Balance in Life Program Expands to Include All Department of Surgery Trainees

Stanford Surgery’s Balance in Life Program (BIL) has been expanded to include all Department of Surgery trainees. Started in 2011, BIL was created to support the physical, psychological professional, and social wellbeing of physicians in the General Surgery Residency Program. Now in its 11^th year, the Department has decided to extend the program’s offerings to residents in the Divisions of Vascular and Plastic Surgery, as well as all clinical fellows in the Department.

“There is a focus on well-being within the department as a whole,” said Dr. Jim Korndorffer, Vice Chair for Education. “The Balance in Life program was a piece of this focus on well-being and when looking at it, the program would be stronger as a departmental focus and not a general surgery residency/divisional focus. 

According to Korndorffer, parts of the program, like access to nutritional snacks in the hospital, was already utilized by all the departmental residencies and fellowships so the expansion is concentrated on expanding the other aspects of the program such as social, professional, and psychological services.

BIL is dedicated to Dr. Greg Feldman, an alumnus of the General Surgery Residency Program who tragically died by suicide four months into his vascular surgery fellowship at Northwestern Memorial. Dr. Cara Liebert, who assumed directorship of the program in 2020 and was a medical student on her surgery clerkship rotation during which Feldman was the chief resident described him as “an exceptional educator and mentor.” Liebert, an alumnus of the General Surgery Residency Program, started her residency the inaugural year of the Balance in Life Program.

“Having known Greg Feldman and how impactful he was to me and so many other Stanford medical students and junior residents, I wanted to ensure the program continued and succeeded,” said Liebert.

As part of the program, BIL provides group coaching sessions with a trained clinical psychologist for all residents within the department.  Lisa Post, PhD, who leads the General Surgery and Vascular Surgery resident groups and has been with the program since its inception, will now serve as the liaison for any Department of Surgery trainee (resident or fellow) for additional coaching, counseling, and connection to WellConnect, WellMD, and mental health services.

“Residents are working long hours dedicated to patient care and often don't have the opportunity to talk with their colleagues outside of work responsibilities,” said Liebert. “The Lisa Post sessions were often how I recognized that my classmates were facing stressors and family emergencies outside of the hospital. It is a time to bond as a PGY class, discuss shared concerns, and foster a culture of peer support.”

Another aspect of the program that will be expanded is the annual BIL Retreat. One day per year, all general surgery, plastic surgery, and vascular residents will have the opportunity to spend time together as a large group outside the hospital participating in outdoor structured team-building activities, such as high ropes courses and orienteering. In addition to the BIL Resident Retreat, the program will now also include an annual BIL Fellow Retreat.

“There are unique challenges to fellowship,” said Korndorffer. “First, a fellow arrives in a new place but often only for one year sometimes without their social support as they may not want to uproot their family. Second, unlike residencies where you enter with a cohort, a fellow is often the only fellow in a particular discipline so that limits the peer support structure as well.”

The inaugural BIL Fellow Retreat took place at Roaring Camp and Henry Cowell Redwoods State Park in September of this year. The attendees participated in geoteaming, where they were divided into small groups and provided GPS devices, maps, and an objective to find as many markers hidden as they could in the allotted time. The remainder of the retreat included small group hiking and a dinner for fellows, partners, and families.

“Our team actually got really into the competitive aspect of the activity, and we all self-selected into our individual roles,” said Dr. Jonathan Delong, Stanford’s current HPB fellow. “I think I had only met two of my team members prior to that morning but by the end of the day I felt like we’d known each other forever. Before our retreat I only knew a few of the other fellows, but now I feel like we’re a crew.”

All of these efforts fit into a larger Departmental focus on wellness and providing all faculty, staff, and trainees with the tools and support to perform their jobs to the best of their abilities. As Liebert said, “[BIL] does not change how hard surgical residency is, but it provides residents with a sense of belonging, peer support, safety net, and resources to help them through the challenging times.”