Residency is a stressful time, with residents facing professional, financial, and personal demands. Our institution has a robust Employee Assistance Program (EAP) for all employees. This program provides free, confidential, short-term mental health services for the individual and family, referrals for more extensive treatment, as well as other services such as classes on stress management and team building. We noted that our residents mainly use EAP as a result of a referral from a program director or colleague, not on a voluntary basis.

In an effort to improve wellness services for our residents, the Graduate Medical Education Committee teamed with the Employee Assistance Department to increase outreach. We hypothesized reasons for low utilization, including lack of familiarity with services, stigma, financial concerns, and lack of knowledge of how to make contact. Our goals were to provide early support from EAP for postgraduate year 1 (PGY-1) residents and familiarize residents with the services available to them, with the ultimate goal of increasing utilization of EAP services.

Group meetings with EAP were scheduled with all PGY-1 residents within the first 6 months of training. Meetings were scheduled by the chief residents of each program so residents were in a group of their peers, with 1 or 2 PGY-2 residents present to help facilitate discussion. No faculty, chief residents, or program directors were present. An EAP counselor facilitated the discussion. Topics such as dealing with the transition from student to physician, imposter syndrome, and personal wellness were discussed.

The goals were to destigmatize use of the EAP, and to familiarize residents with the services and offerings of the program as well as to help them realize they are not alone in their journey as a resident. We felt that increased familiarity would increase the likelihood of a resident reaching out for help if needed. We also placed the EAP telephone number on the backs of all call room doors to ensure contact information was readily accessible.

Seven support sessions were held for PGY-1 residents in the first half of the 2016–2017 academic year. They were so popular that an additional 3 sessions were added at the residents' request. In the first quarter of the 2017–2018 academic year, 20 sessions have been scheduled, with 11 sessions for PGY-2 and higher residents. There has been increased interest in scheduling repeat meetings and meetings for upper-level residents and fellows. Resident acceptance of the sessions has been excellent.

We also noted an impressive upturn in the number of individual counseling sessions. During 2016, 25 individual counseling sessions were scheduled by residents. This increased to 64 for 2017 (data through October 31, 2017). This represents an increase of more than 250% over the prior year. By the end of 2017, we should see a 3- to 4-fold increase. Due to confidentiality, we are unable to track the characteristics of the residents who sought services. At the same time, there have been no other events or interventions that might explain the increase in EAP use. We believe this early interaction has increased their comfort with the EAP staff. Residents experiencing difficulties are more apt to reach out for help and be directed to appropriate resources before a crisis occurs. This intervention utilized already existing services and infrastructure, and did not require any additional expenditures. Most programs chose to incorporate it into their normal conference time, and it allowed flexibility for different specialty needs.

2018