Title

A Proactive Approach to Resident Wellness through Structured Wellness Check-ins.

Authors

Luis Isea Mercado, MD FACP - Assistant Program Director Internal Medicine Residency AdventHealth Orlando, Co-Chair GME Wellness Committee Natasha Bradley, MA - GME Psychotherapist Intern Alexandra Lajeunesse, MA LMHC - GME Wellness Director, Co-Chair GME Wellness Committee Nancy Zerpa Lira, MD - PGY2 Internal Medicine Residency AdventHealth Orlando Diana Lara, MD - Research Assistant Lina Gomez, MD - Research Assistant

Introduction

The transition into residency for first-year medical residents often brings significant stress, burnout, and mental health challenges, which can negatively impact personal well-being and professional performance. Early structured interventions, such as wellness check-ins, may alleviate these concerns by identifying individuals in need of support and provide targeted assistance. However, few studies have evaluated whether wellness check-ins increase the utilization of mental health services or whether they are satisfactory for residents. This study aims to determine if structured wellness check-ins with first-year medical residents increase the utilization of therapy services as well as assessing resident satisfaction with the check-in process, as measured through a post check-in survey.

Methods

The study was conducted at AdventHealth, the largest healthcare system in Central Florida, and involved first-year medical residents from 10 residency programs. The GME Wellness Committee organized the wellness check-ins and follow-up surveys. During September 2024, each resident received an email invitation to schedule a check-in at their convenience. Each 15–30-minute online session was conducted by a GME psychotherapist intern under the supervision of a licensed mental health counselor. During the session, the psychotherapist intern administered a 15-item questionnaire assessing stress, mental health, social support, and future career outlooks. This questionnaire was specifically developed for the study, ensuring relevance to residency challenges. the residents were assured confidentiality, prior to the wellness check-in, to create a safe and supportive environment for honest dialogue. Following the questionnaire, the psychotherapist intern offered all residents the option to schedule an initial counseling appointment, regardless of their responses. To assess satisfaction, residents were emailed a brief post-check-in survey, which included Likert-scale items on usefulness and comfort levels, along with open-ended questions for feedback. Data from the surveys were analyzed to determine satisfaction rates and identify common themes from qualitative feedback.

Results

A total of 97 PGY-1 residents from 10 residency programs were invited to participate, with 73% (71 residents) completing their check-in. Of these, 39% (38 residents) expressed interest in therapy, though only 18 therapy sessions were scheduled. Internal Medicine had the highest participation rate, with 63% (10 of 16 PGY-1 residents) attending the check-in. Among them, 70% (7 residents) expressed interest in therapy, and 50% (5 residents) scheduled an appointment. The post-check-in survey was completed by 45 residents, 85% of whom expressed positive satisfaction with the sessions. Residents appreciated the dedicated time to address mental health concerns and valued the non-judgmental environment provided by the psychotherapist intern. Common barriers to therapy appointment uptake included time constraints, perceived stigma, and scheduling difficulties.

Conclusion

This study demonstrates that wellness check-ins are an effective strategy for promoting mental health awareness among first-year residents. By promoting an open and confidential dialogue, wellness check-ins provide a streamlined pathway for residents seeking support. However, the low therapy appointment uptake highlights the need to address barriers to service utilization. These findings support the value of integrating wellness check-ins as a proactive measure to enhance resident well-being.

References

Eskander J, Rajaguru P. (2021). Evaluating wellness interventions for resident physicians: A review of the literature. Journal of Graduate Medical Education, 13(1), 58-67. https://doi.org/10.4300/JGME-D-20-00344.1 Zisook S, Doran N, Downs N, Shapiro D, Haddad A, Lee D, Newton I, Kawasaki J, Nestsiarovich A, Davidson J. (2024). The Association of Psychotherapy With Burnout, Depression, and Measures of Well-Being in Residents and Fellows: A Pilot Study. Acad Med. doi: 10.1097/ACM.0000000000005750.