"Success is a science; if you have the conditions, you get the result." - Oscar Wilde
Recently, I (MS) attended the International Conference on Physician Health in Ottawa. The opportunity to meet with and learn from a large group of people who were committed to and passionate about well-being in practice and training was very exciting. I returned with ideas for our consideration, which will be introduced over the year. One particularly powerful presentation was by leaders in the field of residency well-being in which they identified the “Top Ten Strategies for a Healthy Residency.” These strategies create the conditions from which a healthy residency experience results. To paraphrase an African proverb, It takes a village to create a healthy residency. This village includes residents, faculty, program directors, Division of Education staff, and many others. As you read through the top ten strategies you will see that some of them require input from residents, others from faculty, program directors, staff, etc. RWBC will increasingly advocate among all the ‘villagers’ to use these strategies. Please consider ways you can incorporate and promote them as well.
- Hold regular retreats - Program or education division wide retreats are held at each new phase of residency to support management of transitions between years, in preparation for graduation and career. Topics include financial planning, time management, balancing work-personal life, coping with change, managing medical mistakes, meditation, and burnout prevention.
- Focus on prevention - Programs facilitate regular, informal gatherings to discuss day-to-day concerns as well as include short presentations on health and well-being.
- Create a Neighborhood Watch - Programs teach and model for residents to look out for and care about each other. This includes helping residents learn how to bring up concerns to each other about how they are doing and offer support or resources to turn to. This rests upon the belief that we are all in this together and that each person’s well-being and success supports our own well-being and success.
- Foster Team Building - Programs promote, and residents participate in activities that help them get to know each other and build team cohesion. These include leisure activities, study groups, etc. Residents support this via maintaining an active Resident Association involved in activities.
- Mentoring Programs - Each program has a formal system in which each new resident is assigned to a mentor with specific expectations in the mentoring relationship. Informal mentoring is also encouraged. Mentors may be faculty or more senior residents. Residents utilize their mentors for consultation on professional and personal concerns.
- Call Schedule - Programs develop call schedules that are fair and set well in advance to allow planning.
- Coverage system for illness - Each program provides one contact person to notify if the resident is ill and has a coverage plan to cover critical gaps due to illness. Residents utilize this system as needed and do not work when ill.
- Flexibility in Training - Programs and division have a process and procedure that facilitates adjustments in training activities to support improvement or recovery with medical, psychiatric, family, or performance issues.
- Real time, constructive evaluations - Feedback is provided in real time, has a constructive focus, is consistent between verbal and written input, and includes self-care items. Residents ask for real time feedback and participate in training on how to seek and receive feedback.
- Appreciation - Given regularly by faculty, program staff, support staff, residents in a timely and specific manner to each other.
Help us build success by working on the top ten strategies together. Talk with your peers, program staff and us at RWBC about what parts are going well and what parts need work. Next issue we will report on plans for the Resident Well-being Workshop.