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Student and Resident Letters to the Editor: Well-Being of Learners

Mindfulness in Residency: Making a Case for More Research

Lavelle, Conor

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doi: 10.1097/ACM.0000000000001755
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To the Editor:

My pager goes off for the sixth time in the last 15 minutes, and by now I haven’t slept for 21 hours. The hairs on the back of my neck literally stand on end. My hands unconsciously fumble to press a button on the pager dangling from the drawstring of my oversized scrubs—anything to make the beeping stop.

I return all six pages, yielding to a request to write a prescription (at 4 am!), answering a question from a nurse regarding new bruising on a patient’s penis (I’m not joking), and seeing the two new patients who were awaiting me in the ER. With the hairs on my neck gradually settling back to a resting position, I tuck my pen into my pocket and head for the meditation room.

Excuse me? Of course I didn’t go to the meditation room. I immediately went to see the sick patient on the ward, and then to the ER where I did two consults.

But what if there were a meditation room? Would it have done me any good? Unfortunately, the evidence is scant. Only a few small studies have attempted to bring meditation to the attention of the medical education community. In 2015, a group at Duke University looked at the impact of mindfulness training on residents’ stress levels and their ability to cope with the cognitive demands of residency.1 In the same year, another group tried to implement a meditation program for residents on call.2 Results from these underpowered studies showed no clear benefit; stress tallies remained fairly constant despite mindfulness training. Yet we know from the medical literature that mindfulness provides a cornucopia of health benefits, and it is even as effective as selective serotonin reuptake inhibitors in the treatment of mild clinical depression.3

We are at a turning point in the history of medical education, where for the first time trainee resilience has become a major theme in curriculum development. Mindfulness meditation deserves appropriately powered research projects to answer questions about its utility in medical education.

Conor Lavelle
Resident physician, Department of Emergency Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada; [email protected]

References

1. Goldhagen BE, Kingsolver K, Stinnett SS, Rosdahl JA. Stress and burnout in residents: Impact of mindfulness-based resilience training. Adv Med Educ Pract. 2015;6:525532.
2. Brennan J, McGrady A. Designing and implementing a resiliency program for family medicine residents. Int J Psychiatry Med. 2015;50:104114.
3. MacKenzie MB, Kocovski NL. Mindfulness-based cognitive therapy for depression: Trends and developments. Psychol Res Behav Manag. 2016;9:125132.
Copyright © 2017 by the Association of American Medical Colleges