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Fostering Meaning in Residency to Curb the Epidemic of Resident Burnout: Recommendations From Four Chief Medical Residents

Berg, David D. MD; Divakaran, Sanjay MD; Stern, Robert M. MD; Warner, Lindsay N. MD

doi: 10.1097/ACM.0000000000002869
Perspectives
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Burnout has become commonplace in residency training, affecting more than half of residents and having negative implications for both their well-being and their ability to care for patients. During the authors’ year as chief medical residents at Brigham and Women’s Hospital in 2017–2018, they became intimately familiar with the burnout epidemic in residency training. The authors argue that addressing resident burnout requires residency programs and teaching hospitals to focus not on the individual contributors to burnout but instead on fostering meaning within residency to help residents find purpose and professional satisfaction in their work. In this Perspective, they highlight 4 important elements of residency that provide meaning: patient care, intellectual engagement, respect, and community. Patient care, intellectual engagement, and community provide residents with a focus that is larger than themselves, while respect is necessary for a resident’s sense of belonging. The authors provide examples from their own experiences and from the literature to suggest ways in which residency programs and teaching hospitals can strengthen each of these elements within residency and curb the epidemic of burnout.

D.D. Berg is a cardiovascular medicine fellow, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts.

S. Divakaran is a cardiovascular medicine fellow, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts.

R.M. Stern is a hematology-oncology fellow, Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.

L.N. Warner is instructor in medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

The authors have informed the journal that they agree that David D. Berg, Sanjay Divakaran, Robert M. Stern, and Lindsay N. Warner all completed the intellectual and other work typical of the first author.

Funding/Support: D.D. Berg is supported by a T32 postdoctoral training grant from the National Heart, Lung, and Blood Institute (T32 HL007604). S. Divakaran is supported by a T32 postdoctoral training grant from the National Heart, Lung, and Blood Institute (T32 HL094301).

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Previous presentations: Brigham and Women’s Hospital Medical Grand Rounds; June 1, 2018; Boston, Massachusetts.

Correspondence should be addressed to Robert M. Stern, Dana Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02115; telephone: (617) 732-3779; email: Robert_Stern@dfci.harvard.edu.

Copyright © 2019 by the Association of American Medical Colleges