Brandon Girardi, MD, MEd; Lisa Sattertgwaite, RN; Maria Mylopoulos, PhD; Carol-anne Moulton, MBBS, FRACS, MEd, PhD; M Lucas Murnaghan, MD, MEd, FRCSC.

Studies on boot camp have shown improvement in technical skills performance using pre and post-test designs. Feedback from residents has been very positive and boot camp is often cited as one of the highlights of training.  Frameworks have been discussed and designed based on trainee feedback but the fact that boot camps are all so different from one another suggests we don’t completely understand why they have garnered this impressive response and rapid uptake.

In a qualitative inquiry exploring the resident experience within boot camp at the University of Toronto, residents who had completed a boot camp at the beginning of their training were selected from across surgical disciplines and at different PGY levels. In this study, residents participated in individual, in-person, recorded interviews with semi-structured questions. Using grounded-theory methods, several themes emerged from the data and were analyzed. Residents experienced the boot camp environment as not only a technical training ground but also a social one. The social groups persisted throughout residency and played key roles in emotional coping, resilience, healthy collegiality, and improved clinical practice and inter-specialty communication.

The transition from medical student to resident offers two discrete points to place a boot camp intervention: the end of medical school training, or the beginning of residency training. Boot camp is in part about supporting changing peer groups, changing environments, changing mentalities and developing new attitudes. This study would suggest that to benefit from the incredible social power of boot camp, it should take place in the trainees new environment, with their new peers, at the beginning of their residency.  Boot camp must also be of sufficient length for residents to form the social cohesion they clearly value. Finally, peer bonding and support group formation was perceived to be enhanced by a shared sense of challenge.  Therefore, the curriculum of the course should offer opportunities for problem solving and skill exploration in a group setting with an emphasis on students working together to develop new knowledge and technical aptitude.

Cover image by Douglas Buller.