• Well-being in Residency: Surviving Training

    There’s no denying that medical school and residency are stressful. The pressures of balancing classroom and clinical instruction, studying in isolation for long periods, testing, matching, and dealing with illness and death up close can take an emotional toll.

    Until fairly recently, few medical schools or residency programs dedicated effort, time, or money to offering resources that support personal well-being. Individual medical students and residents typically have had to seek out these resources on their own.

    While in medical school at the University of Illinois at Chicago (UIC) College of Medicine, Kristina Dakis, MD, realized that if medical students are expected to find well-being resources on their own, many people miss out on getting needed support.

    “There were programs in different departments within the school and [on] campus offering individual wellness resources, but there was nothing cohesive. Students kept to themselves,” Dakis says.

    She recognized that a more systematic approach could benefit all students. During her third year of medical school, Dakis co-founded the Medical Student Wellness Program, pulling together UIC’s disconnected wellness resources to form the basis of the new program.

    A committee comprised of Dakis and other students representing each medical school class started by organizing weekly and monthly extracurricular wellness events. Discussion topics ranged from managing burnout and depression to reducing test anxiety. The committee invited subject matter experts, including attending physicians and psychologists, to participate. One of UIC’s family medicine instructors started hosting a monthly chat in her own home, where medical students could sip on chai tea while offering each other encouragement and support.

    “Getting together with others who [were] going through the same thing was the biggest help to me,” Dakis says.

    Although Dakis has moved on to UIC’s family medicine residency, the program she co-founded continues to develop as new student leaders rotate onto the Student Wellness Committee. Current initiatives include:

    • Wellness and resilience curriculum
    • Weekly mindfulness course
    • Coffee, bagels, and massage chairs during finals week
    • Quiet room available before exams
    • Wellness series presentations
    • Medical student wellness monthly meetings

    The UIC College of Medicine also offers a peer advising program for medical students who need one-on-one emotional support from someone who understands the demands of medical school and can help them access well-being resources.

    When Dakis, who is now a second-year resident, started her family medicine residency at UIC, she found a wellness program already in place. Interns meet once a month with a behavioral psychologist in a support group that provides an opportunity to give and receive advice and encouragement, and to confidentially discuss challenges and explore strategies for dealing with them.

    Dakis notes, “It’s also a good way for us to bond as a class.”

    In addition, UIC Family Medicine Residency offers a mentoring program that matches each resident with a mentor who meets with him or her on a quarterly basis—or more frequently, if needed—to support personal and professional development. During their inpatient service, residents get regularly scheduled, structured support from a behavioral psychologist, attending physicians, and peers. 

    “We meet periodically in the morning during more stressful rotations to share highs and lows and get advice,” Dakis says.

    Being part of a residency culture that values residents’ well-being was especially important for Dakis when her father was diagnosed with colon cancer during her intern year. As the stress and competing demands of the first year of residency and her father’s worsening health mounted, she realized she was having trouble feeling empathy for her patients and was losing sight of why she went into family medicine.

    Fortunately, IUC’s residency program supported her need to step away from work and make her family a priority. The residency has a “jeopardy system,” Dakis explains, in which residents agree to cover for those who need to take time off to deal with personal matters.

    “I took some time off. I got to spend some time with my dad near the end before he passed away,” Dakis says. “It was difficult. But if I hadn’t been in an environment where people were willing to help me, it would have been worse.”

    The three weeks she was away from her residency program also gave Dakis a chance to reflect on why she chose family medicine in the first place. Remembering the satisfaction of experiences like delivering her first patient helped renew Dakis’ dedication to family medicine.

    Kristina Dakis, MD, is a resident physician at the University of Illinois at Chicago College of Medicine Family Medicine Residency.