At the Icahn School of Medicine at Mount Sinai, we are committed to ensuring the well-being of all residents and fellows.
The Office of Graduate Medical Education works closely with leaders in the Office of Well-Being and Resilience in their efforts to remove barriers to well-being and allow residents and fellows to reconnect with the meaning in their work. Below you will learn more about a number of initiatives underway to support the physical and mental health of our trainees and to provide learning environments in which clerical and administrative burden are addressed and burnout is mitigated.
Saadia Akhtar, MD
Associate Dean for Trainee Well-Being and Resilience in Graduate Medical Education
Chaired by Saadia Akhtar, MD and Paul Rosenfield, MD, the subcommittee comprises faculty, program directors, residents, and fellows from across the ISMMS GME training programs, works to promote trainee well-being and takes steps to prevent or mitigate trainee burnout while also aiming to identify and provide support for residents at risk for depression and suicide.
Mental Health Resources
Student Trainee Mental Health (STMH) provides residents and fellows across the Mount Sinai Health System with confidential, high quality and affordable mental health services to improve health, well-being and productivity. STMH services cover a wide range of mental health issues including consultation, psychotherapy and counseling, medication management, and referrals. An introductory video about the STMH program can be found here.
GME Resident/Fellow Well-Being Subcommittee
The subcommittee, which comprises faculty, program directors, residents, and fellows from across the ISMMS GME training programs, works to promote trainee well-being and takes steps to prevent or mitigate trainee burnout while also aiming to identify and provide support for residents at risk for depression and suicide.
GME Expectations for the Promotion of Trainee Well-Being
The Graduate Medical Education Committee (GMEC) at the Icahn School of Medicine at Mount Sinai is committed to restoring and maintaining “meaning in work and professional fulfillment” for physician trainees system-wide. By prioritizing this objective—in accordance with Section VI.C of the revised 2017 ACGME Common Program Requirements and the Well-Being Pathways of the ACGME Clinical Learning Environment Review (CLER) Pathways to Excellence Version 1.1—the GMEC aims to promote a culture supportive of the psychological, emotional, and physical well-being of all trainees within our Health System through the provision of a balanced, safe, and enjoyable training experience. It is well recognized that efforts to improve trainee well-being cannot be undertaken without addressing faculty well-being and should be done in conjunction with existing faculty-level wellness interventions. Departments are expected to focus on resident and fellow well-being by supporting the following areas laid out in the Expectations for the Promotion of Trainee Well-Being.
- Education-to-service balance
- Work hours, leave, and coverage
- Trainee health needs
- Faculty mentorship programs
- Development of a wellness curriculum
- Mandate enforcement, evaluation, and monitoring
GME Well-Being Champions Program
The Office of Graduate Medical Education, in collaboration with ISMMS GME Training Programs, has created the GME Well-Being Champions Program. In this program, faculty are appointed to work toward promoting a culture of well-being within a given residency or fellowship program(s). In order to ensure that wellness is not forgotten among the many competing priorities in academic medicine, the GME Well-Being Champions work to incorporate wellness into the daily operations of the program in both the curricular and extracurricular domains. The program is directed by Sakshi Dua, MD, and the current GME Wellness Champions are:
GME Clinical Intensity Matching Grants Program
It is widely believed that the main drivers of physician burnout and the erosion of trainee well-being are systemic and may be related to excess non-clinical work or clerical tasks. In an effort to promote resident/fellow well-being, matching grants of have been made available to programs to support innovative initiatives that facilitate the reduction of stressors in the learning environments where trainees are placed. These grant awards are some of the largest to come out of the Office of GME with the expectation that funding will remove much or all of the financial burden many trainees experience. The anticipated outcome of this grant program is the identification of initiatives that produce measurable effects on trainee well-being, are sustainable, and can be replicated across programs and departments.
For the 2018-2019 school year, we were honored to bestow grants on many of our trainees. These grant recipients were for the following studies:
- Addressing Resident Burnout by Mitigating Inpatient Medicine Clerical Burden
Internal Medicine, Mount Sinai Beth Israel
- Finding Balance on the Wards: Introduction of a Discharge Liaison to Reduce Work Compression and Improve Education in Inpatient Internal Medicine
Internal Medicine, The Mount Sinai Hospital
- Implementation of a Novel Medical Dictation Platform Using Artificial Intelligence for improved Error Recognition
Neurosurgery, The Mount Sinai Hospital
- Improving Hospital Wellness by Expanding the Mount Sinai St. Luke’s / Mount Sinai West Emergency Department Scribe Program
Emergency Medicine, Mount Sinai St. Luke’s and Mount Sinai West
- MSHS Outpatient Psychiatry Resident Workflow Support: Referral, Outreach, and Connection Coordinators
Psychiatry, Mount Sinai Beth Israel; Psychiatry, The Mount Sinai Hospital; Psychiatry, Mount Sinai St. Luke’s and Mount Sinai West
- Reducing Sleepiness and Burnout in Subspecialty Fellows due to Non-Urgent Overnight Calls
Gastroenterology, The Mount Sinai Hospital
- Removing Clerical Burdens: Resident Assistant to Boost Engagement in Pediatrics
Pediatrics, The Mount Sinai Hospital
GME Well-Being Curricular Resources
While system-level change is likely to have the greatest impact on promoting trainee well-being, there is a recognized additional benefit that can be gained through trainee development of individual resilience skills. As part of the ISMMS Office of GME’s continued efforts to support the well-being of our trainees, the following evidence-based well-being resources are available for programs with the express purpose of integrating such activities into their curricula.
- Facilitated Discussion - Reflection is a critical component of training to become a physician. Young physicians are exposed to an enormous number of stressors, including difficult patients, death and dying, and the prospect of medical errors. The normal reaction to exposures such as these is to evoke an emotional response and yet, there is no dedicated place in traditional training programs that allows one to reflect upon these experiences. Providing such a space to have a discussion, guided by an expert facilitator, and inspired by a brief reading, can be a great outlet for trainees to process the challenging events that occur routinely during training. Furthermore, routine meetings (monthly or bimonthly) with a group of peers have been shown to be effective in reducing job burnout.
- Mindfulness Training - This offering aims to teach simple mindfulness practices to resident physicians with the intent of increasing their capacity for handling the stresses of their training environment and increasing their overall sense of well-being. Mindfulness practices may include formal practices of mindful attention, body scan, mindful movement, and walking meditation, as well as informal practices of mindful moments and awareness of daily activities.
- Narrative Medicine - Medicine is a storytelling enterprise. Research increasingly shows that attention to literature and the arts helps to develop and nurture skills of observation, analysis, empathy, adaptability, and self-reflection. Narrative medicine has two primary objectives: (1) to strengthen clinical practice by using art to enhance observation, increase self-awareness, and explore point of view, and (2) to provide a structured, noninvasive space for trainees to pause and reflect upon their lives and their work.
GME Wellness Survey
As part of the continuing work of the GME Office and GME Resident/Fellow Well-Being Subcommittee, a House Staff Wellness Survey was distributed to all residents and fellows in Icahn School of Medicine at Mount Sinai Sponsored Programs in early 2018. The survey was designed to better understand resident/fellow well-being and impressions of the clinical work environment, including drivers of burnout. The survey will be performed on a periodic basis to allow for continued analysis and measurement.
In my role as the Designated Institutional Official, I take seriously the responsibility of ensuring that our training programs are adequately supported and resourced to provide the highest quality post-graduate training possible. We are committed to developing highly skilled physicians who are able to enter successful, independent practices. I trust you will take time to review this website to see the wide range of resources available to you as a trainee. We are committed to the goals of diversity and inclusion in our training programs and focused on ensuring that all residents and fellows are provided with adequate opportunities to grow and thrive as clinicians, educators, physician scientists, and leaders.