Physician well-being has become high priority and high visibility. Concern about well-being is almost invariably coupled with concern for physician burnout. We see these concerns in almost every issue of every reputable medical journal. The attention is appropriate, essential, and long overdue. We preach the importance of prevention and risk management to our patients, but we are oblivious to our own needs for the same.
Physicians are leaving the medical profession in greater and greater numbers. Many residents are seeing the discontent and disappointment of physicians in practice. They’re asking themselves if they still want to be physicians.
Medscape publishes an annual Residents Lifestyle & Happiness Report, compiled from responses to a survey of residents about relevant topics. The residents answered questions about facing challenges, maintaining wellness, and dealing with stress and burnout. I want to share some of the findings with you. I encourage you to compare yourself, but not because you want to decide if you are more than or less than your peers. It will help you understand yourself. The survey can be an important tool in your search for your first job after residency, and for any job search in the future. You’ll see what is important to you. Look for settings that support your needs for greater satisfaction in your work. That can help guide your job search to positions with which you may be compatible. You may also see vulnerabilities of which you were unaware. It is best to identify them while you are still in training, receiving feedback from your instructors.
Not all is bleak. The number of residents still looking forward to being doctors went from 85 percent in 2017, to 87 percent in 2018.
What are your greatest challenges in residency? The survey reported that the top five challenges were: work-life balance at 33 percent; time constraints at 17 percent; fear of failure or making a major mistake at 15 percent; developing clinical skills at 10 percent; and debt at 10 percent.
Do long shifts and fatigue ever interfere with your functioning? Just 37 percent of residents responded that fatigue was a problem sometimes, 65 percent said rarely or never, and 5 percent said they were tired all the time. Sixty-five percent of the respondents thought long shifts did not lead to more errors.
Do you pursue personal wellness? Thirty-five percent of residents answered that they rarely or never had time for personal wellness, but 19 percent said they did attend to personal wellness regularly, and 43 percent sometimes attended to personal wellness.
Have you suffered a failed personal relationship? Almost 70 percent of your peers have suffered such a loss.
Do you have symptoms of depression and/or thoughts of suicide? One in 10 residents said they suffer from depression all or most of the time, 33 percent said they were depressed some of the time, and 61 percent said they never felt depressed. None of the responders had attempted suicide, but 10 percent said they had suicidal thoughts; 85 percent never had thoughts of suicide.
There were reports of the rewards the residents experienced in training. These were the most rewarding experiences:
- Increasing clinical skills – 76 percent
- Gratitude for their relationships with patients – 69 percent
- Excelling in their work – 68 percent
- Relationships with other residents – 64 percent
- Pride in being a physician – 56 percent
- Making the world a better place – 46 percent
- The potential for high income – 38 percent
Residents were offered suggestions for avoiding burnout. Respondents thought these would help, to varying degrees:
- Manageable work and on-call hours – 64 percent
- Enough income to avoid financial stress – 41 percent
- Reasonable patient loads – 40 percent
- Flexible schedule – 38 percent
- Positive relationships with colleagues – 38 percent
- Adequate support staff – 34 percent
- Enough paid vacation time – 27 percent
- Professional development opportunities – 12 percent
The residents added: having sex, sleep, reading, traveling, time with pets, indulgence in food/drink, playing with their child, hiking, and running.
What can you add?
To learn more about caring for self, which means better care for patients and greater work satisfaction see: https://www.aafp.org/about/initiatives/physician-health-first.html/.