Neurological Surgery Residency and Office of Graduate Medical Education is committed to ensuring that residents remain physically, mentally, emotionally, and spiritually healthy while completing their training program. Residency can be an inherently stressful time, and it is important to take care of yourself so that you can get the most out of your educational experience.

This policy defines the ways in which Residents are supported in their efforts to become competent, caring and resilient physicians while completing Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs at the University of Utah.

1. Program Resources available to residents:
   1. Opt-out Wellness Check-in
      All residents will be given the opportunity for an opt-out wellness check-in with our GME Wellness Team. The goal of this program is to promote physician wellbeing by addressing key components of wellness, including the adverse effects of burnout. Scheduled “check ins” are free, private and confidential with a licensed therapist. No one can access the information provided during this encounter and there will be no records kept in EPIC.
      There may be real or perceived barriers to accessing mental health resources, including stigma, time constraints, and perceived lack of confidentiality. This is a valuable opportunity and we are committed to allow protected time during the workday for residents to talk about how they are doing, while learning more about GME resources.
   2. Wellness and Personal/Professional Days
      The Neurological Surgery program offers additional days off for residents over the holiday season for resident wellness that does not count toward GME allotted vacation time. The program also funds annual resident team building events and provides protected time away from daytime duties so the majority can attend. Residents also receive up to 5 days per academic year they can use for personal or professional needs such as attending medical appointments or other self-care needs and/or professional development such as job interviews, professional society work, or attending professional conferences.
   3. Medical Appointments
      Residents are encouraged to maintain their health through routine and necessary medical, dental, and mental health care appointments, including those scheduled during their work hours. Residents are allowed to use up to five (5) flexible personal/professional days for personal wellness to attend routine and necessary medical, dental, and mental health care appointments. Residents need to work with their assigned rotation and chief residents to ensure appropriate coverage. Residents must follow the leave policy and processes.
   4. Access to Food
      Residents will have access to food while on duty. All residents are given meal money each month. All rotation locations have at least 1 (one) cafeteria for residents to get food.
   5. Call Rooms
      Residents have access to safe, quiet, clean, and private sleep/rest facilities available within proximity appropriate for safe patient care. Department Call Room: 1551
   6. Lactation Rooms
      Resident have access to clean and private facilities for lactation that have refrigeration capabilities, with proximity appropriate for safe patient care.
   7. Self-Screening Tools in Medhub:
      1. ACR Well-Being Index (WBI)
         This screening tool allows residents to better understand their overall well-being and identify areas of risk compared to their peers across the country. This is 100% anonymous—their information will not be shared with anyone, including the ACR.
      2. Burnout Screening
         This confidential questionnaire can help residents screen themselves for symptoms of burnout. It will help them identify feelings and experiences they have about their work, so that they can get a feel for whether they might be vulnerable to burnout.
      3. State of Utah Anxiety, Depression, PTSD and Substance Abuse
         Completing these screenings will help residents determine if their recent thoughts or behaviors may be associated with a common, treatable mental health issue. It takes only a few minutes per screening, and at the end they will be presented with information and next steps.
      4. Self-Compassion
         Developing compassion towards ourselves is an important component of wellbeing. This validated assessment allows residents to evaluate their self-compassion. After taking the assessment they will be directed to several self-compassion exercises.
         Self-compassion is often a radically new way of relating to ourselves. Research shows that the more we practice being kind and compassionate with ourselves, either using informal practices such as the Self-Compassion Break, or formal meditation practices such as Affectionate Breathing – the more we’ll increase the habit of self-compassion.
   8. Program Actions to Promote Well-Being
      1. Residents are encouraged to alert the Program Director, a faculty mentor, Chief Resident, Vice Chair of Wellness, DIO, or GME Wellness when they have concern for themselves, a colleague or a faculty member displaying signs of burnout, depression, substance abuse, suicidal ideation or potential for violence.
         1. We also have an online anonymous reporting mechanism to allow trainees to raise above concerns about a trainee’s wellness to program leadership.
      2. Resident work schedules are annually assessed by Program Directors and discussed with Chief Residents to determine if shifts should be changed to better balance work demands and wellness and to avoid burnout.
      3. We work to cultivate a culture of positive well-being:
         1. Faculty mentorship: Residents are encouraged to identify assigned a faculty mentor at the beginning of residency with whom they meet with at least semi-annually. Faculty mentors are instructed to discuss the trainee’s well-being.
         2. Peer mentorship: First year residents are assigned to a more senior resident with funds to do an activity or have food to promote well-being.
         3. Monthly camaraderie and resident meetings promote team building and open discussions about wellness.
         4. Residents can also raise concerns to Program Directors about issues that may affect their wellness via online anonymous comment box.
      4. Programming on Wellness topics
         1. We engage our GME Wellness Office to provide conferences on burnout, substance abuse, suicide and depression.
      5. Self-assessment using the Well-Being Index referenced above is encouraged annually during one of our monthly resident meetings and is available any time to residents in Medhub.
      6. Annual Internal Surveys of our program allow residents to voice concerns that may not be captured in the ACGME annual survey
      7. Results of ACGME and our institutional GME surveys are reviewed annually by our Program Evaluation Committee and themes/issues are addressed.
2. University of Utah Health Resources
   1. Employee Assistance Program (EAP)
      The Employee Assistance Program is a confidential counseling service sponsored by University of Utah Health to help residents and their family members with a variety of personal concerns including family and relationship issues, stress, grief, depression, anxiety, alcohol/drugs, workplace issues, management consultation and more. The EAP can also provide advice and referrals to help resolve legal, financial, child-care and eldercare concerns. No fees or co-pays are required when using the EAP. The University has agreed to provide these services to benefit eligible employees and their dependents as part of their benefit package. The Employee Assistance Program is available 24 hours per day, 7 days per week and is staffed by professional counselors. There is no specific visit limit for brief solution focused counseling through the EAP. If needs go beyond the EAP, or the individual wishes to see a community provider, individuals are referred to an appropriate Behavioral Health network provider. In order to activate their maximum health care benefit, residents must coordinate services with the EAP. If the employee does not coordinate with the EAP, coverage is reduced. To use this service, call 801-587-9319 or 800-926-9619 at any time.
      EAP is offered at multiple locations within the Salt Lake Valley, including at the Resiliency Center.
      1. How does employee assistance program work?
         Call EAP at 801-587-9319 or 800-926-9619 and you can set up an appointment or have a phone consultation with a licensed psychologist, social worker, or counselor. All contact with EAP is confidential in accordance with state and federal laws.
      2. What is the cost for employee assistance program?
         The University has purchased this benefit for you and your immediate family members. You will have up to 3 visits at no cost. Again, this does not mean that University of Utah Health will have access to your confidential information. The EAP and University of Utah Health respect your right
         to privacy when discussing personal issues. The University of Utah Health has agreed to provide these services for you as a part of your benefit package.
         Key Facts about EAP (Employee Assistance Program) for Residents:
         1. EAP is fully confidential! EAP providers do not use EPIC for records.
         2. EAP provides services free of charge for residents, spouses, and dependents.
         3. EAP is specifically designed to quickly assess resident needs and help them access resources. EAP is easily accessible with a phone call.
         4. The office in Murray has evening hours until 8pm, and has Saturday hours to work with busy schedules.

         5. Some services, like marital counseling and treatment for adjustment disorder, are NOT covered through regular insurance but are covered for free by EAP.

            If for any reason you would prefer to seek services outside of EAP, or have a specific in-network provider you want to see, please call Tina Halliday LCSW, Behavioral Science Manager, at 801-587-9321. If urgent, feel free to page her.

   2. Resiliency Center
      1. Peer Support Program
         The Peer Support Program provides institutional-level support to University of Utah Health (U of U Health) employees during, or after adverse clinical events and other stressful situations like medical error or malpractice litigation. The Peer Support Program consists of a diverse network of U of U Health professionals who are trained as Peer Supporters.
         The Peer Support Program is activated via contacting Dr. Jake Van Epps directly or the Resiliency Center by email or at 801-213-3403.
      2. Peer Support Volunteer
         Please contact the Resiliency Center if you are interested in being a Peer Support Volunteer or if you would like to nominate a colleague to volunteer. Peer supporters are individuals who:
         1. excel in listening and communication and
         2. others tend to look up to and seek out for support.
      3. Resilience Consultations
         Resilience consultations are available to all University of Utah Health employees and are conducted by Dr. Megan Call, a licensed psychologist, and Megan Whitlock, a licensed clinical social worker. These consultations are designed to provide support, motivation and direction in addressing various aspects of work-life integration.
         They can vary in structure and function, including receiving support and referral to EAP or psychotherapy, learning about mindfulness techniques, identifying resources to enhance personal resilience, or exploring how to better advocate for yourself and your team.
         For more information, contact the Resiliency Center by email or at 801-213-3403.
      4. Debriefings & Group Support
         The purpose of this group is to design a support protocol for adverse events and provide evidence-based support guidelines to departments for smaller critical events that can be managed as they arise.
   3. GME Wellness Office
      The GME Wellness Office offers confidential individual and couples counseling services to residents. This service is free of charge, records are kept outside of EPIC, and insurance is not activated. In addition, wellness coaching, test anxiety treatment, and learning assessments are provided. Our office also works with departmental wellness champions to provide workshops, consultation, resources, and wellness improvements to resident programs.
      Some of the areas in which the GME Wellness program can help include:
      1. Resident Mental Health
      2. How are you?
      3. Resident Physical Health
      4. Mindfulness
      5. Sleep Wellness Resources
      6. Child Care Options
      7. Pausing Practices

      8. Wellness Events

         Please visit the GME Wellness website for additional information
         Location: Health Science Education Building
         26 South 200 East, Room 5700
         Salt Lake City, UT 84112
         Contact Dr. Rob Davies
         or Amy Armstrong
         GME Wellness Coordinator
         801-213-8753

3. State Resources:
   1. Utah Recovery Assistance Program
      This program’s purpose is to monitor chemically-dependent licensed professionals in a manner that promotes confidentiality for the licensed professional while assuring the safety of his or her patients. The Utah Department of Commerce’s Division of Occupational and Professional licensing has established the Utah Recovery Assistance Program (URAP) as an alternative to formal disciplinary action. If you have a problem with drugs or alcohol, if you have a patient with a professional license who needs help, or if you know of another licensed professional who needs assistance, please contact URAP at 801-530-6294. The program’s benefits include protection for the safety of participant’s clients, protection for the livelihood and professional licensure of the participant, confidentiality – a private agreement instead of public action, and incentives and support to help participants remain substance-free.
4. ACGME Resources:
   1. Make the Difference: Preventing Medical Resident Suicide
      View a video from the American Foundation for Suicide Prevention and Mayo Clinic for ways to recognize signs of depression and stress and how to help.
   2. ACGME Tools and Resources for Resident and Faculty Member Well-Being
5. Additional Resources:
   1. Crisis Services
      1. The UNI Crisis Line (24/7) is 801-587-3000.
      2. Crisis Text Line: Text START to 741-741
      3. The UNI Crisis Assessment Center (CAC) can be reached 24/7 at 801-587-3187. Adults or children can be evaluated for MH/SU issues by appointment or walk-in. However, the UNI CAC is NOT an emergency service; go to the nearest Emergency Department for any life-threatening emergencies.
      4. The main UNI number is 801-583-2500.
      5. If you are in crisis but it is not emergent, please contact the GME Wellness office to access services through GME.
   2. Other Local & National Resources
      1. In immediate crisis: Call 911, go to your nearest emergency department
      2. National Suicide Hotline: 800-273-8255
      3. University of Utah Emergency Department: 801-581-2291
      4. University Neuropsychiatric Institute: Crisis Line (urgent) 801-587-3000; Warm Line (non-urgent) 801-587-1055
      5. University of Utah Spiritual Care Team 801-213-2484
      6. Utah Recovery Assistance Program (URAP): 801-530-6106