Barriers to the utilization of wellness days in graduate medical education

Abstract

Background: Personal well-being is an important component of a resilient physician and can reduce the risk of burnout. To address this, our institution implemented a wellness-day policy to promote self-care.  The objectives of this study were to determine the frequency in which house staff (HS) use wellness days and to identify barriers to their utilization. Methods: A questionnaire was administered to all HS at a single sponsoring institution through a secure online survey platform in 2019-2021. Those that took one or both of the wellness days were compared with those that took none using Chi-square. Comparisons across years were made using Cochran-Armitage Trend test, with a P value <0.05 denoting statistical significance. Results: There were 386/878 responses, representing a 44% response rate. Only 31% of HS took both wellness days and 50% took none. Reasons for not taking a wellness day included not wanting to burden the program, having no need for them and being discouraged by the program. HS that took one or both days were more likely to identify as female (60% vs 45%, p=0.007) but not more likely to be married or have children. Interns were less likely (38% vs 51%; p=0.04) and fellows were more likely (61% vs 47%; p=0.03) to take a wellness day.  Conclusions: The utilization of wellness days is variable. Increased utilization can serve to normalize their use and minimize the burden felt by house staff. Education at orientation and leadership buy-in is essential to policy success.