure, funding, and resident support. Results: Twenty-two (25%) programs responded. Fourteen (64%) had a formal wellness program. Most programs were led by a faculty wellness officer (27%) or program director (18%). Six (43%) programs were funded with an average annual budget of $2,525. Common funding sources were the PRS division/department (36%) and graduate medical education office (27%). Most respondents (96%) had wellness lectures during the prior year. Popular content was general wellness (59%), resilience (55%), and work life balance (50%). Speakers included institutional faculty (57%), guest faculty (52%), and wellness experts (52%). Financial support for residents most often included educational conferences (95%), loupes (86%), and oral presentations at research conferences (64%). Most programs host a resident appreciation day (77%) and have mechanisms in place for formal positive feedback (73%). Fewer have a formal mentorship program (64%) and engage their alumni in a formal manner (55%) (Figure 1). All programs reported having a process to formally address resident safety concerns and most (86%) reported mechanisms to easily address work hour violations. While few programs allow residents to take vacation anytime (41%), most allot additional time off around the holidays (91%). Only some residencies (36%) formally screen for burnout (Figure 2). In support for resident personal life, most programs have clear parental leave policies (86%) and access to pump rooms (68%). Fair fewer programs (32%) make call accommodations for pregnant residents or have on-site daycare (18%). About 1/3 (36%) of programs offer couples counseling, and 18% offer some form of support for residents' partners and family (Figure 3). Conclusion: Some PRS residencies have introduced a formal wellness program, though few have significant funding. Despite not having a formal wellness program, many residencies offer initiatives that support wellness. These initiatives help build community, career development, and resident autonomy. The most common content offered are wellness lectures and resident appreciation days. Few programs are able offer personal support such as access to daycare or call accommodations for pregnant residents. It is encouraging to see wellness initiatives being formalized at an increasing number of programs, but additional support may be needed for these to be successful.