From the Rush University Medical Center, Chicago, IL.
J Am Acad Orthop Surg Glob Res Rev. 2022 Mar 7;6(3):e21.00227. doi: 10.5435/JAAOSGlobal-D-21-00227.
The challenges associated with surgical residency have been well documented and described. Despite implementation of work-hour restrictions, residency remains a balancing act between patient care, surgical and clinical education, medical record documentation, and research endeavors. The added challenge of balancing these duties with life outside of the hospital further complicates the situation. Multiple studies have documented the stress associated with residency training, highlighting the prevalence of emotional exhaustion, detachment from people both in and out of the hospital, and a concerning rate of clinical depression among residents. Moreover, this emotional exhaustion has been shown to directly correlate with residents' clinical performance and abilities to carry out academic duties. More recently, feelings of isolation and detachment have been exacerbated by the necessity of COVID-19 precautions and change in clinical duties. The Accreditation for Graduate Medical Education (ACGM) now requires all residencies to include programming that focuses on resident well-being. Programs have implemented various strategies in an effort to help their trainees cope with the stress associated with residency and beyond. Despite the variety in approaches of programs, these initiatives have the similar objective of teaching resilience and the ability to navigate stressors in a healthy and effective manner. The programming can also serve to promote resident interaction and develop camaraderie in an effort to minimize feelings of emotional exhaustion and isolation. In this article, we discuss the importance of sustained physician wellness and describe approaches from various professions that can be implemented into the wellness curriculum for residency programs across the country. By promoting a culture of wellness and incorporating effective wellness programming, our aim is that residents will be able to succeed not only in their training but also in their personal lives and professional endeavors after graduation.
外科住院医师培训所面临的挑战已有大量文献记载和描述。尽管已经实施了工作时间限制,但住院医师培训仍然是在患者护理、外科和临床教育、病历记录和研究工作之间取得平衡的过程。在医院之外的生活中平衡这些职责的额外挑战进一步使情况复杂化。多项研究记录了与住院医师培训相关的压力,强调了情绪疲惫、与医院内外人员脱节以及住院医师中临床抑郁的高发率。此外,这种情绪疲惫已被证明与住院医师的临床表现和履行学术职责的能力直接相关。最近,由于 COVID-19 预防措施和临床职责的改变,孤独感和脱节感加剧。毕业后医学教育认证委员会 (ACGM) 现在要求所有住院医师培训计划都包含关注住院医师健康的项目。各计划已实施了各种策略,以帮助其学员应对与住院医师培训相关的压力及其他压力。尽管计划的方法多种多样,但这些举措的目标都是相同的,即教授应对压力的韧性以及以健康有效的方式应对压力源的能力。该计划还可以促进住院医师之间的互动,并培养团队精神,以尽量减少情绪疲惫和孤立感。在本文中,我们讨论了保持医生健康的重要性,并描述了来自不同专业的方法,这些方法可以纳入全国住院医师培训计划的健康课程中。通过倡导健康文化并实施有效的健康计划,我们的目标是使住院医师不仅能够在培训中取得成功,而且能够在毕业后的个人生活和专业工作中取得成功。