Authors’ Reply to “Working Together to Heal Our Physician Well-Being Crisis”

We appreciate Dr Awadallah’s comments on our paper and her commitment to promoting resident well-being. The innovative intervention she describes at her program is consistent with several of the most highly-rated elements of a wellness curriculum in our study: to begin conversations about wellness early and continue them throughout residency training, integrate these conversations into the advising and mentoring process, and measure resident well-being through qualitative methods. It is possible that the individual learning plan (ILP) meetings she describes also could incorporate several other essential elements to promote well-being by serving as a time to connect with a mentor and facilitating confidential disclosure for burnout and impairment.¹ We encourage her and other program leaders to consider how they might be intentional about incorporating the essential elements into their existing wellness initiatives. We also encourage individuals responsible for wellness curricula to advocate for protected time and a budget to implement wellness initiatives, a crucial factor in getting these programs off the ground.²

Regarding other elements of a wellness curriculum, Dr Awadallah points out that many residents do not view mindfulness training and team-building as very helpful and even find them onerous. Though these elements were not as highly rated as those previously mentioned, they were still considered by the expert panel to be essential to a wellness curriculum and have been shown to have benefits for resilience.^1,3 The tension between resident and family medicine educator opinions underscores the importance of delivery of wellness interventions (eg, creating time and space for them, offering options that can be tailored to individual resident needs and the culture/context of the program), so that residents are not left feeling burdened with one more thing to do. This discrepancy also highlights the need to advance the literature on resident wellness by studying the relative effectiveness of the components of a wellness curriculum on well-being outcomes (eg, career satisfaction, resilience) and academic/professional performance.

Finally, we echo Dr Awadallah’s call to action for residency programs to develop and evaluate innovative ways to equip the “next generation of physicians with the tools needed to circumvent the physician well-being crisis.” By sharing best practices, together we can make a difference.