The first ever Resident Wellness Consensus Summit (RWCS) was held this year as a pre-day to Essentials of EM on May 15, 2017 in Las Vegas. This was an amazing opportunity for residents across North America to come together and discuss the important topic of resident wellness. We even had some participants from Fiji! Many of the attendees participated in pre-work for the RWCS through their involvement in the Wellness Think Tank, which is our virtual community of practice that involves residents from across the U.S. and Canada. In addition to pre-work for the RWCS, the members participated in online discussions on wellness and worked closely with our Wellness Strategists.
“We do make a difference, but not just in the setting of resuscitating critically ill or injured people, but in putting people on the pathway to health. We often get cheated out of the ending of the movie. We don’t see the romantic side of what we’ve helped facilitate. We certainly don’t get credit for it.” – Dr. Richard Cantor
There are lots of reasons why Emergency Medicine (EM) has one of the highest burnout rates compared to other medical specialties.1,2 We have long and erratic hours, difficult patients, and an increasing number of bureaucratic tasks such as clicking boxes in an electronic medical records system or ensuring high patient-satisfaction survey responses.2 These stresses are not unique to EM, but our high-volume and high-acuity patient loads do amplify those stresses compared to other fields.
Wellness and Resiliency During Residency: Professional Identity Formation (featuring a podcast with Dr. Michael Weinstock)
“So I had medicine in my blood. But just because you have medicine in your blood doesn’t mean that it’s always smooth sailing.” —Michael Weinstock, MD
What is “professional identity formation”?
As Abraham Fuks and colleagues once said, “One does not simply learn to be a physician, one becomes a physician.”1 Professional Identity Formation (PIF) is the slow transformative process by which an idealistic pre-medical college student becomes a battle-hardened emergency physician attending. PIF occurs slowly over years of exposure to the culture of medicine. From Day 1 of medical school, we watch how doctors in the world around us think, teach, feel, and act and slowly absorb those lessons over time, often without even being consciously aware of it happening. These lessons can be inspiring or toxic.
This week the Wellness Think Tank is launching a resident wellness survey for Emergency Medicine residency training programs across the United States. We want 100% of EM residents to complete this important survey and we need your help! Check out 5 reasons why you should take our survey TODAY, if you are a U.S EM resident!
When I got back home from taking [my board exams], having all these [negative] feelings swirling through my head, I remember driving up and seeing my wife and baby sitting on the porch and suddenly being like, “Isn’t this what life is all about? Is it really about studying for an exam? Is it really about pushing yourself to get triple-boarded or do this or that within medicine? I mean, isn’t THIS what it’s about? Having a wife and a child, a family to call your own, aren’t these the things that are most important that we should value?” After that point, after seeing them on the porch and over the next couple weeks, things really started to change for me.
— Haney Mallemat, MD
“One of the residents that I was working with was yelled at once by somebody else because he had cried while giving a family bad news. I think everyone knows when you’re giving them bad news; it’s not like a big secret. You maintaining a great deal of composure doesn’t change that fact. I think that we’re allowed to be human. If we force ourselves not to be human or have any degree of human emotion, that’s obviously not putting us on the path to wellness and certainly if we force other people not to be human that’s not putting either them or us on the path to wellness.”
—Ilene A. Claudius, MD
Breaking bad news to patients and families is a fact of life for an emergency physician. More than 300,000 patients die in emergency departments each year from either traumatic or nontraumatic cardiopulmonary arrest, and an even greater number are diagnosed with a new life-threatening or life-altering illness, such as cancer, stroke, or traumatic brain injury.1 We stand at the front lines for these patients and families when they are first confronted with death or their own mortality. It is up to us at these moments, not their specialists or family physicians, to comfort and support them in a time of need. While intensely fulfilling at times, this type of demanding emotional support can also be incredibly draining in an environment that never sleeps and never stops moving.
|“Dear colleagues. The unbearable has happened…last Friday we discovered that one of our residents was tragically taken from us… It appears that the resident took their own life in response to acute grief…”
– Dr. Christopher Doty (Program Director, University of Kentucky EM Residency Program)
Calling ALL Emergency Medicine (EM) physicians – residents and attendings alike! It shouldn’t take Dr. Doty’s story or the loss by the resident’s family, friends, and colleagues suffered in order for us to recognize the importance of wellness. Our specialty is known to be high risk and it is surprising that we are so late to the game to try and change that. Well, together we can. We are a strong group of people. We see, hear, touch, and smell things that would make the average person nauseous. We are problem solvers and leaders.