Resident & Fellow Well-Being | Icahn School of Medicine

At the Icahn School of Medicine at Mount Sinai, we are committed to ensuring the well-being of all our residents and fellows.

The Office of Graduate Medical Education works closely with the Office of Well-Being and Resilience in an effort to remove barriers to well-being and allow trainees to regularly reconnect with the meaning of their work.

Several ongoing initiatives, including the Well-Being Subcommittee, support residents and fellows in prioritizing their well-being. The Well-Being Subcommittee takes steps to prevent and mitigate burnout, while also aiming to identify those at risk for depression and suicide. Chaired by Saadia Akhtar, MD, and Paul Rosenfield, MD, along with a peer-selected trainee Co-Chair appointed each academic year, the Subcommittee unites faculty, program directors, residents, and fellows from across our training programs.

As part of the ongoing work of the Well-Being Subcommittee, a House Staff Wellness Survey is also distributed regularly to better understand impressions of our clinical work environments. Responses to the survey allow for continued analysis, measurement, and improvement of well-being resources throughout Graduate Medical Education.

In concert with the Subcommittee, the Student and Trainee Mental Health Program provides our residents and fellows with confidential, high-quality, affordable mental health services to improve their health, well-being, and productivity. These services cover a wide range of mental health issues, including consultation, psychotherapy and counseling, medication management, and referrals. The Center for Stress, Resilience, and Personal Growth is another resource available to our residents and fellows. The Center provides scientifically-grounded services to support resilience and psychological well-being, including workshops and individual support.

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The Graduate Medical Education (GME) Committee at the Icahn School of Medicine at Mount Sinai is committed to restoring and maintaining system-wide “meaning in work and professional fulfillment” for physician trainees. By prioritizing this objective, the Committee aims to promote a culture supportive of the psychological, emotional, and physical well-being of all trainees through a balanced, safe, and enjoyable training experience. It is also well recognized that efforts to improve trainee well-being cannot be undertaken without addressing faculty well-being, which is carried out in conjunction with existing faculty-level wellness interventions.

Departments are expected to focus on resident and fellow well-being by supporting the following areas, as described 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

The Office of Graduate Medical Education created the GME Well-Being Champions Program to ensure that wellness is not lost among the many competing priorities in academic medicine. In this program, faculty members are appointed to work toward promoting a culture of well-being within a given residency or fellowship. Champions work to incorporate wellness into the daily operations of the training program in both curricular and extracurricular domains. The GME Well-Being Champions Program is directed by Sakshi Dua, MD. For a full list of the current GME Wellness Champions, please see our roster.

It is widely believed that one of the main drivers of physician burnout, as well as the erosion of resident and fellow well-being, is excess non-clinical work or clerical tasks. To promote well-being among our residents and fellow, grants have been made available to programs to support innovative initiatives that facilitate the reduction of these stressors in learning environments.

The expectation is that these grant awards 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 2022-23 academic year, we were honored to bestow grants to several programs for the following projects:

The Family Medicine Care Team Assistant Program
Family Medicine, The Mount Sinai Hospital
Facilitation of Accreditation Council for Graduate Medical Education (ACGME) Case Log Entry Through Leveraging of Electronic Medical Record Data
Anesthesiology, Perioperative and Pain Medicine, Mount Sinai Morningside/Mount Sinai West
Decreasing Administrative Burden on Trainees for Inpatient Genetic Testing
Medical Genetics, The Mount Sinai Hospital
Patient Care Coordinator to Improve Resident Burden in Coordinating Care for Complex Patients
Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai

Reducing Work Intensity with a Neurologic Emergency Scribe Program
Neurology, The Mount Sinai Hospital

In 2024, the ACGME awarded thirty recipients in the fourth cycle of funding for Back to Bedside, a resident-led initiative to develop innovative strategies for finding deeper connections with patients to improve physician and patient well-being.

The following trainee-led project was awarded, along with their team leaders:

Improving Resident-Led Care for Hospitalized Patients with Alcohol Use Disorder
Christopher Garcia-Wilde, MD, MPH, MSH Internal Medicine-Pediatrics
Claire Garpestad, MD, MSH Internal Medicine-Pediatric

While system-level change will have the greatest impact on promoting well-being, there is a recognized additional benefit gained through the development of individual resilience skills.

As part of our continued efforts, 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 these exposures is an emotional response, and yet, there is no dedicated place in traditional training programs that allows one to reflect and process 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 has proven 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 stresses of their training environment and increasing their overall sense of well-being. Mindfulness practices 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. For those residents, fellows, and faculty seeking a broader exposure to mindfulness, an eight-week certificate course titled “Mindfulness Based Stress Reduction,” an evidenced-based practice of mindfulness, is offered twice annually with separate trainee and faculty cohorts.

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: to strengthen clinical practice by using art to enhance observation, increase self-awareness, and explore different points of view, while providing a structured, noninvasive space for trainees to pause and reflect upon their lives and their work.
Practice Enhancement, Engagement, Resilience, and Support (PEERS): The PEERS Program was designed at the Icahn School of Medicine at Mount Sinai in 2017 to allow medical students to process challenges and learn coping strategies in a supportive group setting. This trainee-led program has been adopted by residency and fellowship programs, and includes structured, longitudinal content aimed at cultivating well-being, resilience, and community among medical trainees. Jacqueline Hargrove, PhD, is the PEERS Faculty Advisor.

Resilience Workshops: Offered by The Center for Stress, Resilience, and Personal Growth, resilience workshops are designed to give residents and fellows the tools to meet life's challenges, big and small, and to build on their inherent strengths. The workshops focus areas include realistic optimism, facing fears, social support, self-care, finding meaning and purpose, and managing moral distress.