TAGME Resident and Fellow Well-being 2 — Questions and Answers
Question 1: What is 'moral distress' as experienced by resident physicians?
- Stress from taking medical licensing exams
- Distress arising when a resident knows the right action but is constrained from taking it (Correct answer)
- Burnout caused by night float schedules
- Conflict between co-residents
Correct answer: Distress arising when a resident knows the right action but is constrained from taking it
Moral distress occurs when a resident knows the ethically correct course of action but institutional, hierarchical, or systemic constraints prevent them from acting on it.
Question 2: Under ACGME requirements, what must programs do when a resident is on medical leave?
- Automatically terminate the resident's appointment
- Allow the resident to return and complete the program, providing any required make-up time (Correct answer)
- Replace the resident immediately
- Report the absence to the RRC within 48 hours
Correct answer: Allow the resident to return and complete the program, providing any required make-up time
ACGME requires programs to accommodate residents on medical leave and allow them to return to complete their training, with appropriate extensions if needed.
Question 3: Which federal law prohibits discrimination in residency programs based on disability and requires reasonable accommodations?
- HIPAA
- Americans with Disabilities Act (ADA) (Correct answer)
- Family and Medical Leave Act (FMLA)
- Occupational Safety and Health Act (OSHA)
Correct answer: Americans with Disabilities Act (ADA)
The Americans with Disabilities Act (ADA) requires programs to provide reasonable accommodations to residents with qualifying disabilities, prohibiting discrimination.
Question 4: What is the 'second victim' phenomenon in healthcare and its relevance to GME?
- A patient harmed by a resident's error
- A healthcare provider traumatized by being involved in an adverse patient event (Correct answer)
- A faculty member sued for a resident's mistake
- A resident who witnesses a colleague's burnout
Correct answer: A healthcare provider traumatized by being involved in an adverse patient event
The 'second victim' refers to healthcare providers who experience psychological trauma after being involved in a patient safety event or adverse outcome.
Question 5: What is the difference between 'fatigue mitigation' strategies and 'duty hour limits' in GME well-being?
- They are the same thing
- Duty hour limits cap work time; fatigue mitigation strategies reduce the impact of fatigue within allowed hours (Correct answer)
- Fatigue mitigation replaces duty hour rules
- Duty hour limits only apply to PGY-1 residents
Correct answer: Duty hour limits cap work time; fatigue mitigation strategies reduce the impact of fatigue within allowed hours
Duty hour limits set maximum work time, while fatigue mitigation strategies — such as naps, handoff protocols, and safe transportation — reduce fatigue risk within those limits.
Question 6: How should a program administrator respond if a resident discloses suicidal ideation?
- Document the disclosure and take no further action
- Connect the resident immediately with mental health resources and follow institutional emergency protocols (Correct answer)
- Notify the ACGME directly
- Place the resident on administrative leave without support
Correct answer: Connect the resident immediately with mental health resources and follow institutional emergency protocols
Disclosures of suicidal ideation require immediate connection to mental health services and adherence to institutional emergency protocols to ensure the resident's safety.
TAGME Resident and Fellow Well-being 2
What is 'moral distress' as experienced by resident physicians?