Dabrow Sharon, Russell Stephen, Ackley Karen, Anderson Eric, Fabri Peter Jeff
Division of General Pediatrics, University of South Florida, Tampa, Florida, USA.
Acad Med. 2006 May;81(5):436-9. doi: 10.1097/01.ACM.0000222261.47643.d2.
Residency is a time of stress and turmoil for many residents. The stresses are varied and great, often involving both personal and professional issues. One institutional mechanism that has been shown to help residents cope with stress is the use of residents' wellness, or assistance, programs. The University of South Florida (USF) College of Medicine developed the USF Residency Assistance Program (RAP) in 1997, modeled after business employee assistance programs but tailored to enhance the well-being of residents. The program was developed in an organized, thoughtful manner starting with a Request for Proposals to all local employee assistance programs and the selection of one of these to run the program. The RAP is broad-based, readily available, easily accessible, totally voluntary and confidential, and not reportable to the state board of medicine. It is well integrated into all residency programs and has had excellent acceptance from the administration; information about access to the RAP is available to all residents through multiple venues. The cost is minimal, at only seven cents a day per resident. The authors present data from the eight years the RAP has been operating, including information on program use, referral rates, acceptance, and types of problems encountered. One suicide occurred during this time period, and the RAP provided a significant role in grief counseling. Assistance programs are critical to the well-being of residents. The USF program presents a model that can be used by other programs around the country.
对许多住院医师来说，住院医师阶段是充满压力和动荡的时期。压力多种多样且巨大，常常涉及个人和职业问题。一种已被证明有助于住院医师应对压力的机构机制是使用住院医师健康或援助项目。南佛罗里达大学医学院于1997年制定了南佛罗里达大学住院医师援助项目（RAP），该项目仿照企业员工援助项目，但进行了调整以增进住院医师的福祉。该项目是以一种有组织、深思熟虑的方式开展的，首先向所有当地员工援助项目发出征求建议书，并从中挑选一个来运营该项目。RAP基础广泛、随时可用、易于获取、完全自愿且保密，无需向州医学委员会报告。它很好地融入了所有住院医师项目，并得到了管理层的高度认可；所有住院医师都可以通过多种途径获取有关使用RAP的信息。成本极低，每位住院医师每天仅7美分。作者展示了RAP运营八年来的数据，包括项目使用情况、转诊率、接受情况以及遇到的问题类型等信息。在此期间发生了一起自杀事件，RAP在悲伤辅导中发挥了重要作用。援助项目对住院医师的福祉至关重要。南佛罗里达大学的项目提供了一个可供全国其他项目借鉴的模式。
