Physician, heal thyself: tools for resident well‐being

Context and setting We have implemented an introductory workshop during internship orientation to introduce the concept of doctors as healers of themselves and their patients. Why the idea was necessary Medical training is incredibly stressful. Little attention is given to training doctors in self-care. We believe that teaching residents strategies for incorporating personal well-being into their daily lives is essential for longterm doctor wellness and should be part of residents' professional development. What was done We initiated an introductory workshop during orientation, co-facilitated by a doctor and a behaviourist faculty member, on the doctor's role as self-healer. The workshop serves as a catalyst for future discussions on self-care during residency training and plants seeds for personal well-being early on in the training process. First, the interns fill out the health awareness checklist that is given to clinic patients during physical examinations. Anonymously completed and self-reviewed, their answers stimulate a conversation about their personal self-care practices in personal nutrition and exercise, substance use and abuse, sexual health and safety, and overall emotional health. Together, we explore the notion that doctors who are more aware of their own health vulnerabilities and needs are more successful as healers of others. Next, the interns receive a pedometer as a personal fitness tool and are asked to record their steps for 1 month. The ‘step sheet’ is submitted to the faculty and tabulated each week during the first month of residency training. Consistent with the ‘Walk Across America Program’, the intern classes' total steps are calculated and marked with a shoe that indicates their collective progress towards personal fitness along a map of the USA. Wearing their pedometers in clinic serves both to model fitness to patients and to remind and motivate themselves to stay active and take care of themselves. Finally, the interns complete a personal wellness prescription. Here they list 3 commitments to themselves that will improve or maintain their physical and emotional well-being during residency training. These are made confidentially, sealed in envelopes and distributed to the intern's faculty advisor for further discussion. They are asked to re-visit their wellness prescription with their advisor on a bi-annual basis and modify it accordingly. Evaluation of results and impact Three intern classes (n = 21) have now completed the workshop on the doctor's role as self-healer. The data collected have been qualitative and highly positive. The most consistent feedback indicates that the interns feel valued and affirmed that faculty staff ‘care about them’ as individuals and doctor healers, independent of their clinical performance. Many appreciate the focus on raising their own self-care awareness, particularly at a very stressful time in their medical training. They appreciate the wellness prescriptions and their meetings with their advisors to check in on their self-care plan, feeling that this keeps them accountable for their well-being plans. Finally, the residents appreciate the pedometers as tools and reminders of personal fitness, especially as they have entered a training programme where consistent exercise is difficult to achieve. Some commented how patient inquiries about the pedometer have opened discussions about the importance of exercise.

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