Paging Love: Understanding the Experience of Postgraduate Medical Training and its Connections to Mental Health and Well-being from the Perspective of Trainees and Their Intimate Partners

Abstract

Introduction: Postgraduate medical training is often an exciting phase of professional and personal development. However, it is also commonly associated with stresses and work demands, which impact trainee well-being, mental health, and intimate partner relationships. To date, there has been limited research on the role that intimate partners play or could play in supporting trainees and enhancing coping. This thesis aims to better understand the connections between the experiences of training, intimate partner relationships, and mental health and well-being. Methods: This qualitative study used an interpretive descriptive approach. An invitation to participate in 60-minute one-on-one interviews was sent to all McMaster postgraduate medical trainees and their partners. A total of 23 postgraduate medical trainees and 15 partners were selected to participate in semi-structured interviews. All interviews were transcribed, and reflexive thematic analysis was used to analyze the data, which involved an iterative process of data coding, developing and refining themes, and writing the thematic narrative. Results: Seven themes were developed: (1) The inflexible and unforgiving nature of postgraduate medical training, medical culture, and practice: The inhumanity of it all, (2) The mental, physical, and emotional toll of training on the couple, (3) A battle of identities and responsibilities: Whose identity is prioritized? Who shoulders the burden?, (4) The trainee-partner relationship as a protective ‘bubble’, (5) Threats, fractures, and repairs to the relationship ‘bubble’, (6) Expanding the ‘bubble’: The importance of other personal and peer relationships for trainee and partner well-being, and (7) Need for advocacy: A call to change the culture of medicine. Conclusion: This study has identified salient issues which trainees and their partners face during postgraduate medical training and will inform a future experience-based co-design approach in which trainees, partners, and educators will identify and develop potential individual, dyadic, and organizational strategies to address these issues.