A chief resident reports to the program director that a resident has “not been himself lately,” as he abruptly seems more withdrawn and less talkative during conferences. The program director asks this resident's supervising faculty member if she has noticed anything. The supervisor confirms the chief resident's observation, and adds that the resident currently is late in completing progress notes, and that the notes are much shorter than before. The supervisor has mentioned these observations to the resident, but there has been no improvement.
This scenario is not uncommon in residency training. While it might represent transient stress,
