Giving residents back 2 hours a week makes dent in burnout’s toll

Time is perhaps the most valuable commodity for a medical resident. Giving residents a few hours back per week—time in which they can accomplish professional and personal tasks—may lead to decreased burnout and increased well-being, says recently published research.

A study of otolaryngology residents, according to a study recently published in JAMA Otolaryngology-Head & Neck Surgery, examined the effects, over 32 weeks, of giving the residents two hours of protected nonclinical time per week.

The study’s results showed clinically meaningful drops in emotional exhaustion—one of three primary indicators of burnout—as well as a marked improvement on an index of resident and fellow well-being.

As far as how the otolaryngology residents used their time, it was up to them.

“Participants were not specifically limited in what they could do during their nonclinical time,” says the study, “but they were encouraged to use this time in a way they felt would decrease their own personal burnout and increase their well-being, whether performing work-related administrative duties previously performed on personal time or fulfilling obligations that are integral to personal health and well-being that can only be completed during normal business hours.”

Participants were asked to complete weekly surveys in which they accounted for how they spent protected time. The most common answers were:

• Research—15%.
• Personal or other—13%.
• Reviewing upcoming cases—13%
• Preparing for a residency-required presentation—11%.
• Logging cases—11%.
• Dictating or reviewing cases—10%.
• Logging hours—9%.
• Responding to work-related emails—8%.

1. Create a holistic, supportive culture of wellness

   1. This AMA STEPS Forward™️ module provides information about successful residency training wellness programs and identifies ways to create a sustainable culture of wellness. 

2. Show leadership, assess resident burnout and take action

   1. According to preeminent physician burnout expert Lotte N. Dyrbye, MD, MHPE, residents in some specialties reporting burnout in numbers that exceed 60%. Dr. Dyrbye offered a handful of solutions that residency programs can put in place to curb the trend.

3. Learn where physician burnout starts—and how to stop it 

   1. An AMA Innovations in Medical Education webinar highlighted methods for educating medical students, residents and physicians to prioritize their own well-being and addressing the causes of distress and burnout. 

4. Help medical residents combat sleep deprivation

   1. Insights on the science of stress and its reduction, are provided in a 19-minute training module, “Physician Health: Physicians Caring for Ourselves,” designed to address the self-care needs of residents. It’s one of the AMA GME Competency Education Program offerings, which include nearly 30 courses that residents can access online, through their institution’s subscription, on their own schedule.

The idea of taking work off residents’ plates is one with which many residency programs are experimenting.

The “AMA Moving Medicine” podcast —available Apple Podcasts, Google Play or Spotify—spent two episodes featuring a panel discussion on burnout. In the second episode on the topic, AMA member Ryan Ribeira, MD, MPH—a clinical assistant professor of emergency medicine at Stanford University School of Medicine—offered some insight on his views on combatting burnout and how protected time can play into it.

“The solutions that are most appealing to me are solutions that facilitate the development of good habits during training,” Dr. Ribeira said. “At Stanford, in our residency program, in lieu of mandatory wellness lectures, once they kind of got the message around, they said, ‘Well, you know what we're going to do? We're going to give you residency conference credit for doing wellness activities. So instead of going to conference, you can go work out for an hour. And you'll get an hour of conference credit for that.’

“Or, ‘You can go to the dentist, or you can go get a massage, or you can go do whatever you want to do for your own personal wellness, and we'll give you conference credit for that as if you were there.’ That kind of solution I think is excellent. It helps foster those good life habits.”

Learn more about the AMA Resident and Fellow Section and how it gives voice to and advocates for issues that affect residents and fellows.