P2.F104: The Changing Landscape Of Wellness Opportunities In Neonatal-Perinatal Medicine Fellowships

Background: ACGME guidelines require fellowship programs to have wellness programs. Typically, these programs have focused on providing limited respite for trainees in the form of meals, didactics on wellness topics, and protected time for education. With work-related factors continuing to exist as the predominant driver of trainee burnout, understanding how fellowship programs are expanding upon traditional means to enhance well-being is critical to creating a more comprehensive approach to well-being.

Methods: All US Neonatal-Perinatal (NPM) fellowship program directors and associate program directors were surveyed on their fellow wellness opportunities. Descriptive statistics for quantitative questions and thematic qualitative analysis of free text responses were used to summarize findings.

Results: 94 NPM fellowships contributed data on their fellow wellness programs, representing 92% of active NPM fellowships in 2022. Fellowship wellness programs are becoming more diverse and comprehensive, with specific guidance on leave, wellness retreats, mentorship and mental health services (Figure 1). Specific written policies for leave are reported for medical illness, paternity leave and mental health in the majority of programs. 70% (66/94) of programs reported having a fellow retreat with annual (47/66, 71%) half day (30/66, 47%) retreats being most common. The majority of wellness programs were led by the PD and APD (72%) with assistance from GME wellness committees (40%). Budgetary support for wellness programs was reported by 69% (65/94), with 25% of programs reporting no budget for these initiatives. On average programs allocate $53 per fellow per year to wellness activities, or a median of $500 annually per program (Table 1).

Conclusion: Many NPM fellowship programs have developed wellness programs to include morale events, meal provision, protected time for wellness activities, and fellow retreats. Lack of sufficient budgetary support is a significant barrier for development of wellness programs. Development and implementation of written policies for appointments on service and establishing peer mentorship for fellows may be low cost targets for improvement in the future. Increased emphasis on the enrichment of wellness programs at the section or departmental level also have the potential to improve fellow well-being on a broader scale.