from the New York Times:
Over the next two weeks in hospitals and medical centers across the country, new medical school graduates will begin their internship. Among their many worries — moving to a new city, meeting new colleagues, adjusting to medical training — is a more profound, existential concern:
Do I have to lose my self in order to become the doctor I want to be?
According to a study from the Johns Hopkins University School of Medicine in Baltimore, … researchers interviewed residents, or doctors in training, from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, what they believed would be a temporary imbalance between the personal and professional aspects of their lives. While the young doctors interviewed defined well-being as a balance between all those parts, many felt that their medical training was so central to their ultimate sense of fulfillment that they were willing to live with whatever personal sacrifice was required, even if it meant a temporary loss of a sense of self.
“It’s partly a coping mechanism,” Dr. Ratanawongsa said. “We tell ourselves that we can do everything but not at the same time, so we are going to put off the thing that defines us as a person — time with children, running a marathon, painting, playing music — in order to get trained because being a doctor is also rewarding.”
That delayed gratification works well initially because residents believe it is only temporary. “A lot of what matters to residents at this time is the sense that they are learning to care for patients well and growing as doctors. They feel that what they are doing is going to be worth it.”
But when the imbalance persists for longer than initially expected, professional growth is not enough to sustain most young doctors. “The ones who are happier,” Dr. Ratanawongsa observed, “are the ones who have held on to one or two things and have said, ‘I’m not just another resident. I play the guitar, I run races, or I go home to family.’ They don’t do these things to the same extent as they did before residency, but they do them enough to maintain a sense of self.”
Residents who don’t find this balance are at risk of burnout, clinical depression or, more commonly, subtle forms of stress. “These residents may feel that even if they can give excellent care most of the time, there are times when they snap at a patient or don’t order a test fast enough because they are so burnt out.”
Although her study focused on doctors in training, Dr. Ratanawongsa sees the same challenges among doctors who have finished and are currently practicing. “There is always this expectation that at some point things will turn around. The interns say, ‘When I finish internship and become a second-year resident, things will get better.’ The residents say, ‘When I finish training, I will finally have balance again.’ And doctors in practice may believe that they will find more balance once they have retired.”
The danger is that physicians may end up leaving the work force or will become less effective caregivers. Dr. Ratanawongsa suggests that doctors learn how to create a better sense of balance in their lives from the moment they begin training. “We are taught to put our patients before ourselves; it’s in our charter of professionalism. I agree with that, but I also think there has to be some sense that I matter, too, at some point. If something important is going on with our loved ones or with ourselves, we need to be able to advocate for ourselves. And we need time to reflect on who we are and where we are going.”
“My belief,” Dr. Ratanawongsa said, “is that doctors will have a greater capacity to know their patient as a person if they know themselves. That kind of knowledge requires a sense of balance and an understanding of why they chose to become a doctor. It comes down to their capacity to be an empathic, caring and compassionate provider; and it comes not from their medical knowledge but from their soul.”
“This is something we should never sacrifice, even temporarily.”
just posting this article as a reminder not to lose the list of super cool stuff that makes me me.
in the last 24 months, everything has sort of watered down into “i’m a med student”… but i know that’s not entirely true because the About page i wrote 2 years ago has more than 4 words on it.
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photo: my sister Janice at my mom’s softball game last week. it was a gorgeous night to sit outside in lawnchairs, eating sunflower seeds, drinking cream soda and laughing.
Well, I hope we are in with the doctors that head home to their family and that is what defines them. I know I am not looking forward to the long hours, but I am looking forward to learning some medicine and having the great ability to go home to my family.
Love the photo – you can totally tell she is eating spitz! I think you will do a great job of not losing yourself as i believe you’ve work hard over the years to discover and get to know your true self.
:)
PS. What did Brandon think of the prairie storm?
“Residents who don’t find this balance are at risk of burnout, clinical depression or, more commonly, subtle forms of stress.”
LOL- either that is the understatement of the century, or those of us who consider ourselves well-rounded yet still have freakouts that would do Rick James proud, may look forward to relaxing a little once we get to that all-important paycheque phase.