Resident wellness

[Mark7954]

Can anyone speak on their observations on resident wellness/burnout prevention in some of the academic psychiatry programs on the East and West Coast? I know some information can be on the respective websites but was just curious to know previous applicants(who are now residents) observations/perspectives.

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[PsychApp777]

For resident wellness, choose residencies that:
Minimize hours over 50
Minimize overnights
Minimize 24 hr shifts
Minimize weekend call
Have reasonable patient carriage caps
Promote a supportive and collegial work environment

No amount of meditation and yoga will help you in a program with a 70+ hr average work week and Q4 night call.

 

[Bartelby]

I agree with PsychApp. You of course need to balance out getting good training (which in my opinion involves doing overnights etc), but in our culture wellness issues that are systems-based often get translated into terms of individual culpability. So, for instance, if you feel burned out by doing frequent 24-hour shifts, having little time to spend doing things you enjoy, and carrying a high workload in a relatively unsupportive environment you may be offered individual tools (like meditation, exercise, Yoga) or platitudes, but the source of the distress is the poor system that is in place and often "wellness" programs don't touch that.

In short, choose a program that puts its money where its mouth is on wellness as evidenced by satisfied residents managing reasonable workloads. Pay attention to exactly what each program has on offer in terms of call, patient caps, leave policies, elective policies etc. and contrast and compare. Also feel free to ask residents for their opinion on those issues. When I was interviewing I was surprised by the frank answers residents gave me, especially in terms of program weaknesses. As a resident I came to understand that you don't want colleagues to feel tricked into coming to your program, so you do want to provide a realistic picture of the good and the bad. That makes the current residents a very valuable source of information.

 

[Stagg737]

Agree with the above. Know the call schedule and what it entails. Know what call is like (are you covering 3 units and taking calls all night or just one and getting paged 2-3 times). Know how often you're on weekend call. You don't realize how much only having 1 day off adds up until you've been doing it for several weeks in a row (my IM months). I do think going to a program where you're babied too much can be bad. Imo, call should be easy overall, but you do want to experience one or two hell/disaster shifts during residency so you know what they are and how to handle them while you've got the safety net of an attending in place. If the first time you experience this is as an attending, I'd imagine it would be pretty terrifying. Imo the 3 most important aspects of wellness in residency can be summed up as:

1. Is the workload reasonable? (call, patient load, total hours)
2. Can you have a decent lifestyle outside of work? (enough time, geographic location, COL, interactions with other residents)
3. Are the faculty/admins supportive of the program? (as a learning experience as well as general health of residents)

If all 3 are a yes, then you'll be fine (regardless of where you are).

Also feel free to ask residents for their opinion on those issues. When I was interviewing I was surprised by the frank answers residents gave me, especially in terms of program weaknesses. As a resident I came to understand that you don't want colleagues to feel tricked into coming to your program, so you do want to provide a realistic picture of the good and the bad. That makes the current residents a very valuable source of information.

100% agree. Imo nothing is off limits to ask the residents (about the program) and most I encountered during interviews spoke very openly about strengths and weaknesses. Being on the other side, I try and be as candid about my experience and opinions of my program as possible, including the negatives. Like Bart said, I want to work with people who want to be here or at the very least aren't constantly complaining about it, and that isn't likely to happen by throwing out a lot of empty promises.