Resident Physician Contributing Writer
University of Massachusetts Medical School
Emily is a third-year Internal Medicine/Pediatrics resident and Clinical Chief Resident at the University of Massachusetts Medical School. She has undergone teacher training with the Center for Mindfulness and has applied her mindfulness training to her work in the hospital. She is interested in medical education, hospital medicine, and palliative care.
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.
I am very pleased to welcome you all to a new academic year at the esteemed institution at which you find yourself, perhaps somewhat unexpectedly, thanks to the Match. Late June is always somewhat bittersweet, but it is a simultaneously exciting time in the academic year.
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.
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.
The faint glow that is the light at the end of the tunnel hits my face as I realize that intern year is almost over. One would think that having been through the personal loss I have — losing two beloved older brothers at a young age — that intern year would be more than manageable. Yet this past year has been, for me, a chaotic roller coaster ride.
When I took a job as a residency coordinator in graduate medical education at a local community hospital, I made myself a promise: I will not date a resident. They’re too busy, we work together, and we have nothing in common.
One of the trickier things to learn as a young doctor is how to navigate boundaries between patient, doctor, family and friends. Medical school teaches us that it is unethical to treat yourself or your close family due to a lack of objectivity that can affect judgement. It is fairly obvious why doing otherwise can create poor medical care due to blind spots created by subjectivity, hope, selective listening, personal agendas, and bias for a certain approach to treatment.
Attending Physician Guest Writer
Geisel School of Medicine at Dartmouth
Dr. Ronan is an associate professor of neurology and medicine at the Geisel School of Medicine and is the program director of the Dartmouth-Hitchcock Neurology Residency.
Practical Wellness: Perspectives from a Program Director
A program director's perspectives on practical wellness in residency and how graduate medical education leadership can facilitate housestaff resiliency and self-advocacy.
