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The Wellness Chronicles (Our Core Mission)

January 21, 2023

Hi everyone,

To be well, you need to eat, sleep, exercise, and socialize. But that can’t happen if work depletes you. Residency days are long, patients depend on you, and there’s much to learn. To care for yourselves, we need to take care of you too.

Here’s how we do it:

  • Create humane schedules: Each year when we make the schedules, we prioritize vacation requests so you can plan time away. We then strategically insert electives and lighter rotations to mitigate long stretches of inpatient blocks. Hard days pass more easily when breaks are coming.
  • Limit work hours: We strictly enforce ACGME mandates, which guarantee at least one day off and allow no more than 80 hours worked per week averaged over a month. If we exceed these limits, we troubleshoot. To help you get your work done, our hospitals provide excellent ancillary support. We maintain reasonable patient caps, localize firms to single floors, and foster team cooperation to ensure manageable workloads. Next year, when we eliminate q4 28-hour call at the VA, the hours will be better still.
  • Listen: We want to hear your concerns. That’s why we have monthly Program Director’s Meetings, biannual bidirectional feedback sessions with your APD and PD, and key resident committees such as the Executive Council and PEC. Every week, the Chiefs share resident concerns with our leadership group. To fix problems, we need open ears and open minds.
  • Foster agency: We give residents significant control in their training. Resident-led initiatives include developing the Distinction Pathways, MAC program, Resident Procedure Team, Refugee Clinic, and The Beeson Beat; purchasing POCUS equipment; nominating Chief Resident candidates; organizing Arts Night; introducing Wellness Wednesdays; and creating the 8:30A skill-building conference.
  • Respond to the moment: We aim to be nimble. For example, at the height of the pandemic, the Department of Medicine and GME office offered ample PPE, testing, vaccines, humane schedules, and supplemental pay. For much of the pandemic, we provided food and housing to residents who became ill or required isolation.
  • Build community: New Haven lends itself to socializing. Most residents live within walking or biking distance of YNHH, and for the subset who drive, the commute is generally short. This makes it easy for residents to share meals, hang out, plan day trips, head to the beach, or go apple picking. Color blocks promote small communities within the larger program. It’s no wonder Yale residents are such good friends.
  • Promote safety: To learn and care for your patients, you have to feel safe and valued. You need to feel comfortable sharing your thoughts and opinions without fearing harsh criticism. A safe learning climate fosters honesty and courage, which is how we grow.
  • Ensure respect: For all residents to thrive, we must treat each other with respect. Many residents have experienced discrimination and mistreatment because of their gender, religion, accent, skin color, or sexual orientation. Many carry the emotional baggage of micro-aggressions and sexual harassment. We are committed to respecting, cherishing, and defending all members of this community.
  • Offer a living wage: We pay at the 75th percentile while the cost of living in New Haven is at the 50% percentile. This means residents can afford to live in a nice place and have fun without worrying about the bills.
  • Prioritize your health: With the help of the GME office, we ensure everyone can access a PCP and mental health resources. We provide 12-weeks of paid parental leave so you can focus on caring for yourself and your growing family.
  • Cover emergencies: Our policy is “no questions asked” beyond what we need to know to make sure you’re okay. If you’re sick, stay home. If you have a family emergency, attend to your loved ones. Leave the coverage to us.
  • Provide individualized support: We don’t want anyone getting lost in this huge medical center, so every categorical trainee is assigned a faculty MAC (Mentor-Advisor-Coach). All MACs are carefully selected by Dr. McNamara to serve as cheerleaders, confidants, and fonts of practical wisdom throughout your residency.
  • Teach: Your hard work will pay off. When you finish residency, you will be a well-trained physician and have your pick of jobs and fellowships. You’ll be able to handle any medical challenge thrown your way.
  • Express gratitude: We appreciate your work. That’s why we publish resident shout outs and send thank you notes to recognize your contributions (though I’m sure there are many we don’t hear about). Gratitude is the subtext behind next Tuesday’s Arts Night and the Annual Ball in March. We can’t thank you enough for your stellar patient care, teaching, and everything you do to make us proud.

A few years ago, a resident told me that when she matched at Yale, a classmate said they envied her, because it was well known that we took great care of our residents. The classmate had chosen a program with a harsh reputation out of the mistaken belief that suffering was essential to medical education. It saddens me to think there are still educators and trainees who believe such nonsense. The most effective and appropriate way to train doctors is to nourish their minds, bodies, and spirits. It’s our mission—and responsibility—to keep you well.

Have a wonderful Sunday, everyone. I’m heading out for a bike ride before returning to residency applications (we’re nearing the end). Next week, in our final installment of The Wellness Chronicles, we’ll discuss the core commitment every doctor needs to make.

Stay tuned,


PS- Happy Chinese New Year! Tonight, when Heide returns from Fig, we’ll be dining on Ma Po Tofu, Szechuan-Style Chili Dumplings, and Ma Yi Shang Shu.


Submitted by Mark David Siegel on January 22, 2023