We are making resident well-being a priority in the Department of Surgery at the University of Texas Southwestern. To us (residents in the department and its director), well-being is not a cursory objective but rather a conviction sounded repeatedly. There have been too many undue hardships during training, unheard grievances of marginalized residents, and stories of those who endured alone during times of physical and emotional weakness. Consequently, we established a resident wellness initiative, and later committee, that aims to instill a culture in which taking care of oneself and colleagues is an unconditional priority.
At its inception, the initiative was maintained through spontaneous meetings held between OR cases or after educational conferences where ideas were exchanged and plans were contemplated. These loosely organized meetings ultimately led to the creation of a wellness survey that was distributed electronically to all the surgical residents in the department. The survey comprised a list of questions that sought to quantify the residents’ healthy habits such as amount of sleep, frequency of physical exercise, and number of visits to healthcare providers. Using the survey, the committee also better understood the residents’ experiences inside and outside residency. Mentorship, social events, time off, and mental health were tackled in the survey as well.
To change a culture is a momentous task, and to no one’s surprise, the work is challenging and long, whereas the impact is gradual and delayed. Nonetheless, the motivation of the committee members was strong, and their approach was structured such that smaller tasks took priority and more challenging projects were set in motion to be tackled incrementally. Consequently, several straightforward tasks were quickly implemented based on the feedback and suggestions from the residents. First, a holiday schedule was created so that all residents have four days off at either Thanksgiving, Christmas, or New Year’s. This was a no-cost, though somewhat logistically challenging, intervention with a huge impact. Second, the committee identified specific rotations during which residents may take half a weekday off to schedule physician and dentist appointments. Residents were encouraged to take off two half days annually for these important self-care appointments and incentivized by being excused from rounds in the morning. Third, the committee sought funding to buy new refrigerators for the call rooms and to supply these rooms weekly with healthy drinks and snacks. This gesture not only improved access to healthy food and drinks for the residents, but it was intended to show appreciation for the residents’ hard work. Fourth, discounted memberships at the university gym as well as some local gyms were secured.
The initial changes were well-received by the residents, several of who took the initiative to contribute to resident wellness. With avid support from the department, a book club was formed, and all books were funded by the department. Movie outings were scheduled, and a 5K wellness run was organized and turned out to be a blast. Moreover, a UT Southwestern resident life Twitter account was created. Using Twitter, it was seamless to disseminate event schedules and showcase resident activities during work and afterwards. Several faculty also contributed to the resident life Twitter feed by taking over the account at times and live-tweeting their day. The day with one of our breast surgeons was a great success.
The positive feedback and publicity the committee received helped its members take on broader and more challenging tasks. One of these tasks was establishing the resident wellness and counseling center, a joint effort with other departments at UT Southwestern. The center includes a clinic staffed by psychologists and psychiatrists and aims to address mental concerns in an anonymous manner. The clinic staff have been invited several times to surgery grand rounds to discuss depression and burnout in residency.
Now, over a year since the inception of the resident wellness initiative, we are excited and grateful this initiative is ongoing and strong as the efforts and changes made so far are phenomenal. By striving to change the culture, we are talking proud and loud about topics related to healthy habits, mental health, and burnout. We count on motivated future residents and an incessantly supportive department to maintain this initiative and pursue a culture in which taking care of oneself is an unconditional priority.