Challenges and Benefits of Residency Away Rotations: Trainee Perspectives

BACKGROUND: Away residency training rotations, defined as any clinical rotation in a categorical residency program away from the home training institution, can be a common feature in graduate medical education to fill gaps in specific training requirements. Although the number of away rotations in civilian anesthesia residency programs remains unpublished and ever-changing based on the size of the hospital it serves and program needs, away rotations are particularly critical in military residency programs because of limited specialty case availability at some military treatment facilities. Although previous research has focused on the educational benefits of these rotations, less is known about the impact of these experiences on residents' personal and professional lives. Understanding the challenges and benefits of away rotations from the residents' perspective is crucial to optimize learning and mitigate potential negative consequences. This qualitative study investigates the lived experiences of residents during away rotations, from the trainees' perspective, to inform both military and civilian training programs.

MATERIALS AND METHODS: Using a qualitative descriptive approach within a constructivist paradigm, we conducted semi-structured interviews with PGY-3 and PGY-4 anesthesiology residents from four military residency programs. Data analysis using thematic analysis identified key themes related to residents' perspectives of rotations to identify recurring patterns, offering insights to inform future residency training and support strategies.

RESULTS: Interviews demonstrated the following themes associated with away rotations in military anesthesiology training: (1) diverse clinical exposure and professional opportunities; (2) growth personally and professionally; (3) emotional and psychological strain from loss of social support systems; and (4) burden on family and home responsibilities.

CONCLUSIONS: Away rotations offer residents invaluable clinical experience and networking opportunities but also present personal challenges such as feelings of isolation and stress, decreased social support, and negative familial impact, which are risk factors for physician burnout. Although most military anesthesiology residents reported positive experiences, support systems for personal hardships, adverse patient outcomes, familial obligations, and mental/physical health are needed. Future research should focus on mitigating personal consequences and mechanisms to balance residents' wellness and educational attainment. Military training programs are uniquely positioned to lead such efforts, given their reliance on away rotations.