Where does resiliency fit into the residency training experience: a framework for understanding the relationship between wellness, burnout, and resiliency during residency training.

BACKGROUND: Medical literature reports high rates of burnout among medical professionals. The terms wellness and resilience are often used interchangeably in the solution focused discussions. By confusing the terminology, the distinct role of resilience within residency training may be ill-appreciated.The objective of this paper is to define wellness, burnout, and resiliency and detail a proposed framework to explain how these terms manifest within residency training. METHODS: MEDLINE and EMBASE searches were performed using the key words "resilience," "residency," "wellness," and "burnout." The search was limited to English language articles published between 2003-2017. RESULTS: The authors propose a framework based on the literature review. This work supports the implementation of resilience-based interventions that enable residents to engage with workplace adversity in a healthy way, acquire skills during the process and avoid resource depletion and, ultimately, burnout. CONCLUSION: This framework can be used by residency programs to promote educators and residents' understanding of the unique role of resilience within residency, and the importance of differentiating between wellness and resilience initiatives. Future research is required to study the utility of this framework.