Abstract
Background
Residency is a highly stressful and exhausting phase in the professional lives of physicians. Low income, high workload, and uncertainty about their career future can lead to lower job satisfaction among residents, and inadequate attention to this issue can have long-term negative effects on the quality and quantity of healthcare services provided. One of the solutions proposed in this regard is the transition from residency to a full-fledged job. This research explores the feasibility of this solution.
Methods
In this qualitative study, interviews were used to identify the challenges, facilitators, barriers, and solutions for transitioning from residency to a job. In the qualitative section, a total of 26 interviewees and for Delphi 17 expert were selected purposefully at three levels: macro (Ministry of Health), intermediate (university), and executive (hospital). The qualitative data were analyzed using a conceptual framework analysis, while the Delphi data were analyzed quantitatively.
Results
Based on the analysis of the qualitative results, 5 general themes with 13 main categories and 70 sub-categories were extracted as challenges, 2 general themes as facilitators, and barriers to the transition from residency to a job, and 8 main categories with 52 interventions were identified as solutions to overcome these barriers. In the Delphi stage, the number of proposed solutions reduced to 44 interventions. The most significant challenges identified in this study were high workload during residency, low income, career future challenges, welfare services, and educational and communication challenges.
Conclusion
The decrease in residents' willingness, along with the high work and financial pressures on them, poses a serious threat to the healthcare system that requires serious reforms. It appears that transitioning from residency to a full-fledged job can address a significant portion of the expressed needs. These reforms require serious determination and collaboration with sectors outside the healthcare system and should be carried out as part of the comprehensive national healthcare plan, taking into account the country's capabilities.