Policies regarding resident and fellow health

Residency Program Insider, February 5, 2020

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Editor’s Note: The following is an excerpt from Resident Well-Being. For more information about this book, click here.

In a recent survey of residents and fellows, 51% reported not establishing care with a primary care physician (PCP). Seventy-seven percent reported delaying care for a medication problem. Ninety percent cited the inability to leave work during business hours as the most important barrier to seeking care (OHSU, 2010).

All departments should promote seeking healthcare when needed, and interns should be encouraged to establish a PCP within the first quarter of their intern year. Residents should be provided with a list of PCP clinics during orientation (Place & Talen, 2013; Eckleberry-Hunt, Van Dyke, Lick, & Tucciarone, 2009; OHSU, 2010). A fair and transparent policy about resident/fellow access to healthcare should be implemented for all programs, and a copy of this policy should be provided to residents at orientation (Place & Talen, 2013; Daskivich et al., 2015; Eckleberry-Hunt, Van Dyke, Lick, & Tucciarone, 2009; OHSU, 2010). 

Additionally, all programs should have clear parental and pregnancy-related disability leave policies These policies should adhere to the Family Medical Leave Act (i.e., leave may extend to 12 work weeks.) However, policies must also comply with each training program’s ACGME requirements and qualifying time for the boards. Policies should clearly outline the following:

  • Resident responsibilities for written notice
  • Amount of paid leave
  • Total amount of leave allowed
  • How much leave a resident is eligible for before he or she must extend residency training to meet ACGME requirements

In addition to a specific policy, residents should be afforded increased mentoring upon return, as this transition can be particularly difficult in terms of time management, life-work balance, emotional stress, and fatigue.


Daskivich, T. J., Jardine, D. A., Tseng, J., Correa, R., Stagg, B. C., Jacob, K. M., & Harwood, J. L. (2015, March). Promotion of wellness and mental health awareness among physicians in training: Perspective of a national, multispecialty panel of residents and fellows. Journal of Graduate Medical Education, 7(1), 143–147.

Eckleberry-Hunt, J., Van Dyke, A., Lick, D., & Tucciarone, J. (2009). Changing the conversation from burnout to wellness: Physician well-being in residency training programs. Journal of Graduate Medical Education, 1(2), 225–230.

OHSU. (2010, July 1). OHSU policy for resident/fellow health. Retrieved from education/schools/school-of-medicine/gme.

Place, S., & Talen, M. (2013). Creating a culture of wellness: conversations, curriculum, concrete resources, and control. International Journal of Psychiatry in Medicine, 45, 333–44.


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