Emergency medicine residents' perspectives on the professional and psychological impacts of training at an urban level 1 trauma center

Medical residency is a period in the professionalization of a physician defined by increasing clinical responsibility and intense emotional demands. While these psychological and emotional stressors are relevant to all specialties, the training of Emergency Medicine (EM) residency presents a uniquely demanding process due to the chaotic environment of the emergency department, but a paucity of research on this topic exists. This thesis presents findings from 10 semi-structured interviews exploring the psychological and professional experiences of Emergency Medicine residents training in a high-volume, safety-net hospital. Analysis identified four thematic areas: the emotional experience of residency, coping strategies and how the ED environment shaped them, structural constraints on training and well-being, and views on institutional support and ideal interventions. Key findings included universal resonance with the definitions of Compassion Fatigue and Secondary Traumatic Stress, co-residents being seen as the most beneficial source of support, and wellness resources being known to exist by all but used by few. Resident well-being in training environments is an ethical concern with direct implications for the quality and equity of care delivered to vulnerable patient populations, and that meaningful support requires infrastructure designed to reach residents rather than waiting for residents to reach for it.