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NOW AVAILABLE … an interactive web book, Helping Clinicians Help Patients and a digital platform featuring a Clinician Program for Resilience, CPRinformation.com, which presents a structured approach that addresses the needs of all healthcare clinicians who are in training and in the process of transitioning into the clinical work environment as well as presenting an approach to assist academic hospitals to improve their efficiency and patient care. The web book includes the impact of Covid-19 on the medical training environment and strategies on how to most effectively address the current and future challenges presented by this and future pandemics.


A Comprehensive Approach to Improving Clinician Professional Development and Well-Being

“What Hurts the Physician Hurts the Patient” describes the MedRAP system in its entirety and details a clear path to implementation.
The MedRAP Facilitator Manual is a supplement to the book and provides step-by-step instructions for implementing individual topic sessions.

MedRAP responds to challenges common to medical training – such as a lack of effective communication, time management issues, and other onboarding difficulties – which are known to impact the quality of medical care.

Field-tested and proven for over two decades at Baylor College of Medicine in Houston, Texas, MedRAP is now publicly available for the first time.


  • Accelerated transition into the hospital work environment
  • Development of organizational communication and leadership skills
  • Reduced physician stress and burnout
  • Improved hospital and patient care efficiency
  • Assistance in meeting multiple Accreditation Council for Graduate Medical Education (ACGME) requirements

What people are saying about MedRAP
MedRAP has been described as a successful program by hospital management, faculty, and medical trainees.
I highly recommend this book, What Hurts the Physician Hurts the Patient, to all medical residents, resident program directors, department chairs, and administrators who are connected with the training of new physicians. Ms. Mushin has made an enormous contribution not only to resident training at Baylor, but also to the overall training of residents in the United States.

Antonio Gotto, Jr., MD, DPhil

Dean Emeritus, Weill Cornell Medicine
Provost for Medical Affairs Emeritus, Cornell University

During the 25 years of this program, I have also witnessed firsthand the benefits for resident morale and team building. The Quality Improvement component was used to improve both education and patient care. With the introduction of the Core Competencies by ACGME, this program became essential to meeting the milestones expected for accreditation.

Thoughtful, excellent work that will benefit program directors and other institutional leaders and non-physician training programs.

Stephen B. Greenberg, MD, MACP

Chief, Medicine Service
Ben Taub Hospital
Distinguished Service Professor
Margaret M. and Albert B. Alkek Department of Medicine
Baylor College of Medicine

…after MedRAP had been operational for nearly a decade, I have witnessed the benefits such a program offers on multiple levels including that of individual residents, the training program, and the institution as a whole… for many programs, not instituting a program such as MedRAP is actually the more expensive decision.

Amir Halevy, MD, JD

Director of Internal Medicine Residency Program,
Baylor College of Medicine

I personally have had the opportunity to participate in the MedRAP program as an intern and a senior resident mentor, and have observed the benefits from afar as a residency program director… In an ideal world, all residency programs should make programs such as MedRAP a core offering of their residents’ training.”

Anoop Agrawal, M.D.

Program Director
Internal Medicine and Pediatrics Residency Program
Baylor College of Medicine

MedRAP is mutually beneficial for institutions and trainees. The benefits of improved
well-being and stress reduction for health care professionals mirror themselves in
corresponding institutional benefits of operational efficiencies and improved patient care.


Rather than only managing the symptoms, MedRAP provides tools to promote well-being and preemptively addresses problems that lead to stress and burnout.

MedRAP components teach professionalism explicitly and by example.

Participants are more likely to openly discuss and seek solutions for issues they encounter during their training, such as medical mistakes and problems on the hospital wards, when evaluators are not present.

MedRAP provides structured mentorship opportunities, so trainees benefit from strong, supportive, and consistent leadership and role modeling.

The MedRAP structure allows for early identification of trainees experiencing professional and personal difficulties and provides resources to assist them.



The Quality Improvement (QI) component of the program involves the entire health care team to facilitate collaboration and improve the efficiency of the hospital work environment and patient care.

Improving health care professionals’ well-being, organizational efficiency and communication skills ultimately impacts patient satisfaction.

The built-in feedback mechanisms inherent to MedRAP foster collaborative teamwork among medical trainees, faculty, and all health care team members.

Trainees receive information regarding best and most effective practices; collective knowledge is passed down from group leaders who serve as mentors.

MedRAP includes a leadership training component that positively impacts participants’ effectiveness as team leaders in the hospital work environment and thus patient care.

Milestones are addressed in the following competencies: interpersonal and communication skills, professionalism, systems-based practice, practice-based learning and improvement, and patient care.

The positive work and training environment fostered by MedRAP means health care professionals are more likely to be successfully recruited and stay in their jobs longer.

Who else benefits?
MedRAP can be easily tailored to the needs of a wide range of health care trainees.