New Case Studies Offer Actionable Insights to Reduce Clinician Burnout and Improve Well-Being

Clinicians of all kinds, across all specialties and care settings, are experiencing alarming rates of burnout. New case studies from the National Academy of Medicine’s (NAM) Action Collaborative on Clinician Well-Being and Resilience provide an overview of initiatives that reduce clinician burnout and support clinician well-being at organizations across the country.

The Educational Commission for Foreign Medical Graduates (ECFMG®) is a member of the NAM Action Collaborative. Every year, ECFMG sponsors more than 11,000 foreign national physicians in J-1 visa status to participate in U.S. clinical training programs. These residents and fellows face the stresses of living and working in a foreign country in addition to the significant demands of their training programs. ECFMG and its Exchange Visitor Sponsorship Program (EVSP) are refining several initiatives to support these physicians and meet their unique needs.

“Our mission at ECFMG/FAIMER is to advance medical education and help improve health care worldwide,” said Dr. William W. Pinsky, President and CEO of ECFMG and Board Chair of FAIMER. “These case studies are important examples of how we can attend to the needs of clinicians, so they can attend to the needs of their patients.”

The NAM hopes that each case study serves as an idea-generating resource for leaders to implement programs and policies at their own organizations that address systemic factors that contribute to clinician burnout. Each case study is designed to help readers more fully understand the successes that organizations have had in implementing well-being programs.

Ohio State University Case Study

At Ohio State University, initiatives to address burnout and promote the well-being of medical, nursing, and health sciences students, trainees, and practicing clinicians are supported by the highest levels of leadership, including the university president. This case study explores the central coordination and alignment of well-being initiatives that span the university, as well as focused examples of programs and policies within the College of Nursing, College of Medicine, Department of Emergency Medicine Residency Program, and the Wexner Medical Center. The Ohio State University case study also explores the role of the University Chief Wellness Officer in advancing the professional fulfillment and well-being of the entire university community. Ohio State calculates a cumulative productivity net savings of over $15 million from wellness programming as well as a $3.65 return-on-investment for every dollar invested in wellness. Additional impact includes decreased anxiety, depression, stress, and suicidal intent among students, faculty, and staff as well as increased academic performance and levels of healthy lifestyle behaviors. University Chief Wellness Officer Dr. Bernadette Melnyk notes, “Leaders, faculty, and managers must ‘walk the talk’ and provide needed wellness resources as well as support for ‘grassroots’ initiatives. The return on and value of investment—including faculty, staff, and students who are happy, healthy, and engaged—will be well worth it.”

Virginia Mason Kirkland Medical Center Case Study

The Virginia Mason Kirkland Medical Center, an outpatient clinic located outside of Seattle in Kirkland, WA, utilizes an innovative, system-wide management method to improve patient care and safety by eliminating waste and inefficiencies. This management method is used to streamline repetitive aspects of care delivery, standardize clinical roles, and engage in continuous learning activities. Two pillars play a central role in improving wellbeing at the medical center: (1) Workflow optimization and (2) Promoting a culture of collegiality, respect, and innovation. Kirkland Medical Center relies heavily on the integration of clinical pharmacists into the care team to free up time for physicians, physician assistants, and advanced registered nurse practitioners to see patients with more complex conditions. Medical assistants help reduce clinician workload and manage administrative tasks, such as confirming patient medications, processing orders, and replying to patient portal messages. Mandatory “pauses” after every 3-5 patient visits allow clinicians to address documentation needs throughout the day, ensuring that all clinicians can leave for home within one hour of seeing their last patient. Surveys from the medical center show that 90% of Kirkland Medical Center’s non-clinician staff and 93% of clinicians are “content” or “engaged.”

The development of each case study was informed by expert interviews with professionals from each organization. The NAM conducted preliminary interviews, in-person site visits, extensive follow-up interviews, and document review for each case study. Additional case studies are forthcoming.

Read the full case studies: nam.edu/clinicianwellbeing/case-studies.

For questions, please contact the National Academy of Medicine at ClinicianWellBeing@nas.edu.

ECFMG Joins National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience

ECFMG is pleased to be a part of the Action Collaborative on Clinician Well-Being and Resilience, a new initiative of the National Academy of Medicine (NAM) that includes more than 130 health care organizations around the globe. By joining the collaborative, ECFMG and the other member organizations are making a formal commitment to take actions that improve clinician well-being and reduce clinician burnout.

Every year, ECFMG sponsors more than 10,000 foreign national physicians in J-1 visa status to participate in U.S. clinical training programs. These residents and fellows face a number of challenges, including the stresses of living and working in a foreign country, in addition to the significant demands of their training programs. ECFMG and its Exchange Visitor Sponsorship Program (EVSP) are refining a number of initiatives to support these physicians and meet their unique needs.

To learn more, read ECFMG’s Commitment to Physician Well-Being and Resilience statement on the NAM website.

IMG Performance in the 2017 Match

For the 15th consecutive year, the number of first-year (PGY-1) residency positions offered through the National Resident Matching Program® (NRMP®) Main Residency Match® increased. A total of 28,849 first-year positions were offered in the 2017 Match. This represents an increase of 989 positions compared to last year and an increase of more than 8,200 positions since 2002.

Compared to 2016, the number of international medical graduates (IMGs) who participated in the Match decreased by 435. While the number of IMGs who matched to first-year positions decreased by 47, the percentage of IMGs who matched increased. Of the 12,355 IMGs who participated in the 2017 Match, 6,591 (53.3%) matched. In the 2016 Match, 6,638 (51.9%) IMGs were matched to first-year positions. (The preceding data include a very small number of Fifth Pathway applicants who participated in the 2016 and 2017 Matches. For 2017, these data include two Fifth Pathway participants who are not represented in the data below.)

Of the 7,284 IMG participants who were not U.S. citizens, 3,814 (52.4%) obtained first-year positions. The number of non-U.S. citizen IMGs who obtained positions increased in 2017 for the sixth year in a row, this year by 45.

Of the 5,069 U.S. citizen IMG participants, 2,777 (54.8%) were matched to first-year positions, a decrease of 92 from last year. The number of U.S. citizen IMGs matching to first-year positions has increased in 12 of the last 14 Matches.

About the Match

The annual NRMP Match is the system by which applicants are matched with available residency positions in U.S. graduate medical education (GME) programs. Participants submit to the NRMP a list of residency programs, in order of preference. Ranked lists of preferred residency candidates are likewise submitted by U.S. GME programs with available positions. The matching of applicants to available positions is performed by computer algorithm. The Match results announced in March of each year are for GME programs that typically begin the following July.

Additional Resources on the Match and Match Results

The preceding Match data are based on the Advance Data Tables: 2017 Main Residency Match® compiled by NRMP. These tables provide detailed information on the positions offered and filled by the Match in 2017 and prior years. To access these tables, or to obtain further information on NRMP, visit www.nrmp.org.

In December of each year, JAMA: The Journal of the American Medical Association traditionally publishes an in-depth analysis of graduate medical education in the United States. This analysis includes the number of IMGs entering and continuing in U.S. GME programs and a breakdown of IMG resident physicians by specialty and subspecialty. Visit your medical school’s library or http://jama.jamanetwork.com/journal.aspx.

Register Now! AMA-ECFMG Webinar: “No Poster, No Publication, No Problem”

“No Poster, No Publication, No Problem”
An AMA-IMGS and ECFMG Webinar
Wednesday, July 9 at 7:00 p.m. ET

Are you a medical student or graduate who is conducting original research or has an interesting case report (resident/fellow and ECFMG-certified participants only) and would like to submit an abstract and poster for the 12th Annual AMA Research Symposium? Would you like tips from previous symposium winners on how they set themselves apart from the rest? Do you want to increase your attractiveness to residency programs by showcasing your research, clinical vignette, or case at a national research symposium?

If you answered yes to any of these questions, we invite you to join other medical students and graduates (medical students, residents/fellows, and ECFMG-certified IMGs awaiting a residency) to hear Dr. Rashi Aggarwal from Rutgers New Jersey Medical School. Dr. Aggarwal will give an overview of the do’s and don’ts when writing and submitting an abstract and creating a poster for the AMA Research Symposium, which is being held on November 7 in Dallas, Texas. Additional panelists will share their tips for abstract submission, poster and podium presentations, as well as answer your questions. There will be an opportunity to submit questions in advance of the webinar and to submit questions during the webinar.

Registration is free but is limited. Please register by visiting https://ecfmgevents.webex.com/ecfmgevents/onstage/g.php?d=660139979&t=a and send your advance questions to echo@ecfmg.org or img@ama-assn.org.

Now Available: New ECHO Resources for ECFMG-certified Physicians

Each month, the ECFMG Certificate Holders Office (ECHO) publishes free resources for ECFMG-certified physicians, and those about to be certified, who are planning their careers.

ECHO is pleased to announce that the following are now available.

  • Did you know that the U.S. Army offers expedited U.S. citizenship for eligible physicians? We reached out to Army recruiting experts to learn more about the Army’s Military Accessions Vital to the National Interest (MAVNI) program. Learn what MAVNI, and life as an Army physician, may have to offer you in Ask the Experts: MAVNI – Expedited U.S. Citizenship for Eligible Physicians.
  • Curious about how IMGs in the 2013 Match performed? View a report based on some of the data available from the National Resident Matching Program (NRMP, or “The Match”) and from some of the IMGs who participated in the process.

In addition to providing valuable resources, ECHO offers certified physicians ways to stay connected with ECFMG and its expertise. Through ECHO, certified physicians can also connect with information from other organizations and experts, and each other. ECHO offers new ways for certified physicians to communicate with ECFMG, for example, by participating in ECHO’s surveys and sending feedback to ECHO.

For more information, visit the ECHO section of the ECFMG website at www.ecfmg.org/echo.

Now Available: New ECHO Resources for ECFMG-certified Physicians

Each month, the ECFMG Certificate Holders Office (ECHO) publishes free resources for ECFMG-certified physicians, and those about to be certified, who are planning their careers.

ECHO is pleased to announce that the following are now available.

  • Those of you beginning the process of applying for a U.S. residency to start in July 2014 know you have much to do. ECHO is here to help with an interactive 2014 Residency Application Process Timeline highlighting some of the most important things you need to do and when you need to do them throughout the application cycle.
  • Are you just beginning your U.S. residency? Did you know that ECHO has a number of resources to help you learn more about the U.S. graduate medical education (GME) system? A Day in the Life, One Dozen Things, and our different Ask the Experts features are just a few of our ECHO Resources which can help you as you familiarize yourself with the U.S. GME and health care systems.
  • Want to know about your fellow ECFMG-certified physicians? Among the surveys we conduct from time to time was our recent inquiry aimed at finding out more about the physicians using ECHO. Why not check out the Detailed Survey Results from Getting to Know You to learn more about your fellow ECHO users?
  • Are you ECFMG-certified and awaiting a U.S. residency? If so, you might consider participating in a survey that the American Medical Association (AMA) is conducting. The survey is designed to better understand some of the characteristics and burdens of international medical graduates who are waiting to start a residency program in the United States.

In addition to providing valuable resources, ECHO offers certified physicians ways to stay connected with ECFMG and its expertise. Through ECHO, certified physicians can also connect with information from other organizations and experts, and each other. ECHO offers new ways for certified physicians to communicate with ECFMG, for example, by participating in ECHO’s surveys and sending feedback to ECHO.

For more information, visit the ECHO section of the ECFMG website at www.ecfmg.org/echo.

Now Available: New ECHO Resources for ECFMG-certified Physicians

Each month, the ECFMG Certificate Holders Office (ECHO) publishes free resources for ECFMG-certified physicians, and those about to be certified, who are planning their careers.

ECHO is pleased to announce that the following are now available.

  • Teaching is an essential part of residency training in the United States. Whether in the classroom or at the patient’s bedside, there are multiple opportunities for education. We reached out to an expert teacher to find out more about what you need to know about teaching and learning at the bedside. Discover more in Ask the Experts: Ten Tips for Effective Bedside Teaching.
  • Having strong letters of recommendation can be extremely helpful to your application for residency. With the 2014 residency application season upon us, be sure to check out Asking for a Letter of Recommendation (LoR) for a look at who to ask, how to ask, and what information can be helpful for you and your letter writer.

In addition to providing valuable resources, ECHO offers certified physicians ways to stay connected with ECFMG and its expertise. Through ECHO, certified physicians can also connect with information from other organizations and experts, and each other. ECHO offers new ways for certified physicians to communicate with ECFMG, for example, by participating in ECHO’s monthly surveys and sending feedback to ECHO.

For more information, visit the ECHO section of the ECFMG website at www.ecfmg.org/echo.

Now Available: New ECHO Resources for ECFMG-certified Physicians

Each month, the ECFMG Certificate Holders Office (ECHO) publishes free resources for ECFMG-certified physicians, and those about to be certified, who are planning their careers.

ECHO is pleased to announce that the following are now available.

  • Have you wondered how physicians can use social media appropriately? We reached out to Humayun J. Chaudhry, D.O., an expert on the topic of social media to find out more about how physicians can use social media while maintaining their professionalism. As President and Chief Executive Officer of the Federation of State Medical Boards (FSMB) of the United States, Inc., Dr. Chaudhry provides valuable insights into this issue. Learn more in Ask the Experts: Physicians and Appropriate Use of Social Media.
  • The results of the 2013 National Resident Matching Program® (NRMP®) Main Residency Match are in!  Are you curious about how IMGs performed? Check out IMG Performance in the 2013 Match for data at a glance and links to where you can learn more about the results.
  • The Electronic Portfolio of International Credentials (EPICSM) is a powerful, new on-line tool from ECFMG. EPIC enables you to create a digital portfolio of your primary-source verified credentials related to your medical education, training, and registration/licensure. Through EPIC, you can send reports demonstrating the authenticity of your credentials to any organization, anywhere in the world, throughout your career. View our resource Introducing EPICSM ―A Powerful and Innovative Career Development Tool for the World’s Physicians to learn more about the special benefits EPIC has for ECFMG-certified physicians.

In addition to providing valuable resources, ECHO offers certified physicians ways to stay connected with ECFMG and its expertise. Through ECHO, certified physicians can also connect with information from other organizations and experts, and each other. ECHO offers new ways for certified physicians to communicate with ECFMG, for example, by participating in ECHO’s monthly surveys and sending feedback to ECHO.

For more information, visit the ECHO section of the ECFMG website at www.ecfmg.org/echo.

Now Available: New ECHO Resources for ECFMG-certified Physicians

Each month, the ECFMG Certificate Holders Office (ECHO) publishes free resources for ECFMG-certified physicians, and those about to be certified, who are planning their careers.

ECHO is pleased to announce that the following are now available.

  • A Preview of ECFMG’s EPICSM: ECFMG is about to launch a new service, the Electronic Portfolio of International Credentials (EPIC). EPIC is a powerful career development tool for the world’s physicians, allowing them to build a web-based portfolio of their primary-source verified medical credentials and to request that their credentials, and reports verifying the credentials’ authenticity, be sent electronically to any organization, anywhere in the world. EPIC launches in April, but we want you to know about it now, since EPIC offers special benefits for ECFMG-certified physicians. Visit Introducing EPIC to learn more.
  • Focus on Trends in Medical Education: Are you following trends in the dynamic field of medical education? Have you thought about how these trends may affect your medical career? We’ve selected some peer-reviewed research publications on: funding for graduate medical education, medical workforce issues, and international medical education to help you stay up-to-date on these essential topics. Learn more about them in Published Research on Trends in Medical Education.

In addition to providing valuable resources, ECHO offers certified physicians ways to stay connected with ECFMG and its expertise. Through ECHO, certified physicians can also connect with information from other organizations and experts, and each other. ECHO also offers new ways for certified physicians to communicate with ECFMG, for example, by participating in ECHO’s monthly surveys and sending feedback to ECHO.

For more information, visit the ECHO section of the ECFMG website at www.ecfmg.org/echo.

Now Available: ECHO’s January Resources for ECFMG-certified Physicians

Each month, the ECFMG Certificate Holders Office (ECHO) publishes free resources for ECFMG-certified physicians, and those about to be certified, who are planning their careers.

ECHO is pleased to announce the following new resources for January.

  • Match Week is quickly approaching, and it is time to put the potential training programs you interviewed with in order and then submit your rank order list to the NRMP®. Besides reflecting on your interviews with these programs and where you would most like to train, there is much to consider, such as deadlines, policies, and procedures. Visit our new resource NRMP Rank Order Lists: Some Important Considerations to find out more about this process.
  • Do you know what to do if you find out you are unmatched for 2013? We asked the executive director of the National Resident Matching Program® (NRMP) to explain the organization’s Supplemental Offer and Acceptance ProgramSM (SOAP SM) that was put into place to help unmatched applicants find unfilled positions during Match week. Read all about it in Ask the Experts: NRMP’s Supplemental Offer and Acceptance Program (SOAP).

In addition to providing valuable resources, ECHO offers certified physicians ways to stay connected with ECFMG and its expertise. Through ECHO, certified physicians can also connect with information from other organizations and experts, and each other. ECHO offers new ways for certified physicians to communicate with ECFMG, for example, by participating in ECHO’s monthly surveys and sending feedback to ECHO.

For more information, visit the ECHO section of the ECFMG website at www.ecfmg.org/echo.