Physical and emotional health trajectories in PGY-2 residents: a prospective pilot study

Background: Physician residency imposes substantial physical and emotional demands, with the second postgraduate year (PGY-2) being particularly challenging due to increased responsibilities and overnight call. This prospective pilot study examined changes in cardiorespiratory fitness (CRF), body composition, and depressive symptoms across PGY-2 in orthopedic surgery and physical medicine and rehabilitation residents. Methods: PGY-2 residents at a single academic medical center were assessed pre-, mid-, and post-PGY-2. CRF was measured using treadmill cardiopulmonary exercise testing, body composition via seven-site skinfold measurements, depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), and self-reported physical activity via the International Physical Activity Questionnaire. Results: Six residents enrolled (67% male, median age 31 years); four completed all assessments. Physical activity declined from high pre-PGY-2 to moderate mid-PGY-2. Median body fat increased mid-PGY-2 (16.5% to 17.6%) and returned toward baseline post-PGY-2 (16.5%). PHQ-9 scores remained low overall, with a transient mid-year increase driven by fatigue/low energy. Peak CRF showed modest, transient mid-year reductions. Conclusion: PGY-2 was associated with reduced physical activity and transient changes in physical and mental health. These exploratory findings suggest that PGY-2 may represent a window for targeted wellness interventions and support future larger, adequately powered, longitudinal studies.