Insights on Residency Training

Dr. Orlovich is a Chief Resident of Wellness at Stanford University

“We’re not like Stanford” she said to me as we sat next to each other during our breakout session. My cheeks reddened. Somehow, suddenly, I felt as if I became the embodiment of my entire institution. And my furrowed brow revealed my surprise.

Her tone softened. “What I mean is, resident wellness is easier when the program has money. Your program has money. We, though, don’t have the funds for it.”

I looked toward the corner of the room as I thought about this statement. It was interesting. So I decided to examine this a little bit more thoroughly. 

Does resident wellness require a large financial commitment?

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A Study

A large academic general surgery program created a program that delivered a care package to residents, at work or at home (J Surg Edu 2020; 77:13). This package included essential medications, vitamins, nutrition, and hydration. Residents themselves could request a package or colleagues could send one to them.

All (100%) of the residents felt that this package addressed an unmet need in residency and also felt that the supplies helped them recover faster. The majority of packages, 83%, were requested by colleagues, rather than self-requested. The recipients’ narrative comments focused in on feeling valued and supported, and having a feeling of belongingness. 

And here is the most important part – each package cost $7.

The Take-Home Points

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First, this study suggests that interventions for resident wellness need not be expensive or elaborate. It is time we reevaluated the kneejerk association of wellness with fancy retreats and expensive counseling sessions. A phone call, a text message, a handwritten note, or even a heartfelt verbal acknowledgment of hard work goes a long way.

Second, this study reiterates what is already well-known and established in the literature — residents won’t ask for help. It is time we design interventions that go to the residents. Or, allow co-residents and family members to take an active role on behalf of the resident. Most residents I’ve been around want to work hard. They don’t ask to be excused — they ask to be supported.

Third, the intervention is targeted. It provides what is needed and at the right time. No more ‘one-size-fits-all’ approaches that residents themselves didn’t vote on or ask for. On the surface, the care packages might seem reductionist and simplistic. The authors themselves acknowledge that burnout is multifaceted and this study only addressed one aspect of burnout. But the point here is that what the care package communicates is incredibly powerful: 

Residency is hard and the system is complex but you are valued. We care about you in a meaningful way that is useful to you. We want to support you in your journey to be a better physician. 

Conclusion

So to be clear, resident wellness doesn’t necessarily require a large financial investment. It can be a simple, targeted, low-cost intervention that goes to residents and meets an unmet need as determined by the residents. 

What low-cost interventions have you seen? Continue the conversation @SolvngResBrnout