Addressing New Trainee Burnout at the Beginning of the New AY

Thomas J. Nasca, MD, MACP, Chief Executive Officer, Accreditation Council for Graduate Medical Education, released a study a year ago (July 2017) in Academic Medicine on causes of resident death. It was a 14 year study looking at the causes of death for residents in ACGME accredited programs, and it is eye opening. It is a MUST READ for everyone involved in medical education.

My take-a-ways from the article:

  • pay special attention to first year in program trainees

  • 1st and 3rd quarters of the year are critical times to address wellness with trainees

  • identify ways to assure that all trainees have:

  • an identified PCP

  • protected time to go to annual physicals/PCP appts

I recently attended a talk that Dr. Nasca gave at the 2018 AHME conference, where he showed this video on trainee burnout and suicide prevention. He specifically requested that this video, or something similar, be presented to all trainees during the 1st and 3rd quarters of each academic year. This is something I am implementing this year into my program. For our program, we have taken a conference slot to dedicate to this. We will open with the video, then use PollEverywhere to (hopefully) start an honest communication about burnout with our trainees, and then end the session with a short meditation video.

I have spoken to many other program administrators that are working to implement or have implemented extremely creative and thoughtful ways to mitigate trainee burnout in their programs; and I wanted to share with a few of my favorites!

  • Assigning all incoming residents a PCP and scheduling them for their first PCP appointment

  • Incorporating a validated wellness scale (such as the CBI) into resident evaluations

  • Incorporating wellness questions into the Semi-Annual PD review, such as

  • Do you have a local PCP? When was your last PCP appointment? Dental appointment?

  • If you use a wellness scale, review results with each resident individually

  • Questions regarding sleep, stress levels, work hours, at home work hours

  • Ask them how are things going at home (or how's life outside the program?), many programs shy away from this and see it as taboo, but it is ok to ask this!!

  • Things you should NOT ask about are marital/family status or pregnancy. If you are in doubt about anything you can/cannot ask, contact your HR Dept, they can guide you!

  • Annual resident wellness retreat, all trainees at once or split them up by class

  • Implement a resident wellness committee, led by residents with input from a faculty member and the program administrator

  • Posting a list of all wellness benefits available to trainees on a program website or New Innovations

  • Such things as, EPA, on-site yoga classes, fitness benefits, on-site weight watchers, etc

  • Identifying an on-site physician (or a dedicated pager #) that any in-crisis resident can contact 24/7

  • Contact your state's physician health services program to present to your trainees

  • Create a "wellness oasis" in your resident lounge/room; a dedicated computer or corner with wellness related items:

  • pre-loaded PC with wellness apps

  • PC's internet browser bookmarked with wellness sites/videos

  • stress balls/textured squeeze toys/fidget spinners

  • noise cancelling headphones

  • essential oil diffuser

  • mints/chocolates

  • dim-able lamp

  • eye/sleep mask

  • post inspiration quotes and pictures of tranquil natural scenes

  • desktop zen garden

Does your program do something different? Are you loving any of the ideas listed above and want to implement at your institution/program? What more information on anything list above? Then tell us in the comments section below!

#Burnout #Wellness

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