The opening days of residency can be overwhelming and isolating. You are entering your new life, and the road ahead is not easy. Take solace in this fact: You are not alone.
Tani Malhotra, MD, is a fourth-year ob-gyn resident at York Hospital in central Pennsylvania. Looking back to the beginning of her residency, she felt she was too hard on herself.
“I can’t tell you how many times in my first months of residency I felt like I was just not cut out for it, that I was just not good enough, that I would never be good enough,” Dr. Malhotra told AMA Wire®. “The learning curve is so steep.”
A conversation with a fellow resident—one in which they discussed their mutual admiration for each other’s work—changed her vantage point.
“A large part of avoiding burnout, or dealing with it, is having people in my program who may be feeling the same things and being able to talk to them and discuss our issues. It makes a huge difference for me,” she said.
Burnout among medical students, residents and early career physicians is higher than their similarly aged counterparts in the general population, said a March 2014 study in Academic Medicine. The study, which reported the results of a survey of more than 13,000 doctors, med students and physicians-in-training, found the burnout rate was worst—60.3 percent—among residents, compared with 55.9 percent for med students and 51.4 percent for the practicing physicians.
Residency programs are working to address burnout on multiple fronts. In terms of curriculum, programs have been using classroom time and resources to provide physical, psychological, social and professional wellness education.
Daniel W. Robinson, MD, is an assistant professor of medicine in the section of emergency medicine at University of Chicago (U. of C.).
“There is this culture—and if you look at today versus 10 or 20 years ago, it’s getting a lot better—of not talking about a negative outcome or if something really affected you,” said Dr. Robinson, also faculty chair for the U. of C.’s residency wellness committee. “We are getting to the point where people are opening up to talk about those things. We are checking in with them and making sure that the residents are indeed OK. And if they are not, we are getting them some help before it gets too far down the line.”
Building a community starts in a more formal setting. At U. of C., students have found that those conference sessions help to create an open dialogue among residents extends beyond a classroom.
“We’ve really tried to focus on having open spaces where people can talk about their experiences as residents, and how their day-to-day life is,” said Dillon Barron, MD, a third-year emergency medicine resident at U. of C. and a member of the resident wellness committee. “Having these spaces has made it obvious how prevalent burnout is and how overworked and exhausted people become in residency. The grind can start to dehumanize you. It has made it obvious that we are not alone—that other people are going through this stuff too.”
It is not easy to maintain a social life outside of your residency responsibilities, but it can prove to be an essential aspect of maximizing your personal well-being.
At U. of C., the resident wellness committee organizes frequent social outings. While a white-elephant holiday party or fall bonfire may seem trivial, these types of events can prove a necessary outlet, Dr. Robinson said.
“You are going to learn more if you have a positive outlook, and part of that is being in a good place,” he said. “For me, that means having a social life and having good relationships.”
The power of positivity, in both your own outlook at the outlook of those around you, is another key factor for resident success. For all the worry about the grind, you will meet new people and learn the skills to pursue a meaningful career helping patients.
It is worth noting, for example, that the Academic Medicine study cited earlier found that nearly 80 percent of residents reported a high or intermediate level of personal accomplishment.
“Embrace your residency,” Dr. Barron said. “It is going to be a trying and demanding time. It’s also going to be one of the best times in your life. There’s so much media and gossip about burnout and exhaustion in residency, but people don’t get to hear much about how they are going to love it. It’s been one of the most exciting and rewarding things I’ve done.”