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17-01-2020 | Original Article | Uitgave 1/2020 Open Access

Perspectives on Medical Education 1/2020

Support, technology and mental health: correlates of trainee workplace satisfaction

Perspectives on Medical Education > Uitgave 1/2020
Vanessa A. Stan, Ricardo Correa, Jessica R. Deslauriers, Semyon Faynboym, Tina Shah, Alik S. Widge, AMA-RFS Task Force on Resident/Fellow Physician Satisfaction
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s40037-019-00555-2) contains supplementary material, which is available to authorized users.


Although aspects of the American Medical Association (AMA) governance structure assisted with data collection and study coordination, this report does not reflect the official work product of the AMA or any of its components. It does not contain or necessarily reflect official policy positions of the AMA. The opinions expressed herein are those of the authors, not those of the AMA or any funding agency.

Previous presentations

A subset of these results was previously presented in poster form at the 2016 International Conference on Physician Health, September 2016.



Low physician workplace satisfaction may negatively impact patient care. Dissatisfaction may begin during residency training, where trainees face lower autonomy and less control over work conditions. The theoretical and empirical literature on trainees is couched mainly in terms of burnout. Theories of satisfaction, a different construct, are derived from studies of independent physicians. Identifying specific correlates of trainee satisfaction may be a clearer path to preparing a sustainable physician workforce.


We surveyed 3300 residents and fellows (response rate of 7.2% to 46,574 surveys sent) across multiple specialties and institutions in the US. The instrument was adapted from a previous large-scale survey of physician satisfaction, with changes reflecting factors theorized to specifically affect trainee satisfaction. We applied generalized linear regression to identify correlates of higher satisfaction.


A total of 1444 (44%) residents/fellows reported they were very satisfied and 1311 (40%) reported being somewhat satisfied. Factors associated with satisfaction included positive perceptions of supporting clinical staff, the electronic health record, and stability of personal mental health. Surprisingly, a strong negative perception of completing insurance and/or disability forms was also associated with higher satisfaction. Factors often presumed to correlate with satisfaction, such as duty hours, debt load, and specialty, did not show significant associations.


Multiple workplace factors are correlated with trainee satisfaction, but they are not the factors (such as financial debt) that we initially hypothesized. The factors we identified, including clinical staff support and personal mental health, may be targets for further study and/or pilot interventions aimed at improving satisfaction.
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