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Wellness and Resilience in Medicine

Wellness Curriculum
At the University of Kansas Internal Medicine Residency Program, we place priority on wellness and resident well-being. We follow, respect and go beyond all ACGME requirements on Well-Being: "In the current health care environment, residents and faculty members are at increased risk for burnout and depression. Psychological, emotional, and physical well-being are critical in the development of the competent, caring, and resilient physician. Self-care is an important component of professionalism; it is also a skill that must be learned and nurtured in the context of other aspects of residency training. Programs, in partnership with their Sponsoring Institutions, have the same responsibility to address well-being as they do to evaluate other aspects of resident competence." http://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRs_2017-07-01.pdf)

V1.C.1.b) "attention to scheduling, work intensity, and work compression that impacts resident well-being"

  • Inpatient care teams at lower caps than national average to allow for improved teaching (16 patients on a 1 senior/2 intern team)
  • Progressive scheduling in the ambulatory setting to allow for growth and responsibility as you progress through training
  • Longitudinal 3:1 rotational curriculum allowing for adjusting work intensity throughout training
  • "Golden weekend" (both Saturday and Sunday free of duty) after each ambulatory week                         

VI.C.1.c) "evaluating workplace safety data and addressing the safety of residents and faculty members"

  • Every-other month Patient Safety Conferences that are resident-led
  • QuEST Committee (Quality/Safety Educational Steering Team) that includes a core group of program leadership, hospital leadership, chief residents, and residents. This committee meets monthly and addresses ongoing quality improvement and safety at the resident program level.  

VI.C.1.d) "policies and programs that encourage optimal resident and faculty member well-being; and residents must be given the opportunity to attend medical, mental health, and dental care appointments, including those scheduled during their working hours"

  • During our +1 week residents are provided with protected administrative and self-study time in lieu of a clinical experience.
  •  Additionally, during our +1 week, residents have the opportunity to schedule wellness days for self-care activities such as doctor's appointments and other life needs.
  • All residents will be scheduled to meet with our Counseling & Educational Support Services for a free and confidential wellness consultation in lieu of a clinical experience. Residents have found this to be a beneficial opportunity to assess their personal level of wellness and burn out, and to discuss strategies for stress management and improving self-care. This consultation does not require the use of a wellness day.  

VI.C.1.e) "attention to resident and faculty member burnout, depression, and substance abuse. The program, in partnership with its Sponsoring Common Program Requirements Institution, must educate faculty members and residents in identification of the symptoms of burnout, depression, and substance abuse, including means to assist those who experience these conditions. Residents and faculty members must also be educated to recognize those symptoms in themselves and how to seek appropriate care. The program, in partnership with its Sponsoring Institution, must: (1) encourage residents and faculty members to alert the program director or other designated personnel or programs when they are concerned that another resident, fellow, or faculty member may be displaying signs of burnout, depression, substance abuse, suicidal ideation, or potential for violence; (2) provide access to appropriate tools for self-screening; and, (3) provide access to confidential, affordable mental health assessment, counseling, and treatment, including access to urgent and emergent care 24 hours a day, seven days a week.

  • We have annual and ongoing faculty development on both faculty and resident well-being
  • Residents are aligned for close mentorship with a chief resident and program director for ongoing mentorship and monitoring of well-being
  • Residents complete the physician wellness index (a 7 question Well Being Index invented by the Mayo Clinic for Residents as a validated screening tool to evaluate fatigue, depression, burnout, anxiety/stress, and mental/physical quality of life in residents and fellows l https://www.mywellbeingindex.org/login) bi-annually prior to face-to-face semi-annual review meetings with the program directors
  • We have a solid and ongoing relationship with our Counseling and Educational Support Service department within our GME office that offers urgent/emergent care 24/7. As highlighted above, residents are intentionally schedule for a wellness consultation at the beginning of their PGY 1 year to establish knowledge and relationship with our counseling services group.

In addition to all of the above ACGME requirements, we have developed numerous programs and resources to help maintain an appropriate work-life balance.

Resident Social Events 

As much as we enjoy work, we also enjoy spending time with each other outside of the hospital. We have a housestaff appreciation fund which funds resident events to the Royals games, Sporting KC, happy hours, trivia nights, and more! We also have annual Fall, Holiday, and Graduation parties with both faculty and residents. 

Exercise 
We love when we can fit exercise into our workday! All of our residents receive a free membership to the KU Kirmayer Fitness Center, located across the street from the medical center.  We have an under-desk elliptical in our resident lounge as well as a desk bike in our night resident team room. Walking desks are available in the library.

Nutrition 
A fully stocked resident lounge at KU and at the VA provide healthy snacks for residents on call. In addition, residents receive a weekly allocation of monies for the cafeteria. Meals are provided at the majority of conferences.

Financial Fitness 
We realize many residents come into residency with a large amount of medical school debt and a deficit in education about finances. We provide a quarterly seminar focused on financial fitness, bringing in experts including financial advisors, contract lawyers, and others to educate residents about investing, what to look for in a contract, and common pitfalls. Resources are also available to help residents with their financial questions. See links below.

Community Service Activities 
As we strive to maintain a balanced life, we realize volunteerism is an important activity. Residents are involved in JayDoc, a free student-run clinic. We as a program have also been involved in Harvesters, a local community food bank.

Resident Response Team 
The Resident Response Team is a team of peer-selected residents who assist residents in time of sickness, grief, or life changes/stress. Many residents have appreciated being brought food when under-the-weather or flowers during a difficult time.

Debriefing Conferences 
These conferences are divided by PGY level and are led by a palliative care physician. Residents can discuss difficult cases or problems in a safe and protected environment.

Ethics Conferences 
A resident-led conference where ethically challenging cases are brought to the group and discussed. Members of the hospital ethics committee also join in on the discussion.

Counseling and Educational Support Services 
As an institution, we have resources for residents including a writing center, practice interviews, seminars for study tips and learning styles, and confidential counseling.  http://www.kumc.edu/student-affairs/counseling-and-educational-support-services.html

Medical Education Day 
Each year, the residency program has a Medical Education Day where residents participate in a day filled with educational enrichment, and residents are exempt from clinical duties during that time.

Celebrating Accomplishments
Our residents are quite the accomplished group and we like to share good things our residents are doing on and off of campus in regular emails sent by our program leadership team.

External links
Exercise - KU Kirmayer Fitness Center
http://www.kumc.edu/student-services/kirmayer-fitness-center.html

Local Trails
http://kcparks.org/about-recreation/trails/
http://www.jcprd.com/parks_facilities/trailguide.cfm

Healthy Recipes From KU
http://www.kumed.com/health-library/healthy-recipes

Financial Fitness
http://www.finrafoundation.org/resources/education/

Mental Health Links 
http://www.kumc.edu/school-of-medicine/gme/resident-wellness/mindfulness-in-medical-training.html

Academic Resources - GME link to writing center, practice interviews
http://www.kumc.edu/student-services/counseling-and-educational-support-services.html

Last modified: Oct 09, 2019
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