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Question 1 of 8
How often do you feel emotionally drained from your work? Think about your typical week.
1→ Never7→Every day
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Question 2 of 8
How often do you feel used up at the end of the workday?
Question 3 of 8
Have you noticed yourself becoming more detached or going through the motions with patients?
Question 4 of 8
How many hours of sleep do you get most nights?The ACLM recommends 7–9 hours for optimal physician health.
< 5 hours
5–6 hours
6–7 hours
7–8 hours
8–9 hours
Question 5 of 8
How would you describe your energy levels during work hours?
Mostly high — I feel like myself
Mixed — good patches and crashes
Low most of the day, relying on caffeine
Running on empty almost daily
Question 6 of 8
In the past 4 weeks, how often have you felt calm and peaceful?
1 - Never
7 - Always
Question 7 of 8
How true is this right now: "My work as a physician feels meaningful and aligned with who I am."
1 - Not true at all
7 - Deeply true
Question 8 of 8
Outside of work, how well are you refilling your own cup?
Hobbies, rest, connection — anything that restores you.
I have consistent practices that restore me
Occasionally — when I can find the time
Rarely — I’m running low but managing
I can’t remember the last time I did something just for me