The Issues:
We surveyed 700 residents across the country and this is what we found:
- Doctors are 2X more likely to kill themselves than those in other professions.
- 28% have fallen asleep at the wheel post-call.
- 10% of 4th year medical students and 1st year residents report having suicidal thoughts.
- 40% have felt bullied by an attending, resident or nurse.
- Female doctors are 4X more likely to commit suicide than women in other professions.
- 62% of residents have felt so burned out that it has affected their work.
*Data from CIR member surveys and academic literature. 3West, CP et al, JAMA 2006; Desai et al, JAMA 2013; Sen S, JAMA Intern Med 2013
Root Causes
- Residents have increasing workloads with no match for resources or time.
- Residents don’t feel empowered to talk about their issues with administration.
- Residents experience high levels of burnout on a regular basis.
- Dysfunctional culture of medicine encourages resident to endure abuse in the workplace.
Our Solutions:
We believe that medical training doesn’t have to be a demoralizing experience. CIR leaders are addressing the root causes of burnout and un-wellness and finding ways to address them collectively. Check out CIR’s Bill of Rights for hospital interns, residents, and fellows.
We identify systemic issues that lead to physician burnout and address well-being in ways that are enforceable through CIR contracts and labor management mechanisms.
Our framework is one which allows us to come up with innovative solutions to address systemic issues in medical training:
Redesign resident clinical responsibilities to eliminate inefficient systems and work that should be done by other hospital personnel.
Advocate for scheduling that maximizes time for quality, protected education.
Urge programs to retain current schedules, the ACGME states that 24 hours is the maximum, not the minimum.
Enforce leave language in the contract or through the labor/management venue.
Our Process
- Specializes in hospital-based implementation with structures that ensure housestaff engage in contract negotiations.
- Utilizes labor management meetings as a forum for solving ongoing issues.
- Partners with administration to implement strong contracts and track implementation of policies that affect resident and patient safety & well-being.
By Hospital
We believe that medical training doesn’t have to be a demoralizing experience. CIR leaders are finding ways to address wellness issues collectively.
San Francisco General Hospital:
Working with inadequate space is impossible in residency. After moving to a new building, we lacked resident call rooms and work spaces. But through our collective voice in bargaining, we were able to form a taskforce with hospital administration to secure adequate space in the hospital.
Dr. Latoya Frolov
University of New Mexico:
We work hard. We save lives. And it can sometimes feel like we’re taking care of everyone except ourselves. Our bargaining committee negotiated and won a half wellness day each quarter. With increases in workloads, having protected time for study, our family and rest is a necessity.
Boston Medical Center:
Out of title work is an issue for almost every residency program. At BMC we’ve worked diligently with administration to end out-of-title work by ensuring that systems throughout the hospital function properly and various positions are adequately staffed.
Dr. Amir Meiri
Maimonides:
Our committee worked together to expand FMLA (Family Medical Leave Act) protection, allowing residents to take necessary time off when they are sick care for themselves or a sick family member, without the fear of losing their job.
Dr. Nicole Bilbro
