Resident and Fellow Well-Being

Marshfield Clinic Health System’s Resident Well-Being Committee (RWBC) formed in 2004 with a primary goal to promote a healthy and humane learning and work environment for residents and fellows. RWBC focuses on providing individual, group, and program level wellness support and education. RWBC additionally serves as a primary resource to bridge residents and fellows to a wide array of MCHS institutional well-being resources. Resident and fellow wellness programming is a significant strength of graduate medical education training at MCHS, enhancing support resources to maximize growth and well-being through training to independent practice.

What is Well-being?

Well-being is a continuous process of self-awareness and intentional integration of healthy choices and behaviors into daily routines for the purpose of improving life balance.

During residency this process results in a strengthened sense of engagement, learning, accomplishment. Well-being supports a resident's acquisition of knowledge, clinical performance, and positive attitude. These benefits combine to strengthen resilience through the challenges of training.

Dimensions of well-being include:

Physical
Emotional
Intellectual
Spiritual
Social
Cultural
Occupational
Environmental

Prerequisites to positive well-being include:

Feeling engaged and empowered
Maintaining physical health with rest
Healthy diet
Regular exercise
Achieving a balance of work and time away from work
Being present in the moment
Understanding one's own limitations and those of others

Division of Education support for your well-being through training is one example of the Marshfield Clinic Health System's commitment to support for global clinician and health care workforce well-being. MCHS joined the National Academy of Medicine's Action Collaborative on Clinician Well-Being and Resilience in December 2017 with the submission of the MCHS Commitment Statement. We view the 2018 Charter on Physician Health as a very useful guide for RWBC's work with residents and fellows and advocacy within our system to support your well-being.

Activities of RWBC

Consultations with Residents, Fellows and Medical Students

A primary role for RWBC is to provide confidential consultation services to residents. RWBC consultations provide a safe space to talk about personal, interpersonal, professional and program concerns. Consultations are strictly confidential. No information about RWBC contact is shared with the trainee's program or with DOE unless the trainee requests coordination of support with their program/DOE or issues of serious impairment, risk to personal or patient safety or criminal activity emerge. Consultations are typically held at 12 p.m. or after 5 p.m. with one to two members of RWBC.

We listen, help you explore your concern from different perspectives and support you in developing a plan to address your concerns. We help link you to resources if this becomes is part of your well-being plan to address your concerns. Each year up to 20 percent of residents seek RWBC consultation related to a wide variety of concerns. Is consultation with RWBC helpful? Over 150 residents have consulted RWBC through the years and 95 percent report that it was both supportive and helpful. The odds are strongly in your favor that RWBC can be of assistance, so please consider contacting us.

Wellness Programming

Annual Resident & Fellow Well-Being Retreat
PGY1 Resident Wellness Orientation
PGY1 Health and Wellness Assessment
Annual Health and Wellness Assessment – all residents and fellows
PGY1 semi-annual, individual Wellness Checks
Resident wellness Quality Improvement Projects
Self-Assessment Wellness Tools
Recognize, Respond, Refer Suicide Risk Reduction Training with Chief Residents
Crisis resource information
Bridging to Behavioral Health services

Retreats

Each year RWBC sponsors a day long off site retreat for all residents and fellows. DOE and your training programs release you from daytime service after morning rounds/report to attend a day of activities to foster your ability to manage of the stress residency/fellowship and enhance your sense of community with other residents. Please check here for agendas, photos and videos for retreats since 2013. These retreats continue to evolve based on resident input and we look forward to hearing from you with ideas to improve this activity.

Advocacy

RWBC collaborates with DOE, residency, and fellowship programs on well-being education and programming during training. Information is shared about new resources and clinical learning environment strategies to enhance resident and fellow well-being during training. Recommendations are offered in support of well-being and concerns are highlighted based on resident and fellow input. Resident representatives are important members of RWBC and serve as a critical source of idea and feedback to enhance well-being efforts. As new rules and regulations are implemented that affect training programs and residents, RWBC supports communications related to the context for the changes and how DOE and training programs can best care for residents through regulatory changes.

Resident Well-being Committee Member Statements

Jennifer Michels, Ph.D., ABPP

Department of Psychiatry and Behavioral Health

Choosing the profession of medicine for one's career is a noble endeavor, requiring vast knowledge, skills, dedication, tolerance for high levels of stress, and sacrifice. All of this can come at the expense of personal well-being. As a clinical psychologist, I have dedicated my life's work to improving the well-being of others. In my roles as a clinical supervisor, program director, well-being director, teacher, and mentor, wellness in training has been at the forefront of all that I do. I joined the Resident Well-being Committee to extend my commitment and passion for improving professional well-being in medical training, clinical practice, and in the culture of health care systems. When we are healthy and part of systems that prioritizes our health and wellness, we can offer the best of ourselves. Career demands, along with personal roles as a wife and mother, lead to frequent challenges to my own well-being practices. I have come to deeply appreciate that well-being is a life-long, imperfect pursuit. I often find myself needing to "start again" as life gets in the way. My hope is that you will reach out to me and other members of the RWBC when you experience challenges along the way. My door is always open to you for support.

Rana Nasser, M.D.

Department of Infectious Disease

On most days, I love my job. Some days, I have to remind myself why. The challenges of medicine are many, and as residents train in recognizing and treating diseases, so must they train to keep themselves sane while they do it, a more challenging task. This is where I see the role of members of the resident well-being committee: they have been through the experience, still love what they do, and have committed to lending a helping hand. I have lived and practiced in different cultures, and by the nature of my role as an infectious disease physician, interact with many residents. Stop me in the hallway anytime something's on your mind: you might just give me a break from a day where I'm having to remind myself why I love what I do.

Rosemary Reriani, M.D.

Department of Nephrology

I truly believe that medicine is a rewarding career, but I find that many times I need to remind myself why I chose medicine. Other times I have needed my family, friends and colleagues to remind me of the reason for my commitment to a medical career. I was lucky enough to go through all my years of medical training with a very supportive family and two sisters who went through medical school at the same time as I did. For sure, I would not have made it without their support in my most difficult and darkest moments.

You are living life daily in the midst of your training. There will always be challenges and stressors that will present themselves during this time. Your need for balance, self-care and well-being is a constant. Your success at managing your personal life plays a big role in your success as a physician. When life happens, the RWBC is available to you.

I joined the RWBC to provide support and a listening ear. Having recently graduated from nephrology fellowship, I can relate to many of the challenges that residents encounter. So please know that I am always available to provide mentorship, support and encouragement.

Victoria Viegut, M.D.

Department of Pediatrics

As a primary care pediatrician, I work with residents every day. I appreciate your dedication and professionalism. As a working wife and mother with a busy pediatric practice, I also appreciate how much stress you are under to balance your personal and professional lives. I look forward to being available for questions, concerns, discussions, or problems. I am no expert on well-being, but I am looking forward to learning with you. The longer I am in practice, the more I see we have to take care of ourselves before we can take care of our patients.

Mark Ridder, M.D.

Department of Infectious Disease

No one would argue that being around people on their worst day is a challenge. As providers we are constantly exposed to a barrage of emotions, circumstances, in addition to having to make complicated decisions, and perform challenging tasks mired with risks. Without taking time to share in our experiences as clinicians, I have found it easy to have the expectation, unhealthily so, to believe that we could preempt all complications, predict the direction of our consultations, and deliver perfect health care each, and every time. However, on the contrary, one of my greatest joys in practicing medicine has been admitting that I, like my patients, like my colleagues, like my students, I am only so human. Transitioning away from the pressure of always having to have the "right answer" in all instances, delivering care with emotional awareness, accuracy, and intellect. Instead I have come to find tremendous fulfilment, as opposed to finding instances such as this to be exacting, taxing, and draining, due to fearing failure, but instead using them as opportunities instead to share of my vulnerabilities with my patients and fellow colleagues. I hope to share my same passion for shared vulnerability as the starting point of any practice of medicine. Above all else, know that you are not alone. Medicine is hard. It is challenging, but so very rewarding for this exact reason. It is my hope to be able to share this through the resident wellbeing committee, and in my daily practice in general. If you ever have need of someone to talk about these issues with, it is my hope you know that I see it is a tremendous privilege to be able to offer an ear.

Nicole Krolak, D.O.

Pediatrics - Hospitalist

I always knew I wanted to be a doctor and today I feel incredibly blessed to be here. What is more rewarding than helping people as a profession? Every day I get to know and help heal my patients, and this brings me so much joy! This is why we do what we do. But sometimes residency can feel like a Dickens novel “It was the best of times, it was the worst of times". So many aspects of medicine are filled with these intense moments- birthing a baby, responding to a trauma, running a code, having an end of life discussion, watching death... Sometimes taking care of yourself can seem to pale in comparison to these experiences. You may just need a reminder that it is OK to pause and take a breath.

I am honored to be a member of RWBC and to be with you through this journey of training. It will be some of your best days and some of your most trying days. This experience will mold you into the physician you will become. I'm here to listen, take a walk with you, bring a meal to you, or help in any other practical way I can. As a recent graduate from training, I remember keenly the depth of exhaustion post call. As a first time mom in residency, I understand the difficulty of balancing the demands of training with the equally important demands of home life. I lost a loved one during training, I know the days you will never get back. You are not alone in this journey. Please reach out if you need anything.

Resident Representatives