The Master of Applied Positive Psychology Program at PCOM is tackling the well-documented problem of burnout among medical residents.
This month, MAPP Director Dr. Scott Glassman, and recent MAPP graduate Linda Martin (’23), presented a positive psychology-based workshop as part of PCOM’s annual multi-site resident orientation. They hope it will bolster a culture of wellness in residency and reduce the potential for burnout.
The workshop offers a preventive health perspective that aims to better insulate residents against the damaging effects of chronic stress. It also helps them implement practices like gratitude and strengths-finding that could enhance their sense of well-being.
“If we just focus on the worst instances of burnout, with a triage mentality, we miss opportunities to help residents become more proactive about their mental health,” says Dr. Glassman.
Residency is a demanding time that marks a medical student’s transition into the rigorous and in-depth work of a physician. Sleep disruption, high stress work environments, conflicts with coworkers, and overloaded shifts are just some of the factors that contribute to the condition.
According to Maslach and colleagues, there are three core features of burnout: detachment, emotional exhaustion, and low sense of personal accomplishment.
Residents experience these symptoms at high rates, with 55% and 76% meeting burnout criteria according to two studies. The consequences can include depression, suicidal thoughts, medical errors, and poorer patient care.
Dr. David Kuo, associate dean for Graduate Medical Education at PCOM, cites the additional pressure of autonomy in clinical decision-making.
“You are making treatment decisions about very complex medical problems that could have very serious repercussions if you don't choose correctly,” states Kuo. “That is a lot of pressure on someone who is still learning.”
Kuo added that the long hours residents work can negatively affect their personal relationships, limiting time spent with friends and loved ones.
This can create a perfect storm of high stress, diminished connection with others, and a reduction in activities that naturally generate positive emotions.
The first part of an effective prevention plan is increasing self-awareness. This involves helping residents identify when they are entering a “burnout danger zone.”
Glassman and Martin presented a validated two-question burnout screener that can assist with catching early signs. Respondents rate how often they’ve felt burned out and callous toward others. If they indicate once a week or more, they would want to take action to prioritize self-care.
Beyond noticing increases in burnout symptoms, Glassman and Martin presented four strategies around activating gratitude and focusing on personal strengths, which can increase positive emotions and strengthen a positive sense of self:
Dr. Kuo has already elevated personal well-being and burnout prevention to a prominent place in the residency programs he coordinates. A faculty member meets with all programs on a quarterly basis to discuss wellness. Additionally, each program has money set aside for wellness events.
“Some programs have had a day at a park where they enjoyed the outdoors and had food catered,” says Kuo. “Others have gone golfing, bowling, or out to dinner.”
For Kuo, collaborating with the MAPP program represents part of the preventive health mindset.
“I hope the presentation brought to the forefront, the idea of gratitude,” he says. “Gratitude not only for others, but for themselves. They need to remember to be kind to themselves and appreciate the high quality care they are providing to the community.”
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