LAUSR

Burnout is described by Maslach 1 as a syndrome composed of emotional exhaustion, depersonalization, and decreased levels of personal accomplishment. Physicians have higher levels of burnout than the general public. Burnout seems to affect physicians from the beginning of their training. Approximately half of residents experience high emotional exhaustion and a third of residents experience elevated levels of depersonalization. In a 2017 study, suicide was the second leading cause of death among all medical residents and the number one leading cause of death for male residents. A 2017 review listed workload, relationship with colleagues and patients, lack of rewards, insufficient resources, and conflict between work and family as sources of stress. Physical stressors that providers face include sleep deprivation, working night shifts, working serial shifts, and complex communication processes. Physician burnout has become an area of concern for health care individuals, hospitals, and national organizations. The Alliance for Independent Academic Medical Centers’ (AIAMC) National Initiative-VI focuses on addressing physician well-being. In 2017, the Accreditation Council for Graduate Medical Education (ACGME) released updated common program requirements that focus on physician well-being. Despite the increased emphasis on physician well-being, there is little guidance regarding how physician wellness curriculums should look. Emergency medicine has paved the way with a resident wellness consensus summit that was held in 2017. A curriculum was generated for emergency medicine residents to provide a general framework of topics. While the authors feel that this is a significant step in the right direction, we believe that there is a key piece missing. Through our experience in implementing wellness initiatives and surveying residents’ wants and needs, one consistent theme has prevailed: residents consistently request more protected time to socialize and organically debrief with their peers. The residency programs at our institution have implemented myriad wellness initiatives. For example, emergency medicine began hosting wellness small groups to review topics related to health, sleep, exercise, finances, and mindset. Pediatrics implemented meditation, 15-minute sessions devoted to wellness, and more retreats. The most highly attended events were events scheduled during working hours when residents had protected time. Surveys at the end of the year revealed residents request scheduled time off as a class to spend with their peers. Similarly, the psychiatry residents reported they did not enjoy didactics focused on teaching them how to be well—they preferred having the time to do healthy, social activities. Program directors at all of our resident programs repeatedly reported that it appeared their residents were asking for recess. Ongoing conversations and surveys of residents in our programs suggest that residents may need protected free time to socialize for several reasons. First, residents often move to new and unfamiliar locations where they may know few people. For some, making friends and developing meaningful relationships is