What Do Residents Do When Not Working or Sleeping? A Multispecialty Survey of 36 Residency Programs

Purpose To determine how residents spend their time when not working or sleeping, and to examine correlates of these outside activities. Method In 2009, the authors surveyed 36 internal medicine, surgery, pediatrics, and obstetrics-gynecology programs. Residents answered questions about their recently completed first and second residency years, including, "During your past year of residency, outside of working hours, about how often did you ... ," followed by 10 listed activities and a four-point rating scale (1 = " less than once a week"; 4 = " almost daily"). Results The most frequent activity reported across all 634 respondents was using the Internet, followed by watching television and doing household tasks. The lowest reported activity was moonlighting, followed by seeing a movie. K-cluster analyses divided residents into three clusters: (1) " Friend Focused," reporting higher means for time with friends, Internet use, physical exercise, and watching television, (2) " Family Focused," reporting higher means for time with family, Internet use, household tasks, and watching television, and (3) " Low Activity," reporting the lowest ratings for all activities. Comparisons among these three clusters showed the Low Activity residents to have significantly higher scores on validated depression, anxiety, and sleepiness scales; higher stress; more reported work hours and sleep deprivation; and lower ratings for satisfaction, time with attendings, and learning. Scores for Friend-Focused and Family-Focused clusters were similar to each other. Conclusions These data provide new information about the residency experience and suggest that activities outside of work and sleep hours correlate highly with residents' mood, learning, and satisfaction.