How to stay human during residency

Residency can be a time of personal and professional growth. Yet the stressors of new clinical responsibilities, time pressures, sleep deprivation, and constantly being evaluated can also lead to self-doubt, cynicism, and symptoms of burnout.

I became interested in resident health and wellness during my own training and I have continued to explore this topic throughout my career. Here are some suggestions I have compiled for staying resilient, authentic, and happy during residency.

Aim to maintain an “internal locus of control.” Seek to control what you can rather than passively accepting what happens to you. Plan rotations, electives, access to specific supervisors, on-call requests, holidays, conferences, and study leaves in advance. Always have something to look forward to on the horizon.

Draw a “self-esteem pie.” Draw a circle and label 4 slices as work (career), love (all relationships), play (what brings you joy outside of work), and spirit (spiritual beliefs and personal values). How big (or small) is each slice in your life? How balanced are your goals? Hang the drawing on your fridge to remind you where you are and where you want to be in terms of feeling whole and authentic.

Connect with others. Maintaining meaningful relationships is the most protective of all strategies in coping with residency stressors. Prioritize your social and family life (outings, shared hobbies, travel). Use social media to keep in touch with loved ones when you are on call or extra busy. Maintain nonmedical friendships. Support your team members and ask for a hand if you need one. If you feel overwhelmed, your provincial residents’ association can connect you with confidential resources and professional counselling.

Do not neglect the body. Residents are challenged daily around eating, sleeping, and even taking bathroom breaks. Check in with your body every time you wash your hands. What stress signals is it sending? Follow the advice you would give patients about self-care. Find a family doctor. As busy as you are, make time to exercise, eat right, and maximize sleep. Find stress-busting strategies that work for you, such as mindfulness, yoga, prayer, meditation, athletics, artistic pursuits, and spending time in nature.

Know your rights. Read your contract or collective agreement closely to clarify work duties and policies around harassment or labour issues. Find out about benefits including study, illness, and parental leaves; accommodations for special needs; and access to gyms, libraries, and free resources for studying or examination preparation.

Read around your cases. Reviewing a topic when it is immediately relevant to patient care is not only a good motivator, but it also situates clinical principles in a real-world context that you will remember.

Keep a journal. Record your thoughts, feelings, ethical dilemmas, and “firsts” (eg, first delivery, death of a patient, clinical mistake). You think you will remember training highlights and challenges, but you probably will not. Writing even short observations about your evolution as a physician is a good way to check in with yourself and to process stressful—or inspiring—situations.

Be a generous and patient teacher. This applies to junior residents, medical students, and other colleagues. How we treat one another either perpetuates workplace abuse and the hidden curriculum or humanizes us and our profession.

Do not be afraid to say no. If a demand does not fit, does not feel right, or is unreasonable, you have every right to question it.

Live in the moment but consider your options. Many residents feel the only way to “get through” training is to live in the future and neglect their present. At the same time, it is comforting to know that medical training confers many options that most professionals do not have (eg, teaching, writing, research, consulting, travel, volunteering, advocacy). Be creative in your goal planning. Most programs offer access to career counsellors who can help you identify what brings you a sense of sustained purpose and pleasure in work and in your personal life.

You will need to strive for balance and personal growth during these exciting years of training (and beyond). The more empathetic, reflective, creative, and fulfilled you are as a person can only make you a better healer and citizen of the world.

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