Efforts, rewards and professional autonomy determine residents' experienced well-being

Adv Health Sci Educ Theory Pract. 2018 Dec;23(5):977-993. doi: 10.1007/s10459-018-9843-0. Epub 2018 Aug 7.


The well-being of residents, our future medical specialists, is not only beneficial to the individual physician but also conditional for delivering high-quality patient care. Therefore, the authors further explored how residents experience their own well-being in relation to their professional and personal life. The authors conducted a qualitative study based on a phenomenological approach. From June to October 2013, 13 in-depth interviews were conducted with residents in various training programs using a semi-structured interview guide to explore participants' experience of their well-being in relation to their professional life. The data were collected and analyzed through an iterative process using the thematic network approach. Effort-reward balance and perceived autonomy were dominant overarching experiences in influencing residents' well-being. Experiencing sufficient autonomy was important in residents' roles as caregivers, as learners and in their personal lives. The experienced effort-reward balance could both positively and negatively influence well-being. We found two categories of ways that influence residents' experience of well-being; (1) professional lives: delivering patient care, participating in teamwork, learning at the workplace and dealing with the organization and (2) personal lives: dealing with personal characteristics and balancing work-life. In residents' well-being experiences, the effort-reward balance and perceived autonomy are crucial. Additionally, ways that influence residents' well-being are identified in both their professional and personal lives. These dominant experiences and ways that influence well-being could be key factors for interventions and residency training adaptations for enhancing residents' well-being.

Keywords: Effort–reward balance; Influencing factors; Postgraduate medical education; Professional autonomy; Professional life; Residents’ experienced well-being.

MeSH terms

  • Attitude of Health Personnel
  • Humans
  • Internship and Residency*
  • Interviews as Topic
  • Patient Care Team / organization & administration
  • Physician's Role
  • Physicians / psychology*
  • Professional Autonomy*
  • Reward*
  • Work-Life Balance
  • Workplace / psychology*