title: A Patient-Centered Approach to Postgraduate Trainee Health and Wellness: An Applied Review and Health Care Delivery Model.
abstract: Attention to the health and wellness of postgraduate medical trainees has increased considerably in recent years, yet the scholarly literature consistently indicates that, in many instances, the medical and mental health care needs of this population remain unmet or only partially met. As a result, trainee health care often falls short of the current standards of the medical profession. Combined with the prevalence of burnout and other mental health conditions among trainees, inadequate health care for this patient population may result in significant negative consequences for trainees' health, safety, and performance.Here, the authors review the scholarly literature explicating the health care needs of postgraduate trainees. They explore the patient-centered medical home model as a potentially effective solution to address the unmet and partially met health care needs of trainees. The authors describe several practical interventions to improve access to care. These include care coordination and referral support, confidential care without perceived conflicts of interest in the training environment, co-location of medical and mental health care, and accommodations for schedule constraints. Finally, the authors explore the role of the medical home in developing and supporting broader institutional efforts to promote wellness.
authors.affiliation: M.L. Carvour is an infectious diseases fellow, University of New Mexico, Albuquerque, New Mexico. When the idea in this Perspective was conceived and developed, she was a postdoctoral fellow, University of Texas Southwestern Medical Center, Dallas, Texas. B.K. Ayyar is an internal medicine resident, University of Texas Southwestern Medical Center, Dallas, Texas. K.S. Chien is an internal medicine resident, University of Texas Southwestern Medical Center, Dallas, Texas. N.C. Ramirez is a psychiatry resident, University of Texas Southwestern Medical Center, Dallas, Texas. H. Yamamoto is an internal medicine resident, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Carvour
authors.forename: Balaji K
authors.initials: BK
authors.lastname: Ayyar
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Chien
authors.forename: Natalie C
authors.initials: NC
authors.lastname: Ramirez
authors.forename: Haru
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000379:methods*; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological / Q000517:prevention & control*