Thematic analysis comparing stressors for pediatric residents and subspecialty fellows at a large children’s hospital

Figures & data

Table 1. Subthemes, categories, and representative quotes corresponding to the theme, Stressors at Home.

Subtheme	Category for residents	Category for residents and fellows	Category for fellows	Representative quote(s)
Difficulty Maintaining Overall Health	Staying Physically Healthy			‘Access to healthy food’ (R18)
		Lack of or Poor Sleep		‘Lack of sleep or trouble sleeping’ (R5) ‘Struggling with sleep deprivation over multiple night shifts’ (F23)
		Mental Illness and Burnout		‘Anxiety’ (R1) ‘Burnt out, mental fatigue’ (F27)
External Stressors		Finances		‘Financial constraints (high debt, low income, little to no reserve to deal with emergencies)’ (R1)
		Loneliness and Social Isolation		‘Being away from family’ (R1) ‘Limited social network/support system’ (R5) ‘Lack of social interaction due to covid’ (F22)
			Childcare	‘Childcare stressors’ (F28)
			Underrepresented Group Discrimination	‘Feeling like I am taken less seriously as a female physician’ (F14) ‘Being LGBTQ’ (F27)

R-resident respondent; F: fellow respondent.

Table 2. Subthemes, categories, and representative quotes corresponding to the theme, Stressors at Work.

Subtheme	Category for residents	Category for residents and fellows	Category for fellows	Representative quote(s)
Clinical Stressors Innate to Patient Care		Moral Distress and Empathy Fatigue		‘Moral distress related to patient care scenarios’ (F5)
		Sick/Dying Patients and Complex Social Dynamics		‘Watching patients struggle with illness, death of patients’ (F33) ‘Difficult patients’ (F35)
			Clinical Uncertainty	‘Uncertainty in medicine’ (F9)
Demanding Workload and Schedule		Work-Life Balance		‘Minimal free time outside of work for normal life activities such as laundry, cleaning, groceries’ (R27) ‘Juggling personal and professional obligations’ (F24) ‘Missing out on life events for work’ (F33)
		Unusual, Variable, and Uncertain Work Schedule		‘Working nights’ (R28) ‘Unpredictable schedule’ (F10)
		High Workload and Expectations		‘Making time to study’ (R19) ‘Stress with leadership responsibilities’ (R24) ‘Balancing academic expectations with clinical responsibilities’ (F18)
Stressors Related to Culture of Work Environment	Lack of Clinical Autonomy			‘[Lack of control over] clinical situations’ (R5)
		Negative Work Environment		‘Working with other burnt-out practitioners/medical staff’ (R9) ‘Lack of acknowledgement at times’ (F4) ‘Perceived lack of respect’ (F16)
		Lack of Confidence and Feelings of Inadequacy		‘The stress of never feeling like we know enough’ (R15) ‘Imposter syndrome’ (F29)
		Career Planning and Lack of Professional Support		‘Career planning/deciding on your path’ (R5) ‘Job finding stress’ (F5) ‘Lack of mentorship’ (F20)
			Unclear Expectations	‘Nebulous expectations from different attendings’ (F20)

R: resident respondent; F: fellow respondent.

Figure 1. Percentage of respondents in each group (residents and fellows) who identified each category of stressor.

Data availability statement

The data that support the findings of this study are openly available in Open ICPSR at https://doi.org/10.3886/E156342V1, reference number [33].