Institutional conditions and individual experiences in the career-entry period of Swiss medical residents--a qualitative study.
OBJECTIVE
The study investigated first-year residents' career entry experiences according to gender, clinical field and type of training hospital. In addition to quantitatively assessed workplace experiences, this paper reports qualitative data on institutional conditions as well as interpersonal and individual experiences encountered by junior physicians during their first year of residency.


METHODS
The present study is part of the longitudinal Swiss physicians' career development study. After their first year of residency, participants were interviewed for the second time. The qualitative data of this second assessment are reported in this paper. A total of 1861 terms were given by 342 junior physicians working in the two main clinical fields (internal medicine and surgical fields) with regard to positive and negative experiences in the career entry period. The answers were assigned to 12 categories (according to Mayring's content analysis). These categories were then allocated to three superordinate subject areas: Institutional conditions, Interpersonal experiences, and Individual experiences.


RESULTS
Institutional conditions accounted for 17% of all entries, with negative experiences in particular, high workload - predominating. Within Interpersonal workplace experiences (41% of all responses), relationship experiences accounted for the largest proportion of all statements (25.7%), which were mainly positive. Individual experiences (42%) were assessed both positively (professional competence, learning, responsibility, and pleasure) and negatively (working under pressure and curtailment of one's private life). Female and male residents reported similar workplace experiences. Residents in surgical fields more often complained of a lack of professional support than those in internal medicine. Physicians working in university or big county hospitals had more negative experiences with regard to teaching than residents at smaller hospitals.


CONCLUSIONS
The junior physicians' career-entry experiences indicated that a genuine concept of education and training would greatly improve their workplace experiences. Furthermore, senior physicians should bear in mind that they are important role models for the junior staff.
Buddeberg-Fischer
Barbara
B
Department of Psychosocial Medicine, University Hospital Zurich, Zurich, Switzerland. Barbara.buddeberg@usz.ch
Klaghofer
Richard
R
Zivanovic
Irena
I
Vetsch
Esther
E
Buddeberg
Claus
C
D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D013502:General Surgery / Q000193:education; D006784:Hospitals, Teaching; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D007588:Job Satisfaction; D008297:Male; D008505:Medical Staff, Hospital; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013557:Switzerland; D016526:Workload / Q000523:psychology*; D017132:Workplace