The idea of a Hippocratic Oath, in which a physician pledges to uphold ethical standards when caring for patients, has long been a staple of medical training. As physician burnout and moral distress increasingly grew as pressing issues in modern medical practice, a group of doctors realized the need for a new oath to supplement the Hippocratic Oath—one that unapologetically serves as a reminder for physicians that self-care must also be a priority.
In 2020, Drs. Mukta Panda, Kevin E. O’Brien and Margaret C. Lo created the Oath to Self-Care and Well-Being on behalf of the Collaborative for Healing and Renewal in Medicine (CHARM), which was published in the American Journal of Medicine. The Oath to Self-Care and Well-Being, which was driven by the guiding principles of the Charter on Physician Well-Being, is now taken at many key formal gatherings for medical students, residents and physicians, such as white coat ceremonies, graduations, Match Day, orientations and more.
The Oath to Self-Care and Well-Being includes seven main tenants:
- We SOLEMNLY PLEDGE to embrace and promote the well-being of our self, our colleagues and the medical community as part of our responsibility to the effective care of our patients, ourselves and in partnership with our healthcare organization.
- We WILL SEEK TO DEVELOP and ADHERE to habits that promote and maintain humility, meaning and wholeness of self in our work and interactions.
- We WILL BE ATTUNED to the physical, emotional, mental and spiritual needs of our self and others and share our practices of well-being for the benefits of our patients, our colleagues and the advancement of healthcare.
- We WILL COMMIT to integration and balance in our professional and personal life and seek help when we feel we ourselves or our peers are overburdened, fatigued or less compassionate.
- We WILL CHAMPION for a healthcare system that values the well-being of its personnel, uses best evidence for an institutional culture of wellness and recognizes that in so promoting the patients we care for are ultimately best served.
- We WILL FIND the courage to be vulnerable and confront professional wrongdoings to the best of our ability while at the same time showing compassion and respect for all members of the healthcare team.
- I MAKE these promises of well-being to myself and to the vocation of medicine with my highest commitment.
“The use of ‘We’ in nearly every statement of the Oath is quite intentional, and it speaks to how self-care and well-being are a shared responsibility,” Dr. Panda said. “It is critical that physicians make this commitment of self-care and well-being to themselves, which ultimately allows them to thrive in their professional and personal lives, while better caring for patients. However, it’s critical to acknowledge that the real responsibility to create change regarding physician well-being lies on systems, as opposed to individuals. Rather than putting the onus for self-care on the individual, the new oath calls for a partnership and commitment with the system we study and work in.”
Additionally, Dr. Panda began an initiative to encourage medical students to reflect on the Oath they pledge and write notes to their future selves to remind them of their commitment to the Oath to Self-Care and Well-Being, as well as to remember their “why” for becoming a physician. Templated materials for writing notes to oneself can be found here.
“I now realize how important it was for me to make such an intentional commitment to myself, to set aside time to experience the array of emotions felt after a long day’s work, to reach out to my program leadership when help and support are needed and to listen to others and share my experiences in hopes that they may feel somehow comforted or understood,” said Dr. Mikaela Holland, a pediatric resident at Johns Hopkins All Children’s Hospital. “The Oath to Self-Care and Well-Being has provided me a lasting reminder and permission to care for myself.”