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Description

Background

  • House staff officers are more likely to experience burnout than their age-matched peers in the general population.3
  • ACGME Common Program requirements emphasize the importance of well-being in residency programs, including the opportunity to attend healthcare appointments during working hours.1
  • Opt-out programs have been used to increase help-seeking behavior and provide low-barrier access to mental health care and other supports.2, 4-5
  • Self-determination theory proposes that individuals’ well-being can be enhanced if the core psychological needs of autonomy, competence, and relatedness are met.6
  • The lack of perceived autonomy, competence, and connection felt by residents can lead to new or worsening depression, anxiety, and burnout among house staff.
  • Thomas Jefferson University Hospital (TJUH) is a multi-state not-for-profit academic medical system affiliated with the Sidney Kimmel Medical College.
  • The Emotional Health and Wellness Program for House Staff (EHWP) provides long-term counseling, medication management, and outreach services.
  • The EHWP opt-out visit structure was modeled on the framework of creating a safety plan. Residents reflected on their personal signs of burnout, coping skills, supports, and indications for seeking professional help.
  • AY21: 76 visits were scheduled. 61% (46/76) opted in. Of those, 24% (11/46) scheduled a therapy intake.
  • AY22: 369 visits were scheduled. 32% (118/369) opted in. Of those, 34% (40/118) scheduled a therapy intake.
  • This data shows that residents who attend opt-out visits often choose to schedule intake appointments, illustrating an increase in help-seeking behavior.
  • Anonymous survey comments indicated that residents appreciate the autonomy to be able to choose to take dedicated time to reflect on their well-being and be connected to available support that they did not always know existed.
  • Offering opt-out visits meets ACGME requirements and are a low-cost, meaningful addition to residents’ medical training.

Publication Date

2-20-2025

Keywords

GME, opt-out, well-being, wellness, resident physician, self-determination, autonomy, competence, relatedness

Disciplines

Medicine and Health Sciences | Psychiatry

Comments

Presented at the 2025 ACGME Annual Educational Conference: Meaning in Medicine.

Empowering Resident Autonomy, Competence, and Relatedness Through Opt-Out Visits

Included in

Psychiatry Commons

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