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.
The National Health Service (NHS) is the overarching employer of medical graduates in the United Kingdom. The first two years of any new doctor’s training within the NHS is known as “foundation training” (in the United States, this would probably be equivalent to the “rotations” typically completed before obtaining an MD).
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.
During residency, do you ever stop to think why you wanted to become a doctor? What were your reasons? I wish I could remember mine. I could have pursued so many other careers. I used to be a director of a non-profit organization, helping individuals from low socioeconomic backgrounds attain technical skills. I do not recall being at my current level of mental, emotional and physical dysfunctionality while working that job.
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.
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.
Of all the fulfilling and purposeful vocations to pursue, we’ve ended up trying to find our footing in the vast and ever-changing maze of medicine. Propelled by some combination of privilege, perseverance, and circumstance, we became doctors — many of us with the noble drive to heal and support other humans through the physical and spiritual struggles of life.