Well-Being in Graduate Medical Education: A Call for Action

Abstract

Job burnout is highly prevalent in graduate medical trainees. Numerous demands and stressors drive the development of burnout in this population, leading to significant and potentially tragic consequences, not only for trainees but also for the patients and communities they serve. The literature on interventions to reduce resident burnout is limited but suggests that both individual- and system-level approaches are effective. Work hours limitations and mindfulness training are each likely to have modest benefit. Despite concerns that physician trainee wellness programs might be costly, attention to physician wellness may lead to important benefits such as greater patient satisfaction, long-term physician satisfaction, and increased physician productivity. A collaborative of medical educators, academic leaders, and researchers recently formed with the goal of improving trainee well-being and mitigating burnout. Its first task is outlining this framework of initial recommendations in a call to action. These recommendations are made at the national, hospital, program, and nonwork levels and are meant to inform stakeholders who have taken up the charge to address trainee well-being. Regulatory bodies and health care systems need to be accountable for the well-being of trainees under their supervision and drive an enforceable mandate to programs under their charge. Programs and individuals should develop and engage in a "menu" of wellness options to reach a variety of learners and standardize the effort to ameliorate burnout. The impact of these multilevel changes will promote a culture where trainees can learn in settings that will sustain them over the course of their careers.

What Are Some Stressful Adversities in Psychiatry Residency Training, and How Should They Be Managed Professionally?

“…Faculty should role model professional behaviors for residents in managing the prevention and response to clinical adversities encountered in training. Heathcare organizations should provide peer support to any resident involved in emotionally stressful situations [63]. Indeed, the Charter on Physician Well-Being aims in part to remind physicians of their responsibility to examine the culture of medicine and how it facilitates meaning, fulfillment in practice, and professionalism and to encourage a supportive culture [64].…”

Research Priorities for Physician Wellness in Academic Emergency Medicine: Consensus from the Society of Academic Emergency Medicine Wellness Committee

“…A pilot study in a single residency program suggested that EM faculty were quite poor in being able to accurately predict burnout among EM trainees . Because wellness habits, like many other practices, may be “imprinted” during residency training, focusing on the role of burnout and other related states in the unique environment of academic medicine has the potential for long‐lasting effects for both individual physicians and the specialty.…”

The Golden Ticket Project for peer recognition

“…Burnout has been linked to adverse effects in health care providers, including higher rates of depression, increased suicidal ideation and increased rates of medical errors . Furthermore, the American Council for Graduate Medical Education (ACGME) has recently raised resident burnout as an issue of high importance, experts have called for a national response, and newly formed collaborations across medical disciplines are working to address this topic . Research suggests that ‘supportive working environments’ and ‘celebrating accomplishments’ protect against burnout, yet there is a dearth of evidence on how to foster such supportive environments in residency.…”

“…1 Furthermore, the American Council for Graduate Medical Education (ACGME) has recently raised resident burnout as an issue of high importance, 2 experts have called for a national response, 3 and newly formed collaborations across medical disciplines are working to address this topic. 4 Research suggests that 'supportive working environments' and 'celebrating accomplishments' protect against burnout, 5 yet there is a dearth of evidence on how to foster such supportive environments in residency. In this article, we describe outcomes of the 'Golden Ticket Project' (GTP), a resident-led programme that encourages peer-to-peer support and the recognition of positive behaviours and attitudes.…”