Introduction: Neurosurgical residents are immersed in a special environment. From sun up to sun down they are surrounded by sights and sounds and smells that few outside of medicine can relate to. Their emotional environment is filled with death, sadness, tragedy, bad news, self-reproach, loneliness, mayhem, hostility, and performance anxiety. When they do venture out into the “real world” they are at risk of experiencing this world as foreign. Such a response may promote a reclusiveness and lead to a heightened sense of isolation and loneliness, increasing the chances of burnout. Sought to understand better our resident’s reaction to their interfaces with the world outside of the hospital.
Methods: We asked all of our neurosurgical residents to keep a temporary diary of their feelings and responses to time spent socializing outside of the hospital over a period of 3 months. Responses were collected and discussed at length in monthly resilience sessions.
Results: Resident observations were collated. We found significant common threads in maladaptive feelings/responses to the environment outside of the hospital. These included surprise at the general health of people the encountered and the lack of people looking deathly ill; shock when people were spontaneously nice or kind to them; intolerance of mild incompetence or slowness; a sense of surrealism; intolerance of what others felt were important events of the day; a desire to get back into the hospital; and more.
Conclusions: It is critical to realize that a resident’s prolonged exposure to the hospital environment can significantly distort their perception of the outside world. This needs to be a point of focus I resilience building. We need to assist residents in normalizing the outside world and recognizing the deviancy of the environment within the hospital.
Patient Care: Physician burnout compromises patient care. By focusing on resident wellness and resilience, patients will experience better quality of care and decreased medical errors
Learning Objectives: to understand factors contributing to resident burnout