In residency and fellowship training, physicians are learning how to practice the art and science of caring for patients. But to get through that intense time, resident physicians must also care for themselves.
“Especially nowadays, with ever-evolving AI and technology, and the demand to see more patients, it’s kind of easy to get stuck in that machine,” said Alexis Ramos, MD, a family physician and assistant clinical professor in the Family and Community Medicine Department of University of Texas (UT) Health San Antonio. “But what I would tell residents and learners of all kinds is just to take time for yourself. Medicine is amazing and it’s beautiful and it's rewarding, but it is a taker and it'll take what you give it. It just continues to take until you set your boundaries.”
There appears to be good news on the well-being front for physician residents and fellows, with recent, AMA-exclusive data showing drops in doctor burnout and job-stress rates, as well as improvements in job satisfaction. Moreover, individual resilience and “self-care” cannot entirely counter the systemic factors that drive physician burnout.
But amid the pressures of graduate medical education, residents say it helps to take time for what’s important to them, reminding themselves of who they are outside of medicine. Here are some of the things resident physicians tell the AMA that they do for themselves when it comes to their own well-being.
I look for the bigger picture
“Something that I do to preserve my wellness would definitely be to take time to step back after a long shift or after a long month on service and reflect. I really do find it beneficial to remember how small we all are in such a large universe,” said Eve Vanderneck, MD, a PGY-3 in the family and community medicine residency program at UT Health San Antonio.
That involves reflecting “on my purpose and my goal, and to realize that in this convoluted system of so many different hoops that need to be jumped through and so many metrics that need to be met, ultimately—at the end of the day—it is me as a human being trying to take care of other human beings, which are my patients, but also my co-residents and my coworkers.”
Dr. Vanderneck said being in nature and spending time with loved ones helps her keep things in perspective.
“My husband is also a resident, and so he deals with the same thing of getting super-saturated with the different demands of residency. But we both have been able to maintain alignment with our purpose and the ultimate goal of being the best educated and best prepared that we can be,” she said. “Going out into practice and taking care of whatever patient population we end up seeing, it will be a privilege no matter where it is.”
As the leader in physician well-being, the AMA provides organizational solutions that help physicians and health systems optimize practice efficiency, reduce burnout and rediscover the Joy in Medicine®.
I ground myself
“I really love yoga,” said Tanvi Chokshi, MD, a PGY-2 ophthalmology resident at Louisiana State University Health New Orleans School of Medicine. “That's what I've always done for mental health purposes. And it's been really fun to continue that in New Orleans.”
She finds it helpful to periodically do “a lot of introspection and reflection through the training process. I think it helps with burnout.”
Additionally, Dr. Chokshi makes sure to take “a beat between patients as well. Because people just come in with such different stories and such different energies that you have to just take a pause and recalibrate yourself to your baseline.”
I find a creative outlet
“I do a lot of different things because I like variety, but I love reading,” said Mollie Marr, MD, PhD, a psychiatry PGY-4 in Massachusetts. “That's an easy thing I can do every night.”
Dr. Marr, who serves as vice chair on the AMA LGBTQ+ Section Governing Council, also makes art.
“I do photography and then I work on painting the pictures that I photographed so that I get to play with the visual representation in a couple of different media, which I love,” she said. “I find that very soothing because it's something you can do a little bit of. You can do one layer and then you can step away and do another layer and come back to it.”
The AMA has resources to serve as a collaborator in addressing the factors that cause resident burnout and stress, including the AMA STEPS Forward® toolkit, “Resident and Fellow Well-Being: Optimize Well-Being at Work for Physician Learners.” It is enduring material and designated by the AMA for a maximum of 0.25 AMA PRA Category 1 Credit™.
The module is part of the AMA Ed Hub, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content from trusted sources, all in one place—with activities relevant to you, automated credit tracking, and reporting for some states and specialty boards.
Learn more about AMA CME accreditation.
I reward myself after tough stretches
Christopher Wong, MD, MSc, a fourth-year resident in a combined internal medicine and pediatrics program in Texas, said he has learned during his training what’s important to him.
“I always try to make time to see my friends and family. They're a source of support for me,” said Dr. Wong, who is also a delegate for the AMA Resident and Fellow Section. He makes sure to take care of the basics during residency training: eating, sleeping and, for him, connection with loved ones. “Those things are foundational wellness. Those are the things that you need to prioritize hitting. And then anything on top is like icing on the cake.”
Grab those “icing on the cake” moments when they come along, too, he said.
“Something that I like to do to treat myself after a stretch of nights is to get a massage, and it really helps,” Dr. Wong said. “If I have any weird pains from sitting too long or sleeping weird, then it kind of helps hammer me out.”
He said that, for him, earning money for the first time as a physician comes with occasional opportunities for small indulgences.
“Now you're actually being compensated for your time and your efforts and your study,” Dr. Wong noted. “I'm not saying buy a new car or buy a new house—or don't jump right into that immediately. But I think small treats, small rewards for yourself ultimately help with your happiness and your well-being.”
I decompress
“The biggest thing is taking a little time to unwind at the end of each day. Obviously, residency is a very busy time. Sometimes we're working very long hours or getting up in the middle of the night to go take care of patients,” said Kyle Crawford, MD, also an ophthalmology resident at LSU School of Medicine. He makes sure to take “a few minutes at the end of the day to kind of sit down, not watching TV, not on my phone, not doing anything, to just unwind and think about the day.”
Dr. Crawford also makes sure to incorporate physical activity, which for him is non-negotiable.
“I'm a big tennis player,” he said, adding that, “I have yet to miss a gym day during residency. That's my one claim to fame.”
He enjoys relaxing with friends and coworkers, “just remembering that there is life outside of medicine, even though sometimes it seems like we're in the hospital all the time.”
UT San Antonio Health Science Center, the academic health center of UT Health San Antonio, and the LSU Health New Orleans School of Medicine are both parts of the AMA GME Competency Education Program, which makes it easier for institutions to meet ACGME requirements through flexible, on-demand education. The program is designed to fit into residents’ demanding clinical schedules with a micro-learning approach and supports institutions through streamlined reporting tools that reduce administrative burden. Learn more.
