One hundred and twenty-five former residents could be included in our study. E-mail addresses could only be referenced for 113 of them. There were 95 questionnaires completed, with a response rate of 84.1%.
Demographics data
The average age for responders was 36.6 years. Half of responders were married (49.5%), 37.9% in relationship and 12.6% reported being single. One-third of the people did not have children (34.7%). The others reported 1 child (12.6%), 2 children for 27.4%, 3 children for 20% and more than 3 children for 5.3% of the responders. Their native region was the Ile-de-France for the third part (35.8%), Haute-Normandie for 30.5%, Picardie for 7,4% and the rest was distributed in all regions of France. The choice of Rouen University hospital was a geographical choice in 41.1% of the cases, the national ranking examination rank in 38.9%, the reputation of the department in 12.6% of the cases and a relationship choice for the others.
In our cohort, 96.8 % carried out a fellowship. The positions offered were 46.7% as clinical head, 29.3% as regional specialist assistant, 20.7% as hospital specialist assistant and 3.3 % as contractual hospital practitioner.
Current employment situation
For 53.7 %, the clinical activity is exclusively anesthesia practice, for 16.8 % exclusively critical care practice and for 29.5 % mixed activity. The type and structure of exercise are university hospital for 46.4 %, general hospital for 18.9 %, independent private hospital for 18.9 %, private hospital within a health group for 10.5 % and private hospital non-profit health care facility for 5.3%.
The number of working days per week was 5 days or more for 52.6%, 3 to 4 days for 46.3% and 1 to 2 days for 1,1%. A majority of people (77.9%) had night shift activities: 41.1% reported a night shift rate of 3 to 4 per month and 32.6% 5 or more per month. More than half of the respondents (62.1%) said they had on call: 34,7% from 1 to 2 per month, 20% from 3 to 4 per month and 7,4%, 5 or more per month.
For the remuneration, 93 people (97,8%) have answered. It ranges from less 2500 euros to more than 7500 euros without fee: 3,2% less than 2500 € per month, 42.1% earned between 2500 and 5000 € per month, 22.1% between 5000 and 7500 € per month and 30.5% more than 7500 € per month.
The overall satisfaction and level of difficulty felt scores of the current practice are depicted in Table 1.
Evaluation of the training during the residency at Rouen University Hospital
The majority (93.7%) of people felt that both theoretical and practical training was good or excellent (Table 1).
The majority (98.9%) was satisfied or very satisfied about the working conditions during the residency in Rouen. The whole population would recommend the Rouen residency formation to a friend.
Supervised autonomy phase
In our population, 89.5 % reported having been in a supervised autonomy phase during day activity and 91.6% on-call activity (37.6% during their 8th semester, 55.3% during their 9th semester and 56.5% during their 10th semester)
Day activity
The areas of aesthetic and intensive care activity where residents were in supervised autonomy practice have been summarized in table 2 with a majority in Rouen University Hospital. The vast majority of respondents (82.4%) consider that the objectives of the supervised autonomy phase were clearly defined by the department and by the medical team. Moreover, 83.5% did not encounter any difficulties or minimal difficulties during their internship. Only, 15.3% faced moderate difficulties and 1.2% significant difficulties. Situations responsible for these difficulties are depicted in table 3.
On-call activity
The on-call activity was reported for 80.2% to be performed in intensive care units and 56.3% as anesthetic in operating room. The distribution by location was summarized in Tables 4 and 5. The difficulties encountered by the residents (57.9% answered) during on-call activity were described in Table 6.
The autonomy supervised status
This phase was reported as beneficial for their professional formation by 94.2% of the responders. All of them found that the autonomy supervised status was associated with new fields of formation when compared with initial stages of the courses (autonomy for 94%, Organization of working time for 56.6%; training in anesthesia consultation for 36,1%)
Moreover, 72.9% of residents during supervised autonomy stage reported that they had enough free time to work for thesis or university report. Moreover, 93% thought it would be advisable to include systematically the supervised autonomy stage in anesthesia and critical care residency and 97% think that this step had made taking their position as anesthesiologist-intensivist seniors easer. Responders recommend this stage to a friend during day activity for 98.5% and during on-call activity for 92.4% of them.
Suggestions of residents to improve the curriculum
In addition, they suggested that 2 important skills must be improved during residency: the anesthetic consultation and the post-operative care of the patients. Moreover, people would have a facilitated access to university diplomas. University diplomas such as cardiac ultrasound, pediatric anesthesia, regional anesthesia were strongly suggested.