TAKING CARE OF OUR OWN: WHEN A RESIDENT BECOMES A PATIENT. R. Harrison 1 , S. Desai 1 , D. Webster 1 , A.J. Hunter 1 , J.L. Bowen 1 ; 1 Oregon Health Sciences University, Portland, OR PURPOSE: To date there are no studies discussing the experiences of caring for residents who are hospitalized at their own training institution. While providing care for a hospitalized resident at our institution a great deal of turmoil developed among the housestaff and faculty over the issue of house officers providing care for their peers. Using the critical incident technique we assessed the experiences of the resident patient and the house staff taking care of their peer in the hospital. METHODS: In order to better understand the origins and nature of these conflicts focus groups were performed that included the resident patient and the house staff who provided the care. We convened 3 focus groups with the house staff and a separate session with the resident patient. All five residents who cared for the hospitalized resident were invited to participate in this study on a voluntary basis. Consent was obtained before audio recording each confidential session. Each session facilitated by the investigators consisted of one to three resident physician volunteers who were asked to describe feelings, both positive and negative surrounding care of their peer. The audiotapes were transcribed, independently analyzed and coded by each investigator. The coded transcripts were then compared and discussed generating a coding scheme. Disagreements were discussed and resolved by consensus. OHSU IRB approved this study. RESULTS: One hundred percent of eligible participants completed the study. Caring for a colleague had an overwhelmingly negative impact on the residents routine medical decision making, work structure, and team dynamics. Barriers to routine care of the hospitalized resident included intense emotional experiences, ambiguity in the care structure, and concern for confidentiality and privacy. This resulted in paralysis in care decisions leading to reactionary care or even care avoidance. Lack of communication amongst team members, faculty and patient was a commonly sited experience. The housestaff patient perspective was equally negative. Problems with communication and care delivery were emphasized particularly surrounding the issues of objectivity and confidentiality. Themes of vulnerability, frustration and powerlessness dominated the narratives of the resident patient. CONCLUSION: The critical incident technique offers a unique perspective into the experiences of residents taking care of peers in the hospital. Many of the themes were identical to both the residents and resident patient including issues of confidentiality, communication and intense emotional conflict. While many residents choose medical care at their own training institutions, this study demonstrates the potential difficulties with this approach and suggests the importance of determining a policy of care for the hospitalized resident.