From Wellness to Flourishing: Reflections from Trainees in the Midst of Residency
Facilitator: Brewer Eberly, MD, MA is an attending physician practicing at the Fischer Clinic in Raleigh, North Carolina. He recently completed his Family Medicine residency and chief residency at AnMed Health in Anderson, South Carolina. He was a fellow in the Theology, Medicine, and Culture Initiative at Duke Divinity School in 2017 and now serves as a Research Affiliate with the program.
Panelists: Emmy Yang, MD, MTS is a PGY-1 in Internal Medicine at the University of North Carolina at Chapel Hill. She attended medical school at the Icahn School of Medicine at Mount Sinai in New York City and completed her MTS at Duke Divinity School in 2021; Jenna Frush, MD, MTS is a PGY-2 in Emergency Medicine at Boston Medical Center. She attended medical school at Duke University and completed her MTS at Duke Divinity School in 2021; and Anna Berry, MD, MTS is a PGY-2 in Internal Medicine and Pediatrics at Vanderbilt University. She attended medical school at Baylor University and completed her MTS at Duke Divinity School in 2021.
Each of the panelists were fellows of the Theology, Medicine, and Culture Initiative at Duke Divinity School.
To dialogue about deeper issues underlying burnout in medicine; identify theological resources that have bolstered several trainees during residency; discuss the role of moral communities and liturgy in sustaining hope and healing; and spawn creativity in navigating a culture of efficiency
Abstract Body:
Healthcare practitioners have recently critiqued wellness initiatives aimed at addressing issues such as burnout, depression, and attrition in the profession. As several practitioners put it, “we’re not suffering from a yoga deficiency” [1]. One common critique is that initiatives that simply promote mindfulness and bodily health–while important factors to wellbeing–do not take into consideration other contributing factors such as eclipsed connections with patients and colleagues and a decreased sense of purpose and meaning from the work [2]. Some physicians have labeled the state of demoralization and exhaustion from these factors as “existential burnout” [3]. Despite decades of research and initiatives targeted towards reducing or eliminating burnout, it seems that we have still missed the mark.
What we first must discern is that while well-intended, these wellness initiatives may not recognize their own superficiality. If indeed the issue is deeper and existential, we may look to Christian traditions to remind us of our own limits, and how to live, work, rest, and flourish within those. This panel consists of trainees at various levels of residency training in fields including internal medicine, pediatrics, and emergency medicine who identify with a Christian faith background. Each panelist will begin with a brief introduction including a story of their own faith journey, reasons for pursuing a career in medicine, and more specifically, the particular medical specialty in which each practices, and how they have been formed theologically thus far. Panelists will then discuss one resource from the Christian theological tradition that has shaped their practice and how they cope with the challenges of residency. Panelists will briefly explore the history of said practices and how they may pertain to the contemporary medical environment. Topics will include: relationships with time and efficiency, Sabbath rhythms, liturgy, and the role of moral communities. The discussion will be facilitated by a family physician whose research focuses on medical trainee formation and the nourishment of weary clinicians.
After the initial introductions and opening remarks from each of the panelists, we will move into a time of Q&A with the hopes of fostering discussion with audience members. We envision a dynamic conversation in which various healthcare practitioners in the audience may have space to share their own experiences, students may ask questions as they transition to residency, and clergy may offer additional theological insight into the aforementioned practices.
Of note, the members of the panel recognize that our spiritual backgrounds and formal theological training are very similar. Our hope is that this conversation may offer space for those of various faith backgrounds to share their own practices and reflections of flourishing in the medical space.
[1] Mantri S, Jooste K, Lawson J, Quaranta B, Vaughn J. Reframing the Conversation Around Physician Burnout and Moral Injury: "We're Not Suffering From a Yoga Deficiency". Perm J. 2021;25:21.005. Published 2021 Sep 21. doi:10.7812/TPP/21.005
[2] Shanafelt, T. D., and J. H. Noseworthy. 2017. "Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout." Mayo Clin Proc 92 (1):129-146. doi: 10.1016/j.mayocp.2016.10.004.
[3] Abedini NC, Stack SW, Goodman JL, Steinberg KP. "It's Not Just Time Off": A Framework for Understanding Factors Promoting Recovery From Burnout Among Internal Medicine Residents. J Grad Med Educ. 2018 Feb;10(1):26-32.
Abstract Body:
Healthcare practitioners have recently critiqued wellness initiatives aimed at addressing issues such as burnout, depression, and attrition in the profession. As several practitioners put it, “we’re not suffering from a yoga deficiency” [1]. One common critique is that initiatives that simply promote mindfulness and bodily health–while important factors to wellbeing–do not take into consideration other contributing factors such as eclipsed connections with patients and colleagues and a decreased sense of purpose and meaning from the work [2]. Some physicians have labeled the state of demoralization and exhaustion from these factors as “existential burnout” [3]. Despite decades of research and initiatives targeted towards reducing or eliminating burnout, it seems that we have still missed the mark.
What we first must discern is that while well-intended, these wellness initiatives may not recognize their own superficiality. If indeed the issue is deeper and existential, we may look to Christian traditions to remind us of our own limits, and how to live, work, rest, and flourish within those. This panel consists of trainees at various levels of residency training in fields including internal medicine, pediatrics, and emergency medicine who identify with a Christian faith background. Each panelist will begin with a brief introduction including a story of their own faith journey, reasons for pursuing a career in medicine, and more specifically, the particular medical specialty in which each practices, and how they have been formed theologically thus far. Panelists will then discuss one resource from the Christian theological tradition that has shaped their practice and how they cope with the challenges of residency. Panelists will briefly explore the history of said practices and how they may pertain to the contemporary medical environment. Topics will include: relationships with time and efficiency, Sabbath rhythms, liturgy, and the role of moral communities. The discussion will be facilitated by a family physician whose research focuses on medical trainee formation and the nourishment of weary clinicians.
After the initial introductions and opening remarks from each of the panelists, we will move into a time of Q&A with the hopes of fostering discussion with audience members. We envision a dynamic conversation in which various healthcare practitioners in the audience may have space to share their own experiences, students may ask questions as they transition to residency, and clergy may offer additional theological insight into the aforementioned practices.
Of note, the members of the panel recognize that our spiritual backgrounds and formal theological training are very similar. Our hope is that this conversation may offer space for those of various faith backgrounds to share their own practices and reflections of flourishing in the medical space.
[1] Mantri S, Jooste K, Lawson J, Quaranta B, Vaughn J. Reframing the Conversation Around Physician Burnout and Moral Injury: "We're Not Suffering From a Yoga Deficiency". Perm J. 2021;25:21.005. Published 2021 Sep 21. doi:10.7812/TPP/21.005
[2] Shanafelt, T. D., and J. H. Noseworthy. 2017. "Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout." Mayo Clin Proc 92 (1):129-146. doi: 10.1016/j.mayocp.2016.10.004.
[3] Abedini NC, Stack SW, Goodman JL, Steinberg KP. "It's Not Just Time Off": A Framework for Understanding Factors Promoting Recovery From Burnout Among Internal Medicine Residents. J Grad Med Educ. 2018 Feb;10(1):26-32.