Do family physicians develop ambiguity tolerance as they gain experience? A multicenter cross-sectional study

Background: Ambiguity tolerance is important because it contributes to both better patient care and physician well-being. Although a recent study showed that family physicians have greater ambiguity tolerance than non-family physicians, the question of when family physicians develop tolerance remains unanswered. Thus, the aim of this study was to examine the associations between the number of postgraduate years (PGYs) and ambiguity tolerance. Methods: This was a nationwide cross-sectional study involving family physicians in 14 residency programs throughout Japan. Ambiguity tolerance was assessed as the primary outcome using the Japanese version of the Tolerance for Ambiguity in Medical Students and Doctors scale. Secondary outcomes were burnout and work engagement, assessed using the Japanese version of the Burnout Assessment Tool and the ultra-short version of the Utrecht Work Engagement Scale, respectively. Results: 173 family physicians were included in the analysis. Physicians of PGY ≥7 had significantly greater ambiguity tolerance and lower burnout risk than those of PGY 3–6. Physicians of PGY 7–20 had significantly higher work engagement than those of PGY 3–6. Conclusions: Family medicine resident physicians may be vulnerable for the duration of the residency program, although they may develop ambiguity tolerance and improve well-being over the course of the program. Supervisors in family medicine residency programs should examine the learning environment of their program, considering the vulnerability of their trainees.