Kathy Andolsek, MD

by Jim Rogalski

In 2003 a major salvo was launched in the war against physician burnout when the Accreditation Council for Graduate Medical Education mandated limiting medical residents to 80-hour work weeks.

The follow-up attack came that same year when Duke was named principal investigator to develop a national program to teach medical professionals to recognize, manage, and prevent fatigue, impairment, and burnout in themselves and their colleagues.

With a nearly $1 million grant from the Josiah Macy, Jr. Foundation, Duke collaborated with UNC Hospitals and other health care-related entities to create The LIFE Curriculum—a first-of-its kind educational program to promote physician wellness.

Short for “Learning to address Impairment and Fatigue to Enhance patient safety,” the program to date has placed more than 5,000 free educational CDs and teachingguides into the hands of medical faculty and professionals in all 50 states, Washington, D.C., Puerto Rico, Canada, the Netherlands, Thailand, England, Singapore, and Japan.

More than 2,000 medical professionals have attended live workshops.

“It's important to put these tools into the hands of graduate medical education program directors, practicing physicians, and the larger medical audience in general,” says principal investigator Kathy Andolsek, MD, HS'76-'79, associate director of Duke's graduate medical education program. “Our intent is to make them available to everybody so that no one has to reinvent the wheel and we can all learn from one another.”

The program's website—www.lifecurriculum.info—allows visitors to view a snippet of a supporting CD showing a role-playing scene on a given topic and to download a full transcript. To date the website has been visited more than 42,000 times.

Topics include how to recognize and respond to: fatigue, disruptive behavior, stress and depression, substance abuse, burnout, boundary violations, impairments, general and legal issues in graduate medical education, and how to give instructive feedback.

Evidence suggests that burnout and impairment issues start early in medical training and it is crucial to recognize the warning signs early.

“Although being a physician entails many special privileges, there are also significant stressors that put physicians at risk in ways that other professionals and workers are not at risk,” Andolsek says. “We want folks to manage these risks.”

The free CDs and teaching guide can be ordered from the website. Free CME credit is available for those eligible.