The No. 1 concern of today’s residents, both for their residency and first job, is work/life balance, primarily the issues of schedules and call hours, according to the Medscape 2018 Residents Lifestyle and Happiness Report.
The inference from the survey is that resident physicians attribute their symptoms of burnout to the amount of time they are expected to be at work or on call. Yet there are no standard definitions of burnout and universal tools to measure it are also lacking.
Residents face multiple challenges: bearing witness to people’s pain and suffering, delivering bad news and managing ethical questions, as well as a work schedule that can be unpredictable and physically difficult at times.
Residency is a time of self-discovery
However, residency is when you learn how to handle these challenges. It is a time of self-discovery, when the importance of community with colleagues develops. It is the last opportunity in a physician’s career for organized, structured learning with supervision and feedback. It’s where you learn to be a doctor.
I entered the pediatric residency program at Baylor College of Medicine in 1990. This was pre-duty hour restriction and we worked a lot. We residents would, of course, have our “gripe sessions,” but we were all in it together and that seemed to lessen the load.
In return for time spent at work, we saw everything. How a disease process started, the generation of a differential diagnosis, the middle and end of a course of illness, as well as an immense variety of diagnoses. We learned triage and prioritization, as well as how to manage distractions.
We also interacted with families, nurses, consultants, attendings, and most importantly, one another. I completed a neonatology fellowship at Baylor College of Medicine in 1996.
When I took my first job with a private practice in a mid-sized city, I realized how my residency experience–the excellent faculty members, large patient volumes and variety of diseases–was invaluable to my ability to practice medicine.
After 20 years in private practice, I returned to Baylor as a faculty member.
Residency is temporary
As a resident, in the moment, you’ll likely find the long hours and patient care responsibilities daunting. But when you look back, you’ll see how much you grew and learned.
Residency is replete with indispensible learning opportunities, which build a solid foundation of knowledge that benefits physicians for their entire careers. Only 12% of the Medscape survey responders said educational and professional growth opportunities would help them avoid burnout, which suggests that residency is no longer considered a time of great personal and professional growth, but a battle for time off.
The search for the first post-graduate job fares no better. Again, the opportunity for professional development, a supportive organization and potential for advancement take a back seat to work hours and money.
A sacred and special job
Experts use the term work/life integration rather than balance because there cannot be an actual balance. Less work does not necessarily imply more life and does not necessarily create happiness.
Things shown to improve job satisfaction include finding meaning in your work and working for organizations that are value-oriented, have adequate resources and promote autonomy. Whether you work 30 hours per week or 60 hours per week, if you feel powerless and your work holds no meaning, the time away from work may not compensate.
Being a physician, being allowed into people’s lives in their greatest time of need, is a sacred and special job that comes with the opportunity to form profound human connections with both your patients and colleagues.
Don’t lose sight of the unique position where medical training has placed you. Take advantage of all residency has to offer on your journey of medical training. After graduation, evaluate potential work positions in terms of engagement and meaning along with compensation and work hours.