Residency Program Best Practices
Here are some ideas generated at past CREOG/APGO meetings or shared as part of the #ACOGBeWell initiative. Try these in your program!
Some programs find it useful to have a designated faculty member available to direct others to mental health services oversee curricula programs and provide a safe space to discuss delicate subjects. Consider having this person NOT in a formal evaluation role. This person could be responsible for organizing a debriefing after a bad outcome.
Start at orientation/onboarding – data on death by suicide suggest added risk early in residency and during certain months of the academic year. Transitions are a critical point in residents’ lives when they need reassurance and support. Promote a supportive culture and let them know you care. Provide information on prevention, treatment, and emergency support services for mental health and medical issues.
Retreats were the #1 way program directors and residents reported addressing wellness on the 2015 CREOG Survey. Here are some retreat ideas:
1. Make it about improving the program
2. Do team-building outside of your usual environment!
We have heard about scavenger hunts, bowling competitions, painting parties, sailing, skiing. What do you do?
3. Consider a theme (leadership skills) Invite significant others for a social roundup
Here is what they do at Kaiser Santa Clara:
Community Service Day: Once a year, we extend didactics from morning until 6:30pm. The entire residency program picks a community project, such as building homes for Habitat for Humanity or volunteering at a women's shelter (soup kitchen and health fair). We start the day with a breakfast meeting, then do service together, and share an early dinner. Four faculty members cover the hospital. Night float residents can join but they don’t stay for dinner or work the next night. The residency program covers the cost of the day.
Setting aside dedicated time for wellness is a great way to signal to your department that physician wellness matters to your institution. Here is what they do at Oregon Health Sciences University:
5th Friday Wellness Day. There are 4 months in the year when there is a 5th Friday. Instead of the usual protected educational time, the 5th Friday of the month is a Wellness Day. This way, residents can plan ahead to have a day to take care of themselves or even their family members, or just to go to DMV or change the oil for their car.
Connect with your community, and submit your program for consideration for the Junior Fellow Award. Get ideas from previous winners here.
You may have known the benefit that a great mentor can provide. Residents just starting out may not be able to find a mentor right away. Enhance mentoring by senior peers and faculty. Mentors can help to destigmatize asking for help related to depression, burnout, and feelings of inadequacy. Encourage connections between peers, faculty, and within interprofessional teams to reduce social isolation and watch for signs of burnout, depression, and significant changes in performance.
Big Sib/Little Sib
Many residents get their most significant support from other residents. Consider getting the ball rolling before residents even start. At New York University, we pair incoming residents with big sibs among rising PGY-2s (who themselves have PGY-3 and PGY-4 members of their “family”). The PGY-2 may be more approachable, but the upper-levels can provide help with other questions that arise. We connect the interns with their big sib after match day, and invite the big sibs to a special Intern Welcome Reception during the first week of orientation.
Residency Program Manager
Program managers may be the first ones to become aware that a trainee is struggling. Consider professional development through COFTOG. This person often knows what is available for employees through human resources and the Graduate Medical Education Office. Review health insurance and other related elements of human resources policies to remove barriers to residents receiving timely health, mental health, and dental services.
Residency Program Manager: Health Services
Residents may disrupt ongoing care when they move or start residency. Encourage all trainees to arrange for continued care with local doctors during the orientation period. Know who is responsible for house staff mental health at your institution. Is there a physician wellness committee? Encourage your faculty and residents to participate!
Have a great residency program best practice idea? Let us know what you do and we might post it here. Email us at [email protected].