Resident physician well-being in the time of COVID-19 and beyond
By Dr. Ana Hategan
Burnout is an important issue for physicians and continues to pose a significant challenge to their well-being. Physicians-in-training, in particular, face increased stress due to inherent pressures associated with training and systemic challenges common to health care organizations. As such, I believe that residency training programs that create a culture of resilience and wellness are far more likely to produce graduates who are well prepared for an era of sustainable medicine.
Even pre-dating the COVID-19 pandemic, medical educators have been increasingly shifting toward online teaching and other educational supports. In the age of limited faculty and financial resources, residency training programs need to anticipate updating the more traditional curriculum models. I am a strong believer that in order to create a more sustainable curricular ecosystem, training programs might consider sharing their resources. In this vein, in 2018, I designed an electronic resilience curriculum initiative called RESPITE (Resilience in the Era of Sustainable Physicians: An International Training Endeavour).
Teaching individual resilience with an eye for systemic change
The RESPITE tool is a free, online curriculum that promotes resilience for physicians training in various medical specialties. The tool has general applicability to medical training programs interested in supporting training of modern physicians, by addressing the wellness needs of a rapidly changing health care landscape. It discusses strategies to help mitigate chronic stress and burnout, and to optimize one’s own well-being. These strategies can be implemented prophylactically when physicians are well, but also as interventions when physicians are at risk for — or have experienced — psychological injury.
I must emphasize that these strategies focus primarily on ones that can be implemented at the individual level; they can be utilized as harm mitigation and interim measures, until system-level interventions addressing the causes of burnout are meaningfully tackled at the organizational level. Until then, RESPITE users are encouraged to consider how they may contribute to, and advocate for, this systemic change. More than ever before, meeting the wellness needs of an already exhausted and overwhelmed pool of physicians going through the current COVID-19 pandemic may also determine how well we are positioned to survive future public health crises.
RESPITE was envisioned as an international partnership amongst McMaster University; Dalhousie University; University of California, Davis; and Texas A&M University. It was implemented in collaboration with the Division of e-Learning Innovation at McMaster.
It is my hope that readers will find this tool useful.
Ana Hategan, MD, FRCPC, is a geriatric psychiatrist in the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, Ont. She is also a clinical professor and serves as the curriculum developer for the Geriatric Psychiatry subspecialty training program.
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