A multi-residency elective to address well-being as a systems issue

Burnout is a well-established issue in medical training, but optimal systems approaches for well-being and ways to engage residents in well-being work are unknown. The authors developed a multi-residency well-being elective with participants from internal medicine, anesthesiology, and urology residency programs. The elective included an asynchronous learning curriculum, a mentored independent project on system drivers of well-being, and participation in a cross-residency group that set elective priorities. The authors worked with each residency’s leadership to protect time for participation. Concepts from Quality Improvement were used to structure the elective. Project work and resident participation were assessed continually to monitor engagement. Projects led to short- and long-term changes to support well-being in residency programs. Creating opportunities for residents from different specialties to discuss well-being work allowed ideas to spread across residencies. Protecting time to work on well-being issues may enhance a culture of well-being by demonstrating commitment to well-being as a priority equivalent to other educational endeavors. Further research is needed to assess the impact on resident participants and to understand how to optimally incorporate resident interventions into broader organizational strategies for well-being.