Monitor resident wellness

Residency Program Insider, August 12, 2020

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Editor’s note: The following is an excerpt from The Residency Program Director’s Handbook, Third Edition. Click here to order your copy.

Program directors have the crucial role of monitoring resident wellness along with all other aspects of residents’ performance. Scheduled meetings with residents are a mandatory part of the program director’s duties. It would be prudent to meet with residents on a quarterly basis not only to monitor their progress toward mastering the six ACGME competencies but also to inquire about their physical and psychological well-being.

Sleep deprivation and accompanying fatigue and burnout must be acknowledged, and therefore, the program director is also tasked with ensuring that residents and faculty know how to recognize fatigue in their colleagues and respond to it appropriately. Mitigation is an essential part of physician wellness.

Not losing sight of the joy or happiness found in the practice of medicine is also mentioned in the most current Common Program Requirements. An easy-to-remember and comfort-evoking mnemonic to ensure that all aspects of resident wellness are being monitored is “SSSHHH…,” whose letters represent the following:

  • S: Safety
  • S: Sleep
  • S: Support system (peers, mentors, work, family, friends)
  • H: Home life issues (family, finances, and others)
  • H: Happiness level with work and home
  • H: Health issues (psychological and physical, including exercise)

Psychological factors (included in the last “H” of the mnemonic) include such crucial items as substance abuse and suicidal ideation. In a conversational manner, program directors can touch upon each of these important issues, which can dramatically affect a resident’s emotional and physical well-being. Keep a record of these discussions alongside documentation of residents’ advancement in clinical skills. If worrisome issues arise in any of the wellness areas during the quarterly meetings, program directors are expected to have services in place to help the resident manage the particular issue. Immediate access to mental health professionals is an expectation in every residency program. Seeking help for psychological issues must be supported fully, and any stigma associated with mental health concerns must be thwarted. All wellness maladies that are unearthed must be addressed on a case-by-case basis by program personnel and the resources available at each particular institution.

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