Organisational challenges in the adaptation of medical residents to educational and professional activities

Introduction. The challenges of attracting and retaining medical personnel, as well as enhancing their working conditions and health, must be identified, minimised, and addressed promptly at the residency level, which is a crucial stage of professional medical education. Aim. The present research aimed to identify and to compare the organisational challenges faced by medical residents in adapting to educational and professional activities, based on the degree of prevalence and complexity as assessed by the residents themselves. Methodology and research methods. The study was conducted from October to November 2023 and involved over 700 first-year medical residents from Altai, Kazan, Siberian, and Tyumen State Medical Universities. The methods employed included a literature review on the research problem, the use of questionnaires, reflective writing, as well as the analysis and synthesis of results, and the ranking of the obtained numerical data. Results. It was found that nearly half of the medical residents were completely satisfied with their training based on the results from the initial months. However, almost 40% reported experiencing issues. Respondents highly valued the presence of a departmental curator (over 84%), while the presence of a clinical mentor was rated lower (approximately 61%). The clarity of instructions from a mentor received a satisfaction rating of 58%, and the frequency of meetings with curators and mentors was appreciated by 53%. In contrast, the convenience and clarity of the schedule were rated low, at only 41%. Scientific novelty. The study is significant for the advancement of medical pedagogy theory and professional medical education. Assessments by medical residents regarding both direct and indirect indicators of the quality of their training organisation during the adaptation stage were identified and ranked. It was found that medical residents exhibit low readiness to formulate recommendations and engage in discussions about the organisation of their training. Practical significance. The results obtained are highly significant for organising the training of medical residents. This includes the development of software, educational and methodological support, training topics, roundtable discussions for residents and their instructors, and the creation of a specialised adaptation programme, as well as the advanced training of mentors and educators.

1. Kryukov A.I., Nosulya E.V., Kunelskaya N.L., Garov E.V., Romanenko S.G., Kirasirova E.A., et al. Residency is a fundamental stage of professional training of an otorhinolaryngologist. Vestnik otorinolaringologii = Russian Bulletin of Otorhinolaryngology. 2023;88(2):93–98. (In Russ.) doi:10.17116/otorino20228802193

2. Manzoor S., Sajjad M., Anwar I., Rafi A. Coping strategies adopted by medical residents in dealing with work-related stress: a mixed-methods study. BMC Medical Education. 2022;22:449. doi:10.1186/s12909-022-03520-6

3. Gatsura O.A., Deryushkin V.G., Gatsura S.V. Starting physician on the clinical residency threshold: expectations and challenges. Meditsinskoe obrazovanie i professional’noe razvitie = Medical Education and Professional Development. 2019;10(3):64–70. (In Russ.) doi:10.24411/2220-8453-2019-13007

4. Meltzer R.I., Lozovik I.P., Nedbaylik S.R., Mamoshkin M.M., Shurkin S.V. On different aspects of post-graduate clinical course in modern education context. International Journal of Professional Science. 2019;12:9–12. Accessed March 17, 2024. http://scipro.ru/article/03-12-2019

5. Ivanov D.O., Aleksandrovich Yu.S., Kulbakh O.S., Zinkevich E.R., Ditkovskaya L.V., Pshenisnov K.V. The quality of post-graduate training of residents. Vestnik Rossijskoj akademii medicinskix nauk = Annals of the Russian Academy of Medical Sciences. 2019;74(5):333–341. (In Russ.) doi:10.15690/vramn1177

6. Shestak N.V. Residency: problems develop and assess generic competences. In: Sovremennye tendencii razvitiya pedagogicheskih tehnologij v medicinskom obrazovanii. Vuzovskaya pedagogika: materialy konferencii = Current Trends in the Development of Pedagogical Technologies in Medical Education. University Pedagogy: Conference Materials; February 03–04, 2016; Krasnoyarsk. Krasnoyarsk: Krasnoyarsk State Medical University named after Professor V. F. Voino-Yasenetsky; 2016:353–356. (In Russ.) Accessed March 17, 2024. https://elibrary.ru/vjsbtl

7. Burke G., Melvin L., Ginsburg S. “Patients are the people who teach me the most”: exploring the development of communication skills during internal medicine residency. Journal of Graduate Medical Education. 2023;15(1):59–66. doi:10.4300/JGME-D-22-00433.1

8. Noordman J., Post B., van Dartel A.A.M., Slits M.A., Olde Hartman T.C. Training residents in patient-centred communication and empathy: evaluation from patients, observers and residents. BMC Medical Education. 2019;19:128. doi:10.1186/s12909-019-1555-5

9. Tan X.H., Foo M.A., Lim S.L.H., Lim M.B.X.Y., Chin A.M.C., Zhou J., et al. Teaching and assessing communication skills in the postgraduate medical setting: a systematic scoping review. BMC Medical Education. 2021;21(1):483. doi:10.1186/s12909-021-02892-5

10. Driever E.M., Tolhuizen I.M., Duvivier R.J., Stiggelbout A.M., Brand P.L.P. Why do medical residents prefer paternalistic decision making? An interview study. BMC Medical Education. 2022;22(1):155. doi:10.1186/s12909-022-03203-2

11. Fujikawa H., Son D., Eto M. Cultural adaptation and validation of Japanese medical resident version of the workplace social capital scale: a cross-sectional study. BMC Medical Education. 2023;23(1):487. doi:10.1186/s12909-023-04469-w

12. Chuented P., Puranitee P., Pakakasama S., Meepanya S. Factors affecting residents’ internal motivation, grit, and well-being. BMC Medical Education. 2023;23(1):779. doi:10.1186/s12909-023-04679-2

13. Shawahna R., Maqboul I., Ahmad O., Al-Issawy A., Abed B. Prevalence of burnout syndrome among unmatched trainees and residents in surgical and nonsurgical specialties: a cross-sectional study from different training centers in Palestine. BMC Medical Education. 2022;22(1):322. doi:10.1186/s12909-022-03386-8

14. Shah H.P., Salehi P.P., Ihnat J., Kim D.D., Salehi P., Judson B.L., et al. Resident burnout and well-being in otolaryngology and other surgical specialities: strategies for change. Otolaryngology – Head and Neck Surgery. 2023;168(2):165–179. doi:10.1177/01945998221076482

15. Kobritz M., Nofi C.P., Demyan L., Farno E., Fornari A., Kalyon B., Patel V. Implementation and assessment of mentoring and professionalism in training (MAP-IT): a humanistic curriculum as a tool to address burnout in surgical residents. Journal of Surgical Education. 2023;80(1):17–29. doi:10.1016/j.jsurg.2022.11.002

16. Kemelova G.S., Tashkenbaeva V.B., Aimbetova D.B. The role of the clinical mentor in the practical training of residents. Medicinskoe obrazovanie i professional’noe razvitie = Medical Education and Professional Development. 2023;14(4):129–131. (In Russ.) Accessed March 17, 2024. https://www.rosmedobr.ru/rosmedobr2023/thesis/68500/

17. Amonoo H.L., Barreto E.A., Stern T.A., Donelan K. Residents’ experiences with mentorship in academic medicine. Academic Psychiatry. 2019;43:71–75. doi:10.1007/s40596-018-0924-4

18. Katayama K., Nishizaki Y., Takada T., Kataoka K., Houchens N., Watari T., et al. Association between mentorship and mental health among junior residents: a nationwide cross-sectional study in Japan. Journal of General and Family Medicine. 2023;5(1):62–70. doi:10.1002/jgf2.671

19. Flurie R.W., Hylton Gravatt L.A., Radwan R.M., Salgado T.M., Donohoe K.L. Residents’ assessment of mentoring received on lecture performance in a teaching and learning curriculum program. Currents in Pharmacy Teaching and Learning. 2022;14(12):1463–1470. doi:10.1016/j.cptl.2022.10.001

20. Joe M.B., Cusano A., Leckie J., Czuczman N., Exner K., Yong H., Ruzycki S., Lithgow K. Mentorship programs in residency: a scoping review. Journal of Graduate Medical Education. 2023;15(2):190– 200. doi:10.4300/JGME-D-22-00415.1

21. Miller E.M., Goldstein C.L., Tintle S., Ravi B., Hogan M.V., Waterman B.R. Current resident and faculty mentorship satisfaction and important mentee functions in orthopedic surgery: an American orthopedic association North American traveling fellowship project. Journal of Surgical Education. 2021;78(5):1735–1754. doi:10.1016/j.jsurg.2021.01.018

22. Sobel J., Hayden S.R., Wardi G. The knowledge gap: mentorship in emergency medicine residency. Annals of Emergency Medicine. 2023;82(1):47–54. doi:10.1016/j.annemergmed.2023.01.026

23. Skipper M., NØhr S.B., Jacobsen T.K., Musaeus P. Organisation of workplace learning: a case study of paediatric residents’ and consultants’ beliefs and practices. Advances in Health Sciences Education. 2016;21(3):677–694. doi:10.1007/s10459-015-9661-6

24. Robbrecht M., Van Winckel M., Norga K., Embo M. Exploring residents and supervisors’ workplace learning needs during postgraduate medical education. International Journal of Medical Education. 2023;14:65–74. doi:10.5116/ijme.625f.bfb1

25. Yaow C.Y.L., Mok H.T., Ng C.H., Devi M.K., Iyer S., Chong C.S. Difficulties faced by general surgery residents. A qualitative systematic review. Journal of Surgical Education. 2020;77(6):1396–1406. doi:10.1016/j.jsurg.2020.06.003

26. Logvinov Yu.I., Orlovskaya А.I. Organization of a simulation workshop to prepare residents for primary specialized accreditation. Virtual’nye tehnologii v medicine = Virtual Technologies in Medicine. 2023;3(37):180–181. (In Russ.) doi:10.46594/2687-0037_2023_3_1662

27. Karlova Н.А., Boytsova M.G., Zorin Ya.P. Organization of independent work of ordinators in “Radiology” speciality with elements of simulation training. Vizualizaciya v medicine = Visualization in Medicine. 2020;2(4);3–6. (In Russ.) Accessed March 20, 2024. https://ojs3.gpmu.org/index.php/visual-med/article/view/2593

28. Ryabova T., Zhidyaevskij A., Galimova L., Mukharyamova L. Study of the factors of professional adaptation of residents. Kazanskij pedagogicheskij zhurnal = Kazan Pedagogical Journal. 2022;4(153):209–216. (In Russ.) doi:10.51379/KPJ.2022.154.4.025

29. Ryabova T.V., Marapov D.I. Zhidyaevskij A.G., Galimova L.L., Mukharyamova L.M. Factors and conditions of successful professional adaptation of residents. Kazanskij medicinskij zhurnal = Kazan Medical Journal. 2024;105(1):128–136. (In Russ.) doi:10.17816/KMJ321747

30. Plotnikova I.E., Lunina N.A., Gavrish A.V., Berleva S.Yu. Characteristic of the dependence of the individual assessment of the quality of postgraduate studies under the program “Residency” in the context of the employment of students of the Voronezh State Medical University named after Nikolai Nilovich Burdenko. Mir nauki. Pedagogika i psihologiya = World of Science. Pedagogy and Psychology. 2019;3(7). (In Russ.) Accessed March 20, 2024. https://mir-nauki.com/PDF/13PDMN319.pdf

31. Bulycheva E.V., Tkachenko I.V., Kalinina E.A., Lozinskaya T.Yu. Analysis of the progress of independent work of residents in preparation for primary specialized accreditation. Medicinskoe obrazovanie i professional’noe razvitie = Medical Education and Professional Development. 2023;14(3):22– 32. (In Russ.) doi:10.33029/2220-8453-2023-14-3-22-32