Well-Being Policy

I. Purpose of policy

This policy defines the ways in which Residents are supported in their efforts to become competent, caring and resilient physicians while completing Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs at Dartmouth-Hitchcock (D-H).

II. Policy scope

This policy applies to Residents, Faculty, Program Directors, Program Coordinators, and Graduate Medical Education (GME) staff at D-H.

III. Definitions

Burnout: Long-term exhaustion and diminished interest in work. Dimensions of burnout include emotional exhaustion, depersonalization, and feelings of lack of competence or success in one’s work. Burnout can lead to depression, anxiety and substance abuse disorders.

Resident: Any physician in an ACGME-accredited graduate medical education program including residents and fellows.

Resilience: The ability to withstand and recover quickly from difficult conditions or situations. During training, Residents may face difficult patient care, educational or personal events which have the ability to negatively affect their Well-being. Decompressing after such situations, through conversation with peers, mentors or family, and self-care activities, can increase Resilience.

Well-being: Refers to the state of being healthy, happy and successful. Well-being may be positively increased by interacting with patients and colleagues at work, being intellectually stimulated and by feeling that one is making a difference/helping. In addition, self-care activities, including exercise, getting plenty of rest and connecting with others, is beneficial.

IV. Policy statement

Residents’ physical, psychological and emotional Well-being is of paramount importance to D-H and our ACGME-accredited training programs. Residents are encouraged to lead healthy lives and make healthy choices that support them in their personal and professional growth. To that end, we provide the following strategies to support trainee health, Well-being and Resilience:

• Institutional Support
  • Live Well/Work Well (LWWW) provides D-H employees and their families with resources and services that motivate, encourage, and promote healthy lifestyles and foster Resilience. Services include:
    • Health Improvement and Employee Wellness: including Health Risk and Wellness Assessment, MindStrength mindfulness training, health and lifestyle coaching, diet and nutrition resources, fitness rooms, onsite fitness classes and others.
    • Employee Assistance Program (EAP): Confidential and free counseling services which include up to six in-person visits/year and 24/7 telephonic counseling.
    • Live Well/Work Well Primary Care: Coordinated, small team primary care option for D-H insured employees and their dependents.
    • Occurrence Reporting: Patient and employee safety reporting for actual events and near misses.
  • Residents have access to healthy food and beverage options at the D-H cafeteria and from other on-campus food purveyors, including 24/7 service at Cravins Deli.
  • All Residents participate in a half-day Safety Behaviors for Error Prevention course during training.
• Graduate Medical Education Support
  • The Office of GME is a safe place where Residents can ask for and receive help with various needs including academic counseling, coaching, and mentoring.
  • The Office of GME sponsors an annual Residents and Fellows Appreciation Week where Residents have the opportunity to participate in daily wellness activities and shared meals. During the week, D-H community members write notes of appreciation to trainees and individual programs sponsor wellness activities for their Residents.
  • The D-Hx seminar series provides Residents with an opportunity to learn and ask questions about topics of interest to their professional lives and future.
  • Residents may become members of, or participate in, the Associated Resident Council (ARC), its subcommittees, and sponsored events. The ARC membership is composed of a group of peer-elected representatives from each of the core residency programs which comes together to discuss issues affecting Resident life. The ARC seeks to promote harmonious and collaborative relationships amongst Residents, faculty and staff and enhance the Resident community through advocacy, volunteer, and social activities.
  • The Office of GME delivers coffee, fruit and snacks to the Resident call room and provides dinner on Saturday evenings for on-call Residents, free of charge. Meal funding support is also provided to Residents taking overnight in-house call and for Residents who must return to the hospital to provide care when scheduled to home call.
  • Residents may take advantage of free taxi service to and from the hospital in the event that they are too fatigued to drive home after a clinical shift.
  • All Residents and core faculty complete an annual learning module on sleep alertness and fatigue mitigation.
• Program Support
  • There are circumstances in which Residents may be unable to attend work, including but not limited to fatigue, illness, and family emergencies. Each program has policies and procedures in place to ensure coverage of patient care in the event that a Resident may be unable to perform their patient care responsibilities. These policies will be implemented without fear of negative consequences for the Resident whom is unable to provide the clinical work.
  • Residents have the opportunity to attend medical, mental health, and dental care appointments, including those scheduled during their work hours. Residents must follow the program’s procedures for scheduling and notification of these appointments.
  • Residents are encouraged to alert the Program Director, a faculty mentor or Chief Resident when they have concern for themselves, a Resident colleague or a faculty member displaying signs of Burnout, depression, substance abuse, suicidal ideation or potential for violence.

D-H Policy ID: 17709