Reducing burnout among emergency medicine residents is essential and requires interventions at the individual level and among emergency medicine residency training programs.
Shana Ross, DO, MSc, from the Emergency Medicine Department, University of Illinois Hospital and Health Sciences System, Chicago, and colleagues outline strategies to enhance wellness in a recent article published in the Annals of Emergency Medicine. The authors point out that emergency physicians have the highest burnout rate of all physicians, at almost 70%. In addition, physicians are twice as likely as the general population to commit suicide. As a result, residencies have begun to implement wellness activities, but efforts to date have been insufficient.
Effective wellness strategies for individual residents include:
- Proper sleep, exercise, and nutrition
- Using “casino shifts” rather than overnight shifts
- Clockwise shift rotation to permit circadian stabilization
- Establishing a primary care physician
- Maintaining a work-life balance
- Practicing mindfulness and positivity
The emergency medicine training community should establish a wellness committee that regularly measures, analyzes, discloses, and addresses wellness issues identified by residents. Mentorships can help guide residents throughout their training, and administrative requirements should be reduced so that residents can refocus on educational opportunities. The use of dictation services, scribes, or software programs can mitigate the demands of electronic medical record systems, and feedback should be respectful and constructive.
As emergency medicine often deals with tragedy, a debriefing with the entire team should occur immediately after difficult cases. Residents need to know how to identify the signs of stress, burnout, and mental health issues in themselves and among others.
Finally, programs can help foster a supportive work environment by encouraging and highlighting positive interactions with staff and other services, organizing interdisciplinary events, using a third-party mediator when needed, recognizing that all parties are working toward common goals, and encouraging faculty to become role models.
The authors note that with the support of the residency training community, emergency medicine residents can prevent burnout and foster resilience in themselves.
Ross S, Liu EL, Rose C, Chou A, Battaglioli N. Strategies to enhance wellness in emergency medicine residency training programs [published online August 18, 2017]. Ann Emerg Med. doi: 10.1016/jannemergmed.2017.07.007