Residency is a challenging time plagued by long hours, overwhelming clinical service loads, escalating documentation requirements, and inadequate resources for support. A recently published study in the New England Journal of Medicine illustrates how mistreatment in the training environment takes an additional toll on medical trainees.
I had just started my first clerkship of third year at a nearby hospital when the news broke. Hahnemann Hospital, the main teaching hospital of my medical school, was closing. More accurately, the hedge fund manager who purchased the hospital a year earlier was filing for bankruptcy. He separated the valuable Center City real estate from the hospital itself to ensure a tidy profit for investors at the expense of patients and staff.
On October 16, 2019, our collective of health care workers at Yale University disrupted the meeting of the Graduate Medical Education Committee. Heads turned and followed us to the front of the lecture hall, where we unfurled our banner declaring “Doctors are Humans Too.”
I elected to pause my training after completion of a transitional year internship to enter active duty service as a United States Air Force flight surgeon. While it is a less-than-traditional pathway, it allowed me to serve a greater mission.
It wasn’t caterpillars turning into beautiful butterflies, that’s for sure. “The Change” was when a bright-eyed, optimistic female junior resident turned into an angry, and sometimes mean, senior resident with very little patience for anyone.
We are fighting for UW to come up to the national standard in their treatment of residents; we’re not asking for the impossible. Residents deserve to work in humane and livable conditions.
On September 25, we participated in a 15-minute unity break (effectively a walk-out) with over 450 residents and fellows at the University of Washington in protest of UW’s dismal contract proposals during our negotiations. It was led by the University of Washington Housestaff Association (UWHA), one of the few unions of resident doctors in the United States.
It was 2 a.m. and I was downward-dog in the call room. Earlier during this maternal/child health rotation night shift, I had labored with three other moms in so many different positions that my back felt like it might actually break.
Last week, the resident physicians and fellows of the University of Washington collectively decided to walk off the job for a 15-minute “unity break” in protest of unacceptable working conditions and stalled contract negotiations.
Listen to the track “PGY3” by Dr. Roy Souaid and his band “John Lebanon.” The song started in New Orleans during the American College of Physicians National Conference in May 2018 and has been a yearlong project inspired by street buskers, hospital sounds and jazz. It captures the medical resident’s work flow and is set in the medical intensive care unit at the Miriam Hospital in Providence, Rhode Island.
In my first post in this two-part series, I presented an argument for why physicians and administrators need to work together to develop small-scale interventions to bring meaning to medicine while we continue to push for larger systemic change. In this post, I will explore some effective (and some less effective) themes for interventions for residents.
Over the last year, our collective minds have been captivated by stories about child and family separation, detainment of citizens and immigrants, and the quality of the health care within detention facilities. These stories have been jarring and traumatic, and have also awoken an important level of national consciousness about the nature of detention. What has not received as much coverage in recent discourse is the ongoing nature of solitary confinement in our justice system.