A golden pearl for July: Embracing compassion and support in medical training

According to birthstone gemology, July is traditionally represented by a crimson ruby. However, I prefer to associate the month with a golden pearl.

Golden pearls represent a variety of different concepts, including prosperity and luck. They also are thought to bring healing, protection and renewal properties to those who possess these rare gemstones.

In July, the medical community marks the beginning of a metamorphosis, during which medical students transition into interns, then residents and, ultimately, fully licensed physicians. It is a stressful period for both trainees and their seasoned mentors as they are introduced to new environments, staff, expectations and responsibilities.

With that in mind, I believe there are ways to mitigate the strain and make it more endurable, which could result in less burnout and contribute to the making of more well-adjusted physicians. After spending four years as a medical student, one year as an intern, two years as a psychiatry resident and another two years as a child psychiatry fellow (not to mention, having spent the last 32 years as an attending physician and the last seven years as a medical school professor), I’ve experienced the gamut of the emotional and physical manifestations of medical training.

‘We are all doctors’

As we embrace July as a new start, we must remember that regardless of whichever phase of training we are participating in, the reality is that we are all doctors, we are all on the same mission, we all deserve respect and we should stand as one. We are collectively experiencing the trials and tribulations of medical training. We each have our individual strengths and weaknesses. Additionally, we are all adults with families, lives and responsibilities outside of our professional communities.

During ongoing life-and-death medical scenarios, sleep deprivation and crises, we may become negligent and overlook these basic facts. When frustrated, overwhelmed and under pressure, we can even regress into negative and hostile interactions with one another.

However, during these intense moments, it is crucial to remain cognizant of the fact that we are training physicians to be empathic, kind, approachable and professional with their patients. As such, it behooves us to model this behavior. We all function as role models. We should be teaching, mentoring, and encouraging professional growth with patience and respect, regardless of the situation.

We might think of it as addressing our younger self when we were in training. What would we have appreciated from our supervising physicians? What would have made our experience more tolerable? Who stood out as a leader we wanted to emulate, and whose mistakes did we want to learn from?

In medical training, the stakes are always high, and often ratcheted higher by health care crises such as the COVID-19 pandemic. Combine this pressure-cooker situation with skyrocketing medical school tuition and subsequent high levels of school debt, and you can see why burnout, depression and suicide rates remain stubbornly high among physicians and medical trainees.  

As a community, we have the strength and means to reduce this trend.

Awareness and education can facilitate the needed change.

Kind, supportive teamwork

To all the leaders: Being kind and supportive does not diminish your authority, undermine your importance or reduce your leadership role. Rather, it enhances your approachability and ability to be a great leader. There are myriad benefits to this type of leadership. Trainees will appreciate the opportunity to learn while being connected rather than isolated, encouraged rather than criticized and motivated rather than fighting obstacles. All these positive interactions may reduce burnout while the opposite can contribute to it.

To all the trainees: Show gratitude to those who lead with tolerance and support, and emulate them going forward. Ask them for guidance for engaging with those who do not follow suit.

Internalize the positive experiences and file the others under “do not repeat,” and be a better role model to those who follow you.

Strategies for preventing burnout

Preventing burnout may be complicated and multifaceted, but here are some basic strategies which are not:

1. Consistently address staff respectfully.
2. Acknowledge and appreciate their work effort.
3. Mentor and encourage their professional growth.
4. Check in on the mental health of trainees and colleagues alike.
5. Offer mental health resources and encourage trainees and colleagues to seek support.
6. Seek and acknowledge issues inherent in the environment which could be toxic and contributing to burnout. Try to address them the best you can.

With all the facts and knowledge that we acquire during our extensive medical training and subsequent practice, there is a golden pearl which is never outdated. Please, support one another and treat others as you would want to be treated yourself. That is where our power lies!

Related reading:

Third year: The evolution of flashcards

Compassion in medicine: It’s not just the right thing to do—it also makes the most cents