The Division of Medical Education created the RWBC in 2004 to promote the
physical and psychological well-being of our residents.
RWBC is charged with two
major activities. First, to provide educational programming to support resident
well-being. Second, to provide an out of program resource for consultation and
referral for residents dealing with physical, psychological or spiritual issues.
RWBC has been assured by Med Ed and all the program directors that our contact
with residents is to remain confidential unless issues have legal ramifications
or directly impact resident or patient safety. Only non-electronic record of
contact with residents occurs and is secured separately from Med Ed and the
RWBC members where selected based on their reputations for commitment to
resident training and well-being and only if they were not part of program
administration. RWBC members include: Drs. Jerry Goldberg, Vicki Viegut, KJ
Williams and Michael Schulein. Members can be contacted via the Resident
Well-Being Committee email address found under ‘Groups’ or individually by
phone, email or in person. Please feel free to contact us with any questions or
concerns or to just ask us about what the RWBC can do for you.
One of our first initiatives is to encourage residents to identify a primary
care physician for themselves and to obtain regular medical care including
routine screenings and preventive services. A survey of the literature suggests
that many residents do not have a primary care physician. Delva’s (2003) survey
of 122 residents found that over 60% did not have a primary care physician
including 25% of those with chronic illness and 40% who use prescription
medications regularly. In another survey of 316 residents, (Rosen, 2000)
approximately half reported not having a PCP. Closely related to the lack of a
PCP, is a high rate of self-prescribing (Christie, 1998) and informal medical
care consultation with other residents.
A number of concerns exist with this:
First, residency can create stresses that may affect health if not properly
addressed. In a study of residents before and during residency training,
(Osborne, 2003) sleep hours, exercise, family interactions, percentage of low-fat meals,
and attended significant events all were significantly decreased during
residency. PGY1 residents appear to be particularly vulnerable due to the
transition to residency and having fewer coping resources (Monk, 1985). Second,
data suggests that not only should we practice what we preach, but that we tend
to preach what we currently practice. Physicians, who do not engage in good
self-care, including regular medical care, are less likely to promote it in
their patient education contacts (Frank, 2004). Third, rather than practice
making perfect, as our colleague Dr. Michael Miller once noted, “practice makes
permanent.” Getting into the routine of self-care or no-care in residency,
increases the odds of doing the same throughout one’s career.
Given the above, the RWBC is pursuing the following:
- Advocating to Program Directors and Division of Med Ed to incorporate pro-health care seeking attitudes in residency. Developing a PCP, having routine medical care with screenings and preventative services should be viewed as indicators of healthy behavior and not a sign of weakness.
- Advocate for program support and options that reduce the more common obstacles to residents seeking medical care ( schedule unpredictability, work ours, lack of support by attendings and residents, confidentiality concerns).
- Due to the specific stresses, advocating for development of a voluntary referral service for PGY1s to PCPs.
The RWBC is here for you, to support your well-being throughout training. We
encourage you to contact us with any concerns or suggestions. In the meantime,
please consider contacting a physician to establish care here.