New interns should master these 8 domains of well-being

As it is throughout the continuum of medical training, personal well-being is a key in making a successful transition from medical student to intern.

“You have a lot more responsibility as a resident,” said Sonja Raaum, MD, an assistant professor of internal medicine at the University of Utah. “It is more important to be intentional about wellness as a resident because if you are not intentional, it’s very easy to have those responsibilities impact your well-being.”

The AMA’s Facilitating Effective Transitions Along the Medical Education Continuum handbook looks at the needs of the next generation of physicians across the continuum of medical education—from the beginning of medical school through residency. It is the latest publication from the AMA Accelerating Change in Medical Education Consortium.

One chapter in the text examines how to make a successful transition from medical school to residency and the role well-being plays in that process. The chapter breaks down resident well-being into eight key domains. Dr. Raaum, who co-wrote the chapter, gave her take on the importance of the domains and how residents can navigate them. Download the handbook now.

One aspect of each domain Dr. Raaum wanted to highlight is that well-being isn’t a singular pursuit. New interns should rely on their larger support system in their pursuit of well-being.

“Being aware of your peer support system is huge. You also have your program support that offers more direct, professional support in terms of your skills and career development. And then looking to your institution for support around systems that can allow you to meet your work hours and empower you with the right set of circumstances,” she said.

What is it: An awareness of and response to feelings.

Dr. Raaum’s take: “It’s really important to recognize the high-acuity situations you are in in residency where emotions run high,” she said. “Having some ability to navigate your own emotional wellness is going to allow you to be present and be able to grow in those situations.”

Learn more about what helps and what hurts medical resident well-being.

What is it: An exploration of career options, encouragement to pursue opportunities, and satisfaction and purpose in work.

Dr. Raaum’s take: “Figuring out where you want your career to go and what you need to be able to do it. In internship this can be difficult,” she said. “You go from being a med student with a lot of structure to residency where you have the structure of what you need to accomplish day to day, but you don’t necessarily have the structure and direction to pursue larger career goals.

“As an intern, being aware of what brings you happiness in this arena can keep you well in your day-to-day role.”

Find out how to get time off for professional development during residency.

What is it: Keeping yourself stimulated in the intellectual realm extends beyond work-related learning. The AMA handbook highlights that involves engagement in mentally stimulating and creative activities in academics, community involvement, hobbies, and cultural involvement. It could involve reading for pleasure or going to a concert.

Dr. Raaum’s take: “It’s important to hold onto the things that bring you intellectual wellness and recognize that those things are going to keep you whole,” she said. “We are human. It helps us interact with our patients as well, in bringing a kind of depth to our patient encounters.”

What is it: Maintaining a level of physical health that permits you to make the most of your day.

Dr. Raaum’s take: “This domain is about being aware and proactive, but also recognizing that it’s not all or nothing,” she said. “A lot of people were incredibly active before residency, and while they don’t necessarily do all the triathlons and stuff anymore keeping up some kind of routine can be important.”

Discover three keys to help residents get the exercise they need.

What is it: Respecting the relationship between the community, yourself and the environment. It can be accomplished by creating a work environment that is respectful toward team members that builds rapport with the staff as well as the patients.

Dr. Raaum’s take: “Starting to understand how you navigate the environments you encounter can allow you to recreate the circumstances that keep you well.”

What is it: Successful management of financial expenses, debt and savings.

Dr. Raaum’s take: “Figure out your debt situation and, if you do, it’s important to have a plan and figuring out something that works for you for repayment,” she said.

“You need to have some relationship with your finances. You can’t just push them off to the side, but you also can’t put all the pressure on the resident to make every single key life decision during training. It would be really lovely if every institution could help every resident with navigating these big changes.”

Learn more about three key tips that help residents maintain financial well-being.

What is it: Building supportive relationships with communities, individuals and groups.

Dr. Raaum’s take: “The way to attempt it is approaching with some intention and eyes wide open in terms of what you can expect, and also thinking about it as who is closest to you and how do you want to be intentional and maintain those relationships and recognize that you can’t hold those all at the same level.”

Get insight on how medical residents can make the most of their time off.

What is it: Being in harmony with your inner self so that you may be resilient and better equipped for life’s challenges.

Dr. Raaum’s take: “You see a lot of suffering as an intern,” she said. “Sometimes we don’t recognize there are skills that can help us navigate that better. Oftentimes for people, that is true spiritual wellness. Focus on your core values to navigate and recognize the amazing things we encounter in our work, and balance it all.”