Resident Wellbeing: Why the Push? What Can Programs Do? Lauren Talhelm, C-TAGME Program Coordinator for Interventional Radiology & Vascular Surgery Residencies Program Coordinator for CVIR Fellowship President, Association of Vascular Surgery Coordinators Penn State Health Milton S. Hershey Medical Center
Disclosure I have no conflicts of interest to report.
Physicians need to be trained in a way that considers their well-being over the course of a lifelong career. ACMGE Symposium on Physician Well-Being, 2015
Why the Push? Increase in Resident & Physician Burn-out More than 50% of residents experience burn-out; rates approaching 75% [1-3] Residents & Physicians have higher rates of suicide risk Males: 1.41 overall suicide rate compared to general male population Females: 2.27 overall suicide rate compared to general female population [4] Depression in Medical Students & Residents 15-30% estimated range of depressions[5]
What is Burnout? Form of personal distress Characterized by: Emotional exhaustion Depersonalization Decreased sense of accomplishment Symptoms: Treating patients & co-workers as things Feeling emotionally drained Physical & mental exhaustion Poor judgement Feelings of ineffectiveness Depersonalization of relationships [6]
Common Program Requirements NEW Well-Being section in CPR on page 22 Lists responsibilities of the institution and also the program Dealing with: Resident experience Work intensity Evaluating safety Opportunity to attend appointments Sessions regarding burnout, depression and substance abuse Access to appropriate tools and resources
Provide Resources Resident Support What Can Be Done? Small Scale Co-residents; mentors; coordinators; faculty Resident & faculty profiles Resident Involvement Reminder to hydrate Social Media
Medium Scale Resident Fuel Social events Quick Gym; Fitness competitions Sharing Stories Resident Wellness Time Faculty Development Spouse Groups
Large Scale Wellness Coach/Leader Wellness Committee Wellness Curriculum and Handbook Resident Mentorship Milestones 5 Day Trip Institutional Wide Activities
Identifying Burnout Institutional-wide Awareness Involve ALL members of the healthcare team Present at staff/faculty meetings Make resources available to all staff Burnout affects everyone
Questions, Comments?? Lauren Talhelm, C-TAGME ltalhelm@pennstatehealth.psu.edu 717-531-8485
References 1. Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89(3):443 51. 2. West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306(9):952 60. 3. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358 67. 4. Schernhammer ES, Colditz GA. Suicide Rates Among Physicians: A Quantative and Gender Assessment (Meta-Analysis). Am J Psychiatry. 2004;161(12):2295-2302. 5. Andrew LB. (2017 June 12). Physician Suicide. Retrieved from: https://emedicine.medscape.com/article/806779-overview#a1. 6. Balch CM, Freischlag JA, Shanafelt TD. Stress and Burnout Among Surgeons: Understanding and Managing the Syndrome and Avoiding the Adverse Consequences. Arch Surg. 2009; 144(4):371-376. 7. John's Hopkins Medical, Daylight. (2013). Resident Wellness Toolkit: A Prototype!. Baltimore, MD: Author. 8. Physician and Medical Student Suicide Prevention. (2017, September 08). Retrieved October 18, 2017, from https://afsp.org/ourwork/education/physician-medical-student-depression-suicide-prevention/ 9. Khan NR, Rialon KL, Buretta KJ, Deslauriers JR, Harwood JL, Jardine DA. (2017). Residents as Mentors: The Development of Resident Mentorship Milestones. Journal of Graduate Medical Education, 9(4), 551-554. 10. Residency Program Alert: GME New Roundup. HCPRO. 2017. 15(8): 12. 11. McDermott C, Jacob K, Ashcraft Pannu A, Desai S, Bernstein C, Potts S. Burnout s Better Half: Fostering Resident Physician Wellbeing. (PowerPoint Presentation). 11 March 2017.