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Well-Being in Graduate Medical Education: A Call for Action

Ripp, Jonathan A. MD, MPH; Privitera, Michael R. MS, MD; West, Colin P. MD, PhD; Leiter, Richard MD; Logio, Lia MD; Shapiro, Jo MD; Bazari, Hasan MD

doi: 10.1097/ACM.0000000000001735

Job burnout is highly prevalent in graduate medical trainees. Numerous demands and stressors drive the development of burnout in this population, leading to significant and potentially tragic consequences, not only for trainees but also for the patients and communities they serve. The literature on interventions to reduce resident burnout is limited but suggests that both individual- and system-level approaches are effective. Work hours limitations and mindfulness training are each likely to have modest benefit. Despite concerns that physician trainee wellness programs might be costly, attention to physician wellness may lead to important benefits such as greater patient satisfaction, long-term physician satisfaction, and increased physician productivity. A collaborative of medical educators, academic leaders, and researchers recently formed with the goal of improving trainee well-being and mitigating burnout. Its first task is outlining this framework of initial recommendations in a call to action. These recommendations are made at the national, hospital, program, and nonwork levels and are meant to inform stakeholders who have taken up the charge to address trainee well-being. Regulatory bodies and health care systems need to be accountable for the well-being of trainees under their supervision and drive an enforceable mandate to programs under their charge. Programs and individuals should develop and engage in a “menu” of wellness options to reach a variety of learners and standardize the effort to ameliorate burnout. The impact of these multilevel changes will promote a culture where trainees can learn in settings that will sustain them over the course of their careers.

J.A. Ripp is associate professor, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

M.R. Privitera is professor, Department of Psychiatry, and director, Medical Faculty and Clinician Wellness Program, University of Rochester Medical Center, Rochester, New York.

C.P. West is professor, Department of Medicine, Mayo Clinic, Rochester, Minnesota.

R. Leiter is fellow, Harvard Interprofessional Palliative Care Fellowship Program, Boston, Massachusetts.

L. Logio is vice chair for education and residency program director, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College, New York, New York.

J. Shapiro is director, Center for Professionalism and Peer Support, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

H. Bazari is director, Morton N. Swartz, MD Initiative, and program director emeritus, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.

Funding/Support: The Collaborative for Healing and Renewal in Medicine is supported by a grant from the Alliance for Academic Internal Medicine.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Jonathan A. Ripp, 1 Gustave L. Levy Place, Box 1216, New York, NY 10025; telephone: (212) 241-4141; e-mail:

© 2017 by the Association of American Medical Colleges