Table 3. Themes and Quotations From Focus Group.
| Quotation No. | Participant ID | Exemplary quotation |
|---|---|---|
| Demand | ||
| 1 | FGP-1W | “(Some) rotations are necessary evil. You need stress and fatigue to learn what you need to learn.” |
| 2 | FGP-2W | “You know that seeing the patient … always feels good, always makes things seem worth it. But [due to EMR burden] you feel dread, then you feel tremendous guilt. There’s no way out.” |
| 3 | FGP-3W | “Seeing NPs (and others) leave at 6pm you feel both resentful and guilty. Other groups are treated like humans, and it feels like crap to be the only group that’s not.” |
| Control | ||
| 4 | FGP-3W | Having “no autonomy, [reiterating] consults, plans … for multiple people. [This is] totally inefficient and infuriating.” |
| 5 | FGP-4W | “At least 1 holiday off [really works]. Having the schedule 3 months in advance helps [maintain] social life.” |
| 6 | FGP-5M | “Lack of control … no idea of when you can or will leave—that is worse. It’s better when it’s a choice, [when you stay for] a good case, [something] educational.” |
| Support | ||
| 7 | FGP-2W | “[PGY] 2/3s never see people. … More days are long, never have plans, [because] there’s no schedule. All the pressure from the day, the support you need, falls on the people at home. There’s a lot of strain.” |
| 8 | FGP-6M | “I needed [ESRT] more as a [PGY]2 and [PGY]3. Repeating it would have really helped. [As] a [PGY]3 you really need something. … Learn it as interns, build on it as a [PGY]2 and maybe more as a [PGY]3.” |
| Affective regulation skills | ||
| 9 | FGP-7W | “We want to own our patients, to do the operation, to be in charge … resentment, guilt, dread, that’s on us. We have to make our own peace with [our choices and deciding] what’s ‘enough.’” |
| 10 | FGP-8M | “Maybe mid–third year, getting a new consult was no longer fun … It was a drag … I had to remind myself that a consult is a call for help. This was a [mental] shift I had to make to survive.” |
| 11 | FGP-3W | “I felt the rage for sure—simmering rage and acute rage, I felt it a lot. Because of your professional responsibility you always choose your patient first, you never choose yourself first. So, you begin to really feel resentful.” |
Abbreviations: EMR, electronic medical record; FGP, focus group participant; ID, identification; M, men; NP, nurse practitioner; PGY, postgraduate year; W, woman.