Coaching for Success: An Athlete-Centered Approach to Optimizing Performance and Protecting Wellbeing in Neurosurgery Residents

INTRODUCTION: Medicine has long attracted high-performing individuals. In particular, neurosurgical residents are faced with challenging conditions, including long workdays, demanding caseloads, and complex relationships, which rival those of the world’s greatest athletes. Unlike athletes, however, who have personalized programs that optimize performance and protect wellbeing, neurosurgical residents typically have a less-developed support network. METHODS: In collaboration with a human performance specialist, we conducted interviews, team exercises, and questionnaires with residents at our institution over six weeks. Qualitative data were analyzed using domain-classification, sentiment analysis, word association and proprietary algorithms, to identify themes of wellbeing, performance, and culture. RESULTS: Ten residents participated in the sessions; the highest and lowest scoring domains are reported. Five key findings were highlighted on domain analysis: (1) Residents noted meaningful workplace relationships and felt respected by peers; (2) Considerable variation existed in residents’ perceived ability to maintain their work level and in their preferences around sleep, exercise, nutrition, and free time; (3) Major sources of stress included sleep loss, work pace, uncertainty, where to focus wellbeing efforts, and mild performance anxiety; (4) Most residents underutilized relaxation techniques, noting frequent changes in motivation/self-worth; (5) Nearly all residents reported a deep sense of fulfillment/satisfaction. CONCLUSIONS: The neurosurgery residency environment requires sustained high performance. Here, we highlight opportunities for neurosurgery resident wellbeing and performance optimization, including strengthening communication under pressure, strategic decision-making promoting work-life balance/self-preservation, and encouraging a culture prioritizing wellbeing and performance. Importantly, inter-resident diversity accentuates the need for individualized resident support. Based on these findings, several programs were deployed, including a 12-month coaching program, an operating room feedback tool, and a digital advisor providing rapid, personalized guidance on performance and wellbeing.