Residency and Fellowship: Fostering Physician Well-being Over the Career Life Cycle

Being a physician offers tremendous opportunity to make a difference in the lives of patients through meaningful work. A career in medicine is also demanding and challenging. Some challenges to well-being affect physicians at all stages of their career while others impact physicians differently at different career stages. This article is the first in a series of 5 articles considering the different stages of physicians' career life cycle. The present article focuses on exploring the residency and fellowship, or graduate medical education (GME) phase, including a summary of literature on evidence-based interventions. Residents and fellows face a steep learning curve while having significant responsibility for direct patient care, and have unique needs in the system due to their status as both trainee and employee. They are also particularly vulnerable to mistreatment, and are in a unique time of transformative professional growth. With intentionality, organizations can create a training environment that fosters growth, professional development, and well-being for residents and fellows. Leveraging accreditation requirements, funding strategic roles to support resident and fellow well-being, enhancing faculty development programs, and providing benefits and resources can address system challenges. Leaders and faculty can build a supportive culture by modeling vulnerability, community building, developing mentoring relationships, and encouraging and protecting time for residents and fellows to engage in self-care and physical and mental health appointments. Helping residents and fellows develop growth mindsets and self-care skills will also prepare them for a meaningful, productive, and sustainable career with benefits for other phases of the physician career life cycle.