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Correspondence to Radha P. Kohly, PhD, Department of Ophthalmology and Vision Sciences, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M202B, Toronto, ON M4N 3M5, Canada
A recent Canadian survey found that 38.2% of resident ophthalmologists met criteria for depression or burnout and felt that there was not a culture of wellness in their training.
We assessed the wellness of faculty and trainees (residents and fellows) in the Department of Ophthalmology and Visions Sciences (DOVS) at the University of Toronto. We developed a 17-question survey modified from the Centre for Epidemiologic Studies Depression Scale and the Copenhagen Burnout Inventory.
Validity of a 12-item version of the CES-D [Centre for Epidemiological Studies Depression scale] used in the National Longitudinal Study of Children and Youth.
The survey evaluated 3 domains: working conditions, wellness culture, and mental health. Our study was designed to assess the impact of a 28-day meditation intervention on these 3 domains. However, owing to a minimal number of faculty, fellow, and postintervention survey responses, we present our analysis of the preintervention resident responses. This study was approved by the Research Ethics Board.
Results
Of the 11 residents (44%) residents who responded to the survey, 10 (90.9%) were men and 1 (9.1%) was a woman. The median hours worked per week by junior residents (9 of 11; 81.8%) was 85, whereas senior residents (2 of 11; 18.2%) reported 50 hours, including direct and indirect patient care. The majority of residents (64%) responded that most days were “a bit stressful” (3 of 5 on a Likert scale, with 5 = extremely stressful), with their greatest source of stress their “own physical health condition” (5 of 7 on a Likert scale, with 7 = extreme stress). While most residents (9 of 11; 81.8%) described their mental health as “good” or “very good,” 6 of 11 (54.5%) responded feeling burned out at least once weekly. Relationships with coresidents were described as “very collegial, not competitive” (8 of 11; 72.7%). Overall, 90.9% residents reported that they felt that the DOVS created a culture of well-being, respect, and thoughtfulness. A summary of responses from each domain can be found in Figure 1.
Fig. 1A summary of the key resident responses (n = 11) from each of the 3 domains assessed in the wellness survey.
Six residents (55%) reported emotional or mental health problems in the past year, and 2 of these residents had mental health problems “of no importance,” 2 sought professional support, and 2 did not seek help when needed. After tabulating all responses, the median Centre for Epidemiologic Studies Depression Scale score was 4 of 60, with a lower score indicating absence of depressive symptoms. Regarding meditation, 82% of residents never meditated and did not use the offered meditation application.
Discussion
The survey responses indicate a strong culture of resident wellness at the DOVS. These results differ from a Canadian survey that reported that ophthalmology residents felt the need for wellness programs.
Comments from residents in our survey included the following: “DOVS is doing an excellent job supporting me. . . . I do not think other things can be done” (Resident A) and “The [administrative assistant] is the best and really supports wellbeing. . . . The [program directors] do such a solid job of advocating for us” (Resident B). These responses indicate that a strong contributor to resident wellness may lie in the supportive culture fostered at the DOVS by faculty, administrative assistants, and peers.
Faculty and fellow responses were not analyzed owing to lower response rates. Of the 8 faculty who did reply, they indicated that above their own physical/mental health, finances, discrimination, and the pandemic, a significant source of stress was “not enough time” (median score 5 of 7 on a Likert scale with 7 = extreme stress). Five faculty members reported feeling burned out at least several times a month, and 1 faculty member did not feel that he or she could speak to other staff in confidence regarding wellness concerns. Three faculty members felt that their colleagues were “rarely” or “somewhat” considerate of their personal or family situations. Two faculty members reported that they “rarely (1),” “somewhat (1),” “mostly (2),” and “definitely (2)” felt respected within the department. The 2 faculty members who felt “definitely” respected were senior males. These results contrast with resident responses and, while preliminary, suggest that further research on faculty wellness in Canadian ophthalmology is needed.
Only 2 residents used the 5-minute meditation application. One resident commented that meditation allowed “clearer insight into myself and others.” A different resident, who previously sought mental health help, noted that it allowed him or her to be “calmer, less reactive and more balanced.” Though limited, these comments suggest that wellness interventions have the potential to be beneficial.
Footnotes and Disclosure
The authors have no proprietary or commercial interest in any materials discussed in this letter.
References
McFadden T
Simon C
Kobeissi B
Gerin-Lajoie C. Physicians’ access to primary care: results from the Canadian Medical Association National Physician Health Survey.
Validity of a 12-item version of the CES-D [Centre for Epidemiological Studies Depression scale] used in the National Longitudinal Study of Children and Youth.
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