Resident Trainee Access and Barriers to Routine Health Services in the Military Health System

OBJECTIVE: Resident physician wellness has been a highly contentious topic in graduate medical education over the past 2 decades. Physicians, including residents and attending physicians, are more likely than other pro-fessionals to work through illness and delay necessary healthcare screening appointments. Potential reasons for underutilization of health care include-unpredict-able work hours, limited time, concerns about confi-dentiality, poor support from training programs, and apprehension about the impact on their peers. The goal of this study was to evaluate access to health care amongst resident physicians within a large military train-ing facility.DESIGN: This is an observational study using Depart-ment of Defense approved software to distribute an anonymous ten question survey on routine health care practices of residents. The survey was distributed to a total of 240 active-duty military resident physicians at a large tertiary military medical center.RESULTS: One hundred seventy-eight residents com-pleted the survey with a 74% response rate. Residents from 15 specialty areas responded. Compared to male counterparts', female residents were more likely to miss routine scheduled health care appointments to include, behavioral health appointments (54.2% vs 28%, p < 0.01). Female residents were more likely to report that attitudes toward missing clinical duties for health care appointments impacted their decision to start or add to their family more than male coresidents (32.3% vs 18.3%, p = 0.03). Surgical residents are also more likely to miss routine screening appointments or scheduled follow ups than residents in nonsurgical training programs; (84.0-88% compared to 52.4%-62.8%) respectively.CONCLUSIONS: Resident health and wellness have long been an issue, with resident physical and mental health being negatively impacted during residency. Our study notes that residents in the military system also face barriers accessing routine health care. Female surgical residents being the demographic most significantly impacted. Our survey highlights cultural attitudes in military graduate medical education regarding the prioritization of personal health, and the negative impact that can have on residents' utilization of care. Our survey also raises concerns particu-larly amongst female surgical residents, that these attitudes may impact career advancement, as well as influence their decision to start or add to their families. (J Surg Ed 80:581-587. Published by Elsevier Inc. on behalf of Associ-ation of Program Directors in Surgery.)