There is no doubt about it: Actions such as eating balanced and regular meals, taking necessary breaks and getting adequate, restful sleep can help mitigate some of the stress and burnout that are driven by systemic factors during residency training. But one well-being expert says a crucial tool in the resident physician’s self-care kit should be understanding that there is only so much they can control during the hectic—and temporary career stage—in which they find themselves.
“What gets really tricky is that I don't think residents always realize how much residency is going to force them outside of their usual self-care strategies, rituals and routines,” said Kelly Shaw, PsyD, a licensed clinical psychologist and program director for graduate medical education well-being at the Geisinger College of Health Sciences. “Many of them come into residency saying: I'm going to work out this many times a day, I'm going to meal prep in this way, I'm going to get my eight hours of sleep. But then they find that the actual demands of residency or fellowship simply do not allow that to happen.”
Then, some resident physicians find themselves contending not only with stress, but also feelings of guilt about not being able to do more of the self-care activities that might help alleviate it, Shaw said.
Danville, Pennsylvania-based Geisinger is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine. And Shaw said she has learned lessons in her time with physicians at Geisinger about how they can create a self-care plan in residency that is about much more than one-time actions.
It is the mindset that really matters, she said.
“There's a big component of this that says, given the present circumstances, what does this now look like for you? Similar to many other life circumstances, we have to adjust,” Shaw noted. “The universal skill that is ultimately needed, more than just saying ‘practice good self-care,’ is the ability to tune in and understand what you need in light of what you're going through.”
Research shows that systemic actions are far more important to physician well-being than are any individual actions a resident can take.
That is not to say that residents and fellows are powerless over their circumstances—Shaw stressed just the opposite.
“That's not healthy for people to believe that everything's just out of my power and I'm just a victim of the whims of my employer or the world around me,” she said. “But there does need to be an important balance in self-awareness and understanding, and then the self-compassion, that comes along with having to make difficult choices.”
In the following article, resident and fellow physicians will learn:
- Why mindset matters more than rigid routines during residency.
- How shifting expectations can help prevent self-blame and guilt.
- Data revealing common self-care struggles among residents—and signs of improvement.
- Tips to make realistic compromises for well-being amid a demanding schedule.
