The Difficult Trainee: Strategies for Recognizing and Addressing Training Challenges

Abstract

Challenges among trainees can impact their surgical education, their ability to provide quality patient care, and the training program as a whole. The extent to which trainees in difficulty are identified and addressed can serve as a barometer for the culture of a program. As such, it is incumbent upon residency and fellowship program directors to take interest in better understanding their trainees at an individual level, and the collective fabric of their training program at a systems level. This chapter explores the dimensions of difficulties in training, focusing both on trainees who present with difficulties through their interactions and behavior, and contrasting this with residents who may also find themselves in difficulty by virtue of external stressors. The overall goal of this chapter is to examine and identify an approach to ensuring the wellbeing of individual trainees, and that of a training program collectively. Educators must ensure that trainees meet their clinical and professional competencies, as well as the goals of the surgical training program. To train a generation of thoughtful and adept surgeons, it is essential to address difficult trainees and focus on cultivating professional behaviours within a positive training environment.