During my fourth year of medical school, I was completely unaware that I was suffering from clinical depression. Even now as I write this, I struggle to put my finger on how it all started. Was my appetite the first thing to go? Or the loss of enjoyment in socializing and sex? Maybe it was all three at once. It is truly too hard to tell.
Last May, Evan matched into a fellowship that will take him across the country for a year, beginning in August. Because he’s a little bit off in the head, he chose subspecialty training that will likely entail even longer hours than residency at the same pay scale.
Here I am, come and get me! A playful provocation we have all used with much more than literal meaning as a mantra. But going through the rigors, chills and metaphorical bacteremia of medical education, I lost some of the pieces that made me confident to be myself.
Neurology resident physician Nita Chen, MD journals through her first year of residency in her graphic medicine column, Pocket Doodles: My First Year as a Physician.
On St. Patrick’s Day 2014, New York’s coldest in a decade, I was a grass snake banished from the fair isle of pediatrics. In the National Residency Matching Program, just half of one percent of approximately 2,500 pediatrics slots across 194 programs remained unmatched, something like four total positions nationwide.
I am an intern physician currently enrolled in a residency program, writing anonymously for fear of of retribution. I am also chronically injured and disabled. In my time off from work, I’ve had the chance to reflect on being injured in residency, and one particular incident comes to mind.
In the 1950s, my grandmother wanted to be a doctor. She asked her father for her dowry money, wanting to use it instead to get her medical degree to become the first female doctor in her hometown. She married another doctor and practiced from an office below her home, accepting vegetables and dry-cleaning services as pay.
Career and specialty choice aside, the debt accrued for physicians is very real. Obtaining accessible and accurate advice on what to do with that debt is, at best, disappointing. My goal for this article is to educate, provide adequate resources that can help alleviate stress, set you — the reader and colleague — up to be financially successful, and hopefully make you “money wise” when it comes to your early career.
Dear intern: I see you. Yes — you over there. That unsuspecting look on your face tells me exactly what you must be thinking. You are no longer a medical student which means you are no longer invisible, or, at best, ancillary.
Two months ago, I woke up one morning at 5:30 a.m., as usual. I played my gym motivation playlist in the shower, ate oatmeal for breakfast, and headed out the door, as usual. I swore at the car that swerved into the lane in front of me without signaling, as usual. An hour later, I pre-rounded on one of my favorite patients, a man with wide, childlike eyes who had a great deal of difficulty expressing his feelings.
My partner Evan’s third year of residency completed his trajectory toward what is commonly called “burnout.” Two out of the 10 residents in his class left the program. In an already understaffed department, the remaining residents picked up the slack, taking extra call and working longer days. The general misery index among his cohort skyrocketed.
Overwhelmed and exhausted, a resident recently came to me to ask, “Can we do something about call?” Defeat and despair had taken over his psyche. He felt unable to cope with the tasks of residency, including the seemingly never-ending demands of fielding consults, pages and patient needs. He imagined that the problem could be solved by taking less overnight call.