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A Trust Fall a Day...

For Stanford's surgical residents, mandatory fun.

Stanford surgical residents take to the medical school's lawn.

Stanford surgical residents take to the medical school's lawn.

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Stanford surgical residents take to the medical school's lawn.

The day involves blindfolded obstacle mazes.

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Stanford surgical residents take to the medical school's lawn.

An imaginary minefield.

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Stanford surgical residents take to the medical school's lawn.

All in the name of healthier doctors in the operating room.

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One day last September, about 30 of Stanford Medicine’s surgical residents ditched the hospital to go play games on the lawn. In their scrubs, pagers on their hips, the fledgling doctors donned blindfolds, frolicked through a ropes course, and generally acted un-doctor-like for a few hours. It was recess as medicine.

If having surgical residents take time away from the operating room for lawn games sounds a little juvenile, consider this: Recent surveys conducted by the American College of Surgeons found that 40 percent of surgeons reported burnout, 30 percent screened positive for depression, and almost half did not want their children to follow in their professional footsteps.

These are stats that Dr. Ralph Greco, a professor of surgery at Stanford, understands all too well. In 2010, a chief resident named Greg Feldman moved to Chicago to start his vascular surgery fellowship. Four months later, he killed himself. “It just rocked this place to its knees,” Greco says. “He was about the greatest guy I’ve ever had in 25 years of being a program director.”

By the next summer, a committee of faculty and residents had put together the Balance in Life program to make life easier for residents, who are under enormous pressure to learn quickly and produce good patient outcomes—all while working 80-hour weeks on little sleep.

“When things don’t go right, it’s hard,” says Arghavan Salles, a current resident who worked under Feldman and helped design the program. “Most of us have never gotten a B in a class, much less failed at something. And many of us are ill equipped to handle that.”

To help residents cope with the pressures of their jobs, Stanford now supplies a fridge stocked with snacks like yogurt and fruit that they can raid when the cafeteria is closed. The program encourages residents to go to the dentist and the doctor (turns out, not much time for that), organizes happy hours, plans team-building exercises—there’s talk of a sailing retreat—and sets up mentorships. There’s a class representative system to make sure that concerns are voiced, and residents attend mandatory group counseling every six weeks, led by a psychiatrist who works with the 49ers.

Some snacks and an afternoon ropes course might not sound like much, but Greco and his residents argue that the unique program reflects a massive change. “The old-school surgeon mentality is that surgery is your life,” says Lyen Huang, a fourth-year resident who was a friend of Feldman’s. “The very existence of the program is an acknowledgment that a cultural shift is occurring.”


Originally published in the January issue of San Francisco

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