February 27, 2018

Physician Well-Being: The ACGME and Beyond

Physician well-being has been a key issue for the ACGME for as long as the organization has been serving the GME community.

In November 2015, the ACGME held its first Symposium on Physician Well-Being, which brought together more than 150 representatives from across the medical continuum, including board members, administration, staff members, health care professionals and leaders, friends and family of physicians, learners, and well-being experts, to engage in a national discussion to initiate positive change in this area. The event was a success, and the ACGME held the third Symposium in November 2017. Each year, the gathering has gained momentum, with speakers and roundtable discussions delving into well-being issues for residents, faculty members, medical students, and beyond.

ACGME President and CEO Thomas J. Nasca, MD, MACP maintains a personal and professional commitment to raising awareness about this very important issue. At the Annual Educational Conference in 2014, Dr. Nasca began calling for the thousands of attendees to work together to identify gaps and solutions. This week, he will again emphasize this issue in his CEO address (Friday morning).

In May 2017, Dr. Nasca issued a letter to the GME community articulating the ACGME’s commitment to leverage its resources to facilitate dialogue and action around physician well-being for both residents and faculty members. He encouraged the community to take special note of the potential impact on well-being during transition periods, such as the new academic year or during onboarding, and discussed the need for mentoring, support, and encouragement around finding joy and meaning in work.

“First, we must provide residents with the opportunity to receive the appropriate level of medical and surgical care required to live healthy lives,” he said. “In addition to our efforts around the clinical learning and working environment, it may require evolution of our culture where admitting needs or weakness has been often seen as a sign of lack of commitment. It also likely requires our willingness to permit our colleagues on the faculty to be treated in the same fashion. We must model the behaviors we wish to instill in our residents.”

We can’t do it alone
In 2016, the ACGME, Association of American Medical Colleges (AAMC), and National Academy of Medicine (NAM) joined forces to form the Action Collaborative on Clinician Well-Being and Resilience, a network of 130 (and growing) organizations dedicated to reversing trends in clinician burnout. The Action Collaborative is working to improve baseline understanding of challenges to clinician well-being, raise the visibility of clinician stress and burnout, and elevate evidence-based, multidisciplinary solutions that will improve patient care by caring for the caregiver. The ultimate goal is to spark a national dialogue regarding the well-being of caregivers in the US, and the impact it has on the ability to fulfill the mission of health care service to our society. Dr. Nasca has served as co-chair since its creation.

In another significant milestone around physician well-being, the ACGME revised Section VI of its Common Program Requirements to more comprehensively address the issue. The changes include requiring programs to provide support to individual residents through 24x7 access to urgent and emergent care, and confidential mental health assessment, counseling, and treatment. They also include requirements to facilitate the creation of a “culture of well-being.”

In support of these changes, the ACGME’s Task Force on Physician Well-Being Tools and Resources Subcommittee recently created and announced a compendium of materials and other references for residents and faculty members as a resource for well-being, wellness, and related tools to help identify solutions that best meet local needs. It is the ACGME’s hope that these resources will support the elements in Section VI of the ACGME’s Common Program Requirements. The requirements emphasize that psychological, emotional, and physical well-being are critical in the development of the competent, caring, and resilient physician.

The materials, ranging from educational videos to toolkits to screenings, can be found on the ACGME website, here. We welcome feedback and ideas to expand on this collection.

Finally, building upon the theme of finding joy and meaning in work, the ACGME Council of Review Committee Residents created the Back to Bedside initiative in 2017 to empower residents and fellows to develop transformative projects that combat burnout by fostering meaning in their learning environments and engaging on a deeper level with their patients. The ACGME provided funding for 30 projects for up to two years, and their work will be a main focal point for the 2019 Annual Educational Conference.

What to expect at the Annual Educational Conference

In a recent Twitter poll we posted, the topic of physician well-being ranked highest in terms of Annual Educational Conference attendee interest, and there will be many opportunities for the community to share with and learn from each other, contributing to national efforts to shine a brighter light on this issue.

In addition to Dr. Nasca’s CEO address on March 2, physician well-being will be covered in more than 10 sessions over three days and the content will be presented by a range of leaders in the graduate medical education space, including DIOs, program directors, program coordinators, and residents/fellows.

Focus areas include:

  • Signs and symptoms of burnout in program coordinators
  • Embracing inclusion
  • Creating and implementing well-being programs
  • Resident engagement
  • Creating a culture of well-being
  • Mindfulness and stress reduction
  • Gender-specific challenges in burnout

Thursday evening’s poster session allows presenters to showcase their projects in well-being and discuss their work. Come back to the blog for more details about the sessions and posters later this week as we report from the conference!

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