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).
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.
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.
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.
“Philosophically committed to the objectives of the facility,” read the original job posting for a physician by The GEO Group in the prestigious Journal of the American Medical Association (JAMA). The GEO Group is a for-profit company that runs correctional facilities not just in the United States, but also in the United Kingdom, South Africa and Australia. It also operates several Immigration and Customs Enforcement (ICE) processing centers in the United States.
After reading the title of this article, you may think that I am one of those hospital higher-ups trying to peddle “social hour” as a miraculous cure for burnout rather than an ineffective band-aid on a broken system. I can assure you, I am not. I am one of the residents on the front lines.
My wife and I were preparing to move overseas so I could begin medical school in Israel. We both wanted children young. I grew up as one of five siblings, and we looked forward to a big family. I knew that having kids would change my medical education experience, but I had no idea how grateful I would be for the advice I received that sunny spring day in Alabama.
In 2019, sexual harassment and discrimination in medicine prevent patients from receiving the best possible care. We all deserve better. Not only do all who practice medicine and care for patients deserve an equitable workplace, patients deserve optimal care provided by medical teams in which all members are respected and valued. This is why I’m proud to be a founding member of TIME’S UP Healthcare.