Trends in Resident Perception and Program Response of Annual Institutional Internal Survey in COVID Era: A 6 Year Analysis

The Accreditation Council for Graduate Medical Education (ACGME) conducts an annual trainee survey to evaluate program quality, but many institutions also use internal surveys to identify concerns earlier. This study examined resident and fellow perceptions of graduate medical education at one institution, particularly the effects of the COVID-19 pandemic on training and satisfaction. From 2018 to 2023, approximately 225-250 residents and fellows across multiple ACGME-accredited programs participated in annual surveys covering duty hours, faculty engagement, evaluations, wellness, scholarship, and quality improvement. Surveys were distributed via institutional email, responses captured on a 5-point Likert scale, and data analyzed with descriptive statistics and chi-square tests. Completion rates improved significantly from 78% in 2018-2019 to 99% in 2022-2023. Key improvements included compliance with the 80-hour workweek (84.4%-91.7%), faculty supervision (72.3%-84.5%), and wellness initiatives (68%-79%). Faculty effectiveness and educational interest also improved. Evaluation accessibility and feedback showed positive but non-significant trends. Participation in quality improvement declined during the pandemic but rebounded afterward. Overall, institutional responses to survey findings, supported by structured feedback, the House Staff Association, and wellness committees, enhanced satisfaction, compliance with ACGME standards, and educational outcomes. Internal surveys effectively complemented the national ACGME survey, providing a proactive tool to adapt programs and strengthen resident wellness, particularly during the challenges of the COVID-19 pandemic.