Residency Wellness Program

Dr. Dawn Motyka
Chief of Family Medicine Service
Chief Residency Wellness Officer

Joy in Medicine

We are committed to sustaining JOY in all aspects of our personal and professional lives. Well-being is what lets me rest easy at night; JOY is what gets me out of bed the next morning! 

Our experience in medicine incorporates the "3 Cs of JOY":

1. Connection to important others
2. Control of and autonomy in your environment
3. Competency to be able to do your job well and have a positive impact on others

We are balancing, from one approach, an individual's ability to "self-care" with, from another approach, what we can do to take care of each other. "Well-being cannot be achieved alone". Our team says: Whatever we do, we do it together.

— Casey KirkHart, DO 
     Chief Medical Officer Santa Cruz Community Health FQHC
     Site Director Family Medicine Practice (Resident Continuity Clinic)

A Personal Note From Your Wellness Champion, Dawn Motyka, MD

Our Wellness Curriculum and Well-Being Benefits

Welcome to your future as a family physician. As our Residency’s Chief Wellness Officer, i.e., your faculty wellness champion, our program pledges to provide each and every resident with a supportive, skilled and empathetic cohort of faculty and staff whose goal is for you to graduate as your own wellness champion! It is foundational to our diversity, equity, inclusion, and BELONGING culture.  

Learning to be your own wellness champion means that we aim to ensure you graduate as a family physician who is resilient, competent, compassionate and personally healthy. We want you to be a family physician who can model best practices, and safely assist others to find their way through adversity of all kinds. Together we will create and sustain your individualized learning plan that includes your personal wellness program, your collaboration skills, and your connection to meaning. Resilience is a key to health and crucial to succeeding as a family physician – whether for an individual, a community or an entire ecosystem, the principles are the same.  

Where is the healing? In any personal or clinical situation, I find myself asking these questions.

• What can I do to assist and heal this situation? 
• How do I best assist my patient-body, mind, and spirit?
• How can I help the family?
• Are there bystanders who are traumatized? 

As we embark upon this journey together, I have asked myself this same question about the residency program. We are all recovering medical students, with adaptations that have gotten us this far. Many are very positive yet some of these habits of thought and behavior may be destructive. Are there better strategies for you to keep yourself together? How can we use your time in training to strengthen those that work well while ridding yourself of those that may not? Can you emerge from the crucible of residency as refined and precious as platinum or a diamond? Can you grow stronger, smarter and more compassionate? Yes, you can.  Yes, we can. Here’s how:

Wellness Program:

Our family medicine residency wellness program is a comprehensive program designed to promote physical, mental, emotional and spiritual well-being among our residents. We strive to do more than detect and prevent burnout and thus we have a faculty position dedicated to resident and faculty health and wellbeing, i.e., our Chief Wellness Officer (CWO), and a Residency Wellness Committee.  

We have structured our program to promote and support a healthy lifestyle and promote professional and personal development during residency. Specific examples of how we intentionally support Resident wellness include:

• “Healthy” Compliance with ACGME “Work Hours: Our rotations average at 60-80% of the duty hour requirements. We believe that by adhering to best practices of Competency Based Medical Education (CBME), our residents can achieve excellence while maintaining work life balance and joy in practice. 
  
  
• Limited Overnight Call: PGY2 and PGY3 rotations do include one week of Night Float rotation each quarter designed with ample time for rest and self-care to ensure an optimal learning experience balanced with maintaining one’s mental and physical well-being. While rare, any other “call” is motivated by learning opportunities and approved by the curriculum committee and wellness committee which includes Resident participation.
  
  
• No Jeopardy Call: With an emphasis on CBME and experiential learning, we have eliminated what is often referred to as “Jeopardy Call”, i.e., when a resident on a rotation needs unplanned paid time off (PTO) because of an illness, family emergency, etc., then another resident must sacrifice their rotation to cover the absent resident. We have engaged adequate faculty resources to ensure that we can support such absence without infringing on other residents’ rotations and time. Jeopardy call has proven to be a significant stress in resident education. 
  
  
• Clinic First: All rotations are scheduled to ensure work life balance is supported, including “Clinic First Principles” which emphasize focused, well supported time when seeing your own patients in the Family Medicine Practice (Continuity Clinic with one’s own panel of patients), specifically protecting the time from possible other responsibilities on the specific rotation one is on (e.g., OB, Inpatient Medicine, Surgery, etc.). This minimizes stress and cognitive overload. 
  
  
• Resident Balint Group: Balint is a group method of discussing and reflecting on the doctor-patient relationship. The purpose of the Balint Group discussion is to build empathy for the patient and explore creatively the unique bond between doctor and patient. It supports each resident’s quest for meaning and purpose as a healer, truly key to physician well-being. 
  
  
• Personal & Professional Development (P&PD) Groups: Regularly scheduled, protected time for each class, twice per rotation/month, P&PD sessions are facilitated by trained faculty to foster support and community during the powerful time of personal and professional growth during residency. 
  
  
• Physician Wellness Inventory: Quarterly administration of a confidential inventory to monitor one’s emotional and mental health and thereby measure one’s condition and progress in line with your Individual Learning Plan. 
  
  
• Specific Resilience Training: HeartMath and mind-body techniques such as guided visualization meditation, Tai Chi, Biofeedback, and more. 
  
  
• Functional and Integrative Medicine: While these curricula focus on patient care, Residents can use this time with Dr. Motyka and other certified faculty for self-reflection, personal health goal setting, and practicing with respect for body, mind, and spiritual dimensions of their resident experience. 
  
  
• Faculty Advisors: Every resident is assigned a faculty advisor at the start of their training. This advisor periodically checks in with them to help with professional development and offer support, suggestions and time off for personal health needs or family issues. They are also available in between these meetings to address any concerns including wellness. Each resident will have an individual learning plan that includes a personalized wellness plan for maintaining and improving their health, developing resilience and adaptability. 
  
  
• Residency Wellness Committee: Meets quarterly to assess the existing programs and develop new activities.  Any resident may attend these meetings to offer feedback and suggestions. We are building this ship together! This committee is co-chaired by a Resident ("Resident Wellness Champion") and the faculty Chief Wellness Officer, Dr. Dawn Motyka, Board certified in Family Medicine, Functional Medicine and Acupuncture.

Benefits Supporting Resident Well-Being:

• Counseling Program: As employees of Dominican Hospital, Residents will be invited to schedule individual time with a counselor free of charge, at least quarterly in an entirely confidential and private setting. While not required, the goal is to proactively encourage personal insight, honesty with self and avoid a situation of people deciding to “go it alone” due to concerns about being judged or stigmatized.  Our effectiveness as healers depends on our own willingness to acknowledge our own wounds and work toward healing them. To support this goal, access to additional mental health services, faculty-supported leave of absence, peer support groups, and the Dominican Hospital Physician Well-Being Committee are also available.
  
  
• Wellness Administrative Time: Most rotations have time allotted as “wellness administrative time” for Residents to use for personal care, i.e. appointments or other self-care.
  
  
• MyWellness: “Let’s work together!” A CommonSpirit program “to focus on your well-being journey, in ways to make it easy and rewarding.” Support with resilience, sleep, nutrition, movement and more. Connect with a lifestyle coach to focus on your unique goals. Personalized account from work, at home and via mobile app.
  
  
• Nutrition: There are classes in nutrition “Blue Zone” and other health cuisine preparation.
  
  
• Employee Gym: Available to all residents on a 24/7 basis on the hospital campus just across the parking lot from the Resident Lounge.