Title

MED Groups: Adapting a Bottom-Up Resident Wellness Success for Attendings

Authors

Alan A. Kubey and Gretchen A. Colbenson

Introduction

In response to clinician burnout, Mayo Clinic residents created Resident Experience Discussion (“RED”), a resident-led form outside formal programs to promote wellness. RED focuses on unique challenges and emotions faced during training in a casual format focused on non-judgmental discussion which prioritizes reflection rather than solution generation. “Mayo-RED” has successfully persisted for nearly a decade and has been duplicated with similar longevity and success in other residencies (e.g., “Jeff-RED”). Attending clinicians face similar stresses with potentially more professional isolation and ever-more-complex professional and non-professional sphere demands and tensions. We sought to adapt RED to “MED” (Medicine Experience Discussion) for attendings and assess benefit.

Methods

MED was designed similar to RED groups: pre-planned topic chosen by participants, dinner at attendings home followed by discussion with the same RED ground rules. To accommodate schedule constraints, we chose a less frequent cadence, hosting at most monthly and sometimes quarterly. We first trialed MED at Jefferson Hospital Medicine (Jeff-MED) in February 2022. We used the same feedback system as RED to iteratively adjust sessions to attendees’ preferences. All attendings except senior leadership were invited. After success with Jeff-MED we trialed MED groups at Mayo Hospital Internal Medicine (Mayo-HIMED) in June 2023.

Results

We received 51 responses across 14 Jeff-MED/MED-HIMED sessions surveyed (not all sessions were surveyed). 51/51 (100%) of physicians agreed the topic was relevant to them. 50/51 (98%) responded that they would attend again (the single “no” answer was a physician moving to another state). Topics discussed in MED groups are at times similar to RED groups and are sometimes more attending specific. They continue to touch on themes outside formal curriculum and continuing medical education. Similar topics include: A Difficult Patient; When A Case Hits Close to Home; Family Expectations of 'The Doctor in the Family'; and The Patient is Suffering and I Cannot Help. MED specific topics have included: I Am Exhausted from The Work and Feel Guilty for Not Doing More; Finding Direction When There are No More Checkboxes; A Non-Clinical Administrator is Calling -- Oh Joy!; The Lonely Attending: Transitioning to Life After Residency – When All Your Friends . . . Chose Fellowship Out of State; Medicine - What I Thought It Is and What I Have Learned It Is; But Really, I'm the Attending?! -- Leaning Into Imposter Syndrome; Turn It Off? Stuff it Down? Decompressing, Processing The Week On; It's Not You, It's . . . The Team; Review By The Faceless, Anonymous, Aggregate Mob: How to Face Teaching After That Annual June Summary PDF; HM Telomeres: How to Sustain a Hospital Medicine Career Without Reducing Time?; and The Healthcare System is Broken; I am the Face of it.

Conclusion

MED is a success at two institutions and can be reproduced elsewhere to provide a valuable experience for our attending peers. It is a cherished venue to discuss some of the most charged and impactful aspects of physician life that may not otherwise be explored. Focusing on attending-specific topics and allowing scheduling flexibility has helped to sustain MED.

References

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