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Resident and Fellow Burnout Case Report: The University of Alabama at Birmingham Tinsley Harrison Internal Medicine Residency Program

Background: The University of Alabama at Birmingham Tinsley Harrison Internal Medicine Residency program has always held dear our namesake's thoughts on medical education. Dr. Harrison believed that medical education required both the head and the heart. This was represented in his equation, E=hH2, where the “h” represented the head (the medical knowledge) and the “H” represented the heart of medicine. Both are important, but giving your heart to teaching and learning was the more crucial part of the equation and thus it was capitalized and squared in his equation. Despite learning about burnout, many concepts do not become “real” until personally experienced. Some of the major components of burnout, including depersonalization, emotional exhaustion, and lack of autonomy, can drain the hearts of residents. The Tinsley Harrison Internal Medicine Residency Program sought to create a committee to preserve the hearts of residents and reemphasize Dr. Harrison's inspiring thoughts on medical education.

Action: To focus on combatting the individual components of burnout and preserving the hearts of residents, the residency program created a resident driven committee, the Resident Wellness Committee. To prevent depersonalization, community service projects were organized that specifically did not involve the provision of medical care. The goals of these projects were to get residents out of the hospital to see different aspects of their community and spend time together. The community service also aimed to diminish feelings of inadequacy. To address emotional exhaustion, we pioneered a Memorable Patient Lecture series. In this series, faculty share positive patient stories, focusing on reflections about a specific patient he/she may have known for years or decades, a type of relationship residents have yet to experience in their early careers. For the lack of autonomy, we initiated a problem solving subcommittee with the goal of tackling 1-2 resident stressors a year with resident-driven solutions.

Results: Since the creation of the Resident Wellness Committee in 2013, residents have participated in community garden projects, The Over the Mountain Miracle League to help children with disabilities play baseball and Habitat for Humanity. The committee, comprised of residents from all levels of training, meets quarterly to plan future projects. The Memorable Patient Lecture series has had seven speakers from 2013-2015, including the Department Chair of Medicine and the Residency Program Director. Feedback from these presentations has been highly positive with attendees expressing “very heartfelt” and “great realistic discussion.” The problem solving committee addressed scheduling stressors by creating a new cross-cover system on General Medicine wards. The Resident Wellness Committee has enjoyed time together away from the hospital and has led to the creation of a standing social gathering and sports clubs. Early feedback suggests that combatting the individual components of resident burnout can be an effective way to preserve the hearts of residents.

The Resident Wellness Committee continues to be a positive influence for residents. Dr. Nicholas Hoppmann (PGY3) led the efforts to create this committee, with the support and encouragement of Program Director, Dr. Lisa Willett and Associate Program Director, Dr. Jason Morris. This summary was provided by chair of the committee, Nicholas Hoppmann (PGY3). To learn more about the committee please visit the link below. http://www.uab.edu/medicine/imresidency/alumni/l2t-issue6-spring2015/162-resident-wellness-update.

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