Chief Resident Leadership Chief Resident Leadership Conference:Conference:

Caring for Your ResidentsCaring for Your ResidentsRoseanne C. Berger, MDRoseanne C. Berger, MD

Senior Associate Dean for Senior Associate Dean for Graduate Medical Education Graduate Medical Education

&&ACGME Designated Institutional Official (DIO) for UBACGME Designated Institutional Official (DIO) for UB

Goal: Support residents Goal: Support residents experiencing problems that impede experiencing problems that impede learning.learning. FatigueFatigue

Academic DifficultyAcademic Difficulty

HarassmentHarassment

ImpairmentImpairment

www.cphny.org 800-338-1833

Relative Risk by Specialty

0 0.5 1 1.5 2 2.5 3 3.5 4

Pathology

General Surgery

Pediatrics

Ophthalmology

Orthopedics

Internal Medicine

Neurology

Psychiatry

Radiology

Thoracic Surgery

OB/ Gyn

Otolaryngology

Family/ General Practice

Plastic surgery

Neurological Surgery

Emergency Medicine

Anesthesiology

www.cphny.org 800-338-1833

Warning Signs

Selected Warning SignsSelected Warning Signs

Deteriorating personal Deteriorating personal

hygienehygiene

Unfocused, confused, Unfocused, confused,

distracteddistracted

Mood swingsMood swings

Unprofessional demeanor or Unprofessional demeanor or

conductconduct

Anger/Abusive LanguageAnger/Abusive Language

Frequent lateness, absence Frequent lateness, absence

or illnessor illness

Isolation: avoidance of Isolation: avoidance of

associatesassociates

Inappropriate response to Inappropriate response to

patient needs or staff patient needs or staff

requests requests

Ignoring requests to catch Ignoring requests to catch

up on paperworkup on paperwork

Uncooperative and defiant Uncooperative and defiant

approach to problems approach to problems

and/or performance and/or performance

feedbackfeedback

Impairment/Substance AbuseImpairment/Substance Abuse

Signs & symptoms of impairmentSigns & symptoms of impairment Report to PD or GME – do not handle Report to PD or GME – do not handle

yourselfyourself Encourage individual to self-report to GME Encourage individual to self-report to GME

or Committee on Physician’s Health (CPH)or Committee on Physician’s Health (CPH) Treatment optionsTreatment options

Coincident with trainingCoincident with training Leave of Absence – up to 3 monthsLeave of Absence – up to 3 months

1 (800) 338-1833or

(518) 436-4723The Committee for Physician Health

99 Washington Avenue, Suite 410Albany, NY 12210

Fax: (518) 436-7943Email: terry@cphny.org

All calls are confidential!

CPH Contact InfoCPH Contact Info

Sexual Harassment in Sexual Harassment in Medical EducationMedical Education

Events of Sexual Mistreatment Reported by Events of Sexual Mistreatment Reported by Graduating US Medical School StudentsGraduating US Medical School Students

Denied opportunities for training or rewards Denied opportunities for training or rewards because of your genderbecause of your gender

Subjected to unwanted sexual advances by Subjected to unwanted sexual advances by school personnelschool personnel

Subjected to offensive sexist remarks/names Subjected to offensive sexist remarks/names directed at you personallydirected at you personally

Received lower evaluations or grades solely Received lower evaluations or grades solely because of gender rather than performancebecause of gender rather than performance

19961996 20032003

4.3%4.3% 2.4%2.4%

4.7%4.7% 2.1%2.1%

8.7%8.7% 4.1%4.1%

6.1%6.1% 3.0%3.0%

Recupero, et. al. Academic Medicine 79(9). 2004

Harrassment/DiscriminationHarrassment/Discrimination

Sexual or other forms Sexual or other forms  If possible, tell harasser to stopIf possible, tell harasser to stop Discuss with PD, Chair, DIO, Office of Discuss with PD, Chair, DIO, Office of

Equity, Diversity, and Affirmative Action Equity, Diversity, and Affirmative Action 645-2266 645-2266

https://secure.newmedialearning.com/https://secure.newmedialearning.com/psh/ubuffalo/ psh/ubuffalo/

UB/GME ResourcesUB/GME Resources Susan Orrange, M.EdSusan Orrange, M.Ed. . sorrange@buffalo.edusorrange@buffalo.edu Roseanne Berger, M.D. Roseanne Berger, M.D. bergerrc@buffalo.edu bergerrc@buffalo.edu Chief Resident ListservChief Resident Listserv Policies on Impairment, Harassment, and Academic Policies on Impairment, Harassment, and Academic

StatusStatus www.ACGME.orgwww.ACGME.org

Common Program RequirementsCommon Program Requirements RRC Requirements for your programRRC Requirements for your program

The Joint CommissionThe Joint Commission

http://www.jointcommission.org/http://www.jointcommission.org/

LIFE CurriculumLIFE Curriculum(Learning to Address Impairment and Fatigue to Enhance Patient Safety)(Learning to Address Impairment and Fatigue to Enhance Patient Safety)

Self-directed learning modules in the Self-directed learning modules in the areas of:areas of: FatigueFatigue Disruptive PhysiciansDisruptive Physicians Stress & DepressionStress & Depression Substance AbuseSubstance Abuse BurnoutBurnout ImpairmentImpairment Negative FeedbackNegative Feedback

UB Human ResourcesUB Human Resources http://hr.buffalo.edu http://hr.buffalo.edu

Work/life balanceWork/life balance UB Employee discountsUB Employee discounts

• Fitness centers, theme parks & attractions, software, Fitness centers, theme parks & attractions, software, wireless phones, moving services, and morewireless phones, moving services, and more

Learning & DevelopmentLearning & Development Registration & Course CatalogRegistration & Course Catalog

• Short courses in Career and Personal Development, Short courses in Career and Personal Development, Software and Computer Productivity, Wellness & Software and Computer Productivity, Wellness & Worklife BalanceWorklife Balance

• Over 1,000 online, self-directed learning modules Over 1,000 online, self-directed learning modules (Skillsoft)(Skillsoft)

Case ScenariosCase Scenarios

Remember…for struggling residents

Make diagnosis and treatment plan

Include objective assessments

Provide frequent honest feedback

Consult appropriate people, resources, and policies

Involve program director and faculty