BackgroundTo improve wellness among residents, many graduate medical education programs have implemented formal wellness curricula. Curricular development has recently shifted focus from drivers of burnout to promotion of wellness. The specific components of successful wellness curricula, however, are not yet well defined.ObjectiveTo review the published literature assessing core components of wellness curricula in graduate medical education programs.MethodsSearches were conducted through June 2020 in PubMed, Education Resources Information Center, Google Scholar and Web of Science using the search terms wellness curricula, wellness programs, well-being and graduate medical education. Additional articles were identified from reference lists. Curricula from primarily undergraduate medical education, singular interventions, non-peer-reviewed studies and non-English language studies were excluded.ResultsEighteen articles were selected and reviewed by three authors. Critical drivers of success included support from program leadership and opportunities for resident involvement in the curriculum implementation. Most curricula included interventions related to both physical and mental health. Curricula including challenging components of professionalisation, such as critical conversations, medical errors and boundary setting, seemed to foster increased resident buy-in. The most frequently used curricular assessment tools were the Maslach Burnout Inventory and resident satisfaction surveys.ConclusionsDifferent specialties have different wellness needs. A resource or ‘toolbox’ that includes a variety of general as well as specialty-specific wellness components might allow institutions and programs to select interventions that best suit their individual needs. Assessment of wellness curricula is still in its infancy and is largely limited to single institution experiences.

Introduction. Advocacy is a perceived social and professional obligation of physicians, yet many feel their training and practice environment don’t support increased engagement in advocacy. The aim of this qualitative project was to delineate the role advocacy plays in physicians’ careers and the factors driving physician engagement in advocacy.  Methods. We identified physicians engaged in health advocacy in Kansas through personal contacts and referrals through snowball sampling. They received an email invitation to participate in a short in-person or phone interview which was recorded using Apple Voice Memos and Google Dictation. Two team members independently identified themes from interview transcripts, while a third member served as a moderator if themes identified were dyssynchronous.  Results. Of the 19 physicians invited to participate, 13 were interviewed. The most common reasons for engaging in advocacy included the desire to change policy, obligation to go beyond regular clinic duties, giving patients a voice, and avoiding burnout. Physicians reported passion for patients and past experiences with disparities as the most common inspiration. Most physicians did not have formal advocacy training in school or residency, but identify professional societies and peers as informal guides. Common support for advocacy were professional organizations, community partners, and employers. Time was the most common barrier to conducting advocacy work.  Conclusions. Physicians have a broad number of reasons for the importance of doing advocacy work, but identify key professional barriers to further engagement. Providing accessible opportunities through professional organizations and community partnerships may increase advocacy participation.

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