The habits you develop during residency can set the foundation for how you’ll practice throughout your career, says Kristin Yates, DO, an ob-gyn at Garrison Women’s Health in Dover, New Hampshire, who has written about residency habits.
“Unhealthy habits can persist throughout residency and can solidify themselves in your practice and life,” Dr. Yates says.
Traditionally a very busy, high-stress time in one’s career, residency training has been even more challenging during the COVID-19 pandemic as trainees simultaneously grapple with a new role and myriad other worries, which can include PPE shortages, infecting their families and hospital sick leave policies.
“The COVID pandemic is the first time I can recall when residents and fellows felt that their lives were literally endangered by coming to work,” says Alex Auseon, DO, an associate professor and cardiology fellowship program director at the University of Illinois Chicago. “Added to that, so little was known in the early spring of 2020 and things were changing so rapidly that the anxiety was incredibly intense.”
The added stresses of the pandemic mean making self-care a regular habit is even more important, Dr. Yates and Dr. Auseon agree. Below, they share ideas on how to do that, as well as other habits that can help residents succeed in their training and make the transition from resident to attending easier.
- Make time for self-care
The suicide of Lorna Breen, MD, in April highlighted the need to be mindful of the toll the pandemic was taking on physicians and hospital staff, Dr. Auseon notes.
“Exercise and time away from medicine needed to be recognized as a priority by trainees and attendings,” he says.
Many hospitals, employers and organizations are offering self-care resources, such as discounts on relaxation apps and free confidential counseling, he notes. The AOA’s Physician Wellness Hub has a list of free or discounted wellness and meditation apps, free webinars and other resources.
Alleviating pandemic anxiety should not just fall on individual residents and physicians, notes Dr. Auseon, who recommends this JAMA opinion article that summarizes steps hospitals can take to address the specific stresses health care workers are facing during COVID-19.
“Reading this piece helped me better understand the feelings we were all having and begin to have productive conversations about what to do,” he says.
Self-care is paramount during this turbulent time, agrees Dr. Yates.
“The burden on physicians is greater than ever, and if we don’t make time for self-care, we will burn out,” she says.
One component of self-care can be working through feelings of insecurity or feeling like an imposter. Dr. Yates has a podcast about overcoming imposter syndrome and also created a free online self-coaching course.
While residency is an intense time for physicians, life as an attending can also be highly stressful. Developing healthy coping skills for stress will serve you beyond your time in residency, Dr. Yates says.
“It’s easy to think, ‘Everything will get better after I’m an attending,’ ” she says.
Simple wellness techniques such as stepping outside for a moment or deep breathing may seem obvious, but they can fall to the wayside during residency, says Dr. Auseon, who also urges residents to prioritize sleep as much as possible.
- Be an active listener
While listening has always been an important skill for successful physicians to develop, it’s more important than ever right now, says Dr. Yates.
“People are struggling and may be relying on their doctors to provide guidance and advice,” she says. “Also, with mask wearing being a priority, we don’t have the benefit of facial expressions to help us with our communication.”
Seeing high volumes of patients and managing complex cases can cause some physicians to get into the habit of making unfair assumptions about patients.
“Try to avoid negative labels that either misunderstand or misinterpret why a patient makes the choices they do,” Dr. Auseon says. “There are a lot of barriers to adherence to therapy.”
Instead of labeling a patient as noncompliant with medications, you can find out why they ran out of their medication and strategize with them on ways they can avoid that problem in the future.
Dr. Auseon says the pandemic has also underscored the importance of truly listening to one’s colleagues as well.
“I found it important to express how hard it was to deal with the intense emotions and the grueling work during the spring,” he says. “I was constantly trying to be transparent about my own struggles while striking a balance with leading our fellowship program in a confident and reassuring manner. It was also important to lean on one another and communicate—maybe more than ever before in my career.”
- Practice gratitude
Every morning, when Dr. Yates wakes up, she finds one thing to be thankful for, even if it’s something minor, such as working with her favorite nurse that day.
“Teaching your brain to be positive can drastically improve the quality of your education,” she says.
- Find the right leaders
Residents are exposed to positive and negative role models during training, says Dr. Auseon.
“Try to seek out the advice and counsel of people you’d like to emulate when it comes to your career, patient care or even coping skills,” he says.
- Set goals for beyond residency
When you’re in the midst of training, it’s easy to have tunnel vision because the finish line of graduation can seem far away.
Dr. Yates hadn’t planned any goals for after residency. She never thought about what her life might look like as an attending.
Setting goals beyond residency has become even more important during this time, she says. She encourages residents to think about what their ideal life would look like after residency, both inside and outside of medicine, and to consider contingency plans to cover possible job instability or job loss.
“Think about how you want your career to play out 10 years after residency,” Dr. Yates says.