Staying healthy should not be an option. As emergency physicians, it should be our mandate to stay healthy so that we can promote healthy living, optimize our ability to care for our patients, extend our careers, and be there for our families. However, modern life can be hectic and unpredictable. While we all desire an active and healthy lifestyle, maintaining one in practice can be difficult for physicians despite our extensive education and resources. 1 As emergency physicians we face the additional challenge of working a schedule that has been shown to have negative health implications. 2


This brings us to the question that we hope to address with the #HealthyInEM series: How do you stay healthy while practicing emergency medicine?

Taking inspiration from the “How I Work Smarter” series, #HealthyInEM poses a series of standardized questions to emergency physicians identified as health and wellness experts via a snowball sampling technique. 3 We are excited to hear how inspiring emergency medicine (EM) physicians at various levels of training from around the world are able to maintain their health. We hope that this series will focus attention on an important issue in emergency medicine while providing emergency physicians with a repository of ideas and inspiration for how to stay healthy.

  • zafrina-poonja-circle-150Name: Zafrina Poonja
  • Location: University of Saskatchewan, Saskatoon, Saskatchewan
  • Current job(s):  PGY-1 in Emergency Medicine
  • One word that describes how you stay healthy: Balance
  • Primary behavior/activity for destressing: Music and a treadmill

What are the top 3 ways you keep healthy?

  1. Keep up with sleep. I am one of those individuals that need a certain number of hours to function. This can be difficult in residency, but maintaining good sleep hygiene makes a big difference. Developing a bedtime routine trains my mind and gives me a better quality of sleep. This also means no caffeine after 5 or 6 in the evening, unless I have a night shift.
  1. Stay active. Scheduling time to keep up my fitness is very important to me. I have always been an athlete growing up, so staying active is just part of my routine. It makes me feel good, keeps the body happy, and keeps the mind ticking. Whenever I can, I like to get involved in team sports – it brings out some good friendly competition and gives you a chance to socialize with friends.
  1. Life is short, so don’t take it too seriously. There are times when you have to be serious and professional, but when you don’t, keep it light! I love joking around with my staff and fellow residents. It keeps the environment warm and the makes the time you spend together more memorable.

What’s your ideal workout?

My ideal workout includes at least 30 minutes of cardio (preferably something team-based and interactive so I don’t get bored) followed by some sort of weight training. Getting your heart rate up and working on your endurance is essential, but dedicated weight training of a specific muscle group makes that next day “burn” so much sweeter.

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Tackling Tom’s Thumb in Scottsdale, AZ during Christmas

Do you track your fitness? How?

I like to use my iPhone 6. It contains all the apps I use in one place, such as the Nike+ app. Plus it has access to all my music, which for me is essential.

How do you prepare for a night shift? How do you recover from one?

I am still working on perfecting my night shift routine. If I have the opportunity, I try and get in a good sleep the night before so my morning is productive. During the day, I try and conquer one or two of the tasks on my list and get in a solid workout. This primes me for a good nap, and I am usually up two hours before my shift starts so I have time to shower and get down a good meal before I head to the hospital. Before all shifts (day and night), I need something to pump me up and get me in the zone so I crank up the music on the way to the hospital to let my mind know that it is go time!

I haven’t perfected my recovery rituals either. Like I said, I need my sleep so when I can I sleep until I feel rested. Although this often results in a few hours less to do work surrounding my shifts, I am much more efficient with the time that I have.

How do you avoid getting “hangry” (angry due to hunger) on shift?

Snacks, snacks, and more snacks. I always have an extra granola bar or two in my backpack. And when I am super desperate, storing some extra change around in my locker or bag comes in handy for those nutritious vending machine options. In an attempt to avoid the vending machines I usually cut up a bunch of fruit and other snacks at the beginning of the week. Dividing them into separate portions makes it easy for me to “grab and go” before a shift. I try and bring things that are quick to eat, provide enough calories to keep me going, and don’t weigh me down. That said, if you’re as lucky as I am, your co-residents will often come to your rescue anyway.

How do you ensure you are mentally in check?

Balance and perspective.

Maintaining the balance between my residency and personal life is crucial. I find that if I have major stressors in one aspect of my life the other areas are affected no matter how hard I try. This was highlighted for me over the last 6 months when one of my close family members was ill. This experience taught me that sometimes I need to ask for support to maintain my balance. Talking things out with others is one of the ways I am able to organize my thoughts when I feel overwhelmed.

The other thing I gained from dealing with an ill family member was perspective. Sometimes the days are long and things do not always go right. But we work in an environment that constantly provides perspective. It is difficult, but if I can put my thoughts into a “big picture” that includes the challenges that others are going through I realize that things are not as bad for me as they may have seemed.

What are the biggest challenges you face in maintaining a longstanding career in EM? How do you address these challenges?

I haven’t figured these ones out yet… I’m still working on the night shift.

Best advice you have received for maintaining health?

I learned this one from my Dad: Constantly ask yourself if you’re happy. And if you’re not, figure out what’s making you unhappy and start changing it.

Like I said before, life is short, so I try not to be too hard on myself. I can eat right, study hard, and work out regularly, but if I’m not happy with where I are at, none of those things are going to change the way I feel, and that is not good for my health.

Who would you love for us to track down to answer these questions?

Nadim Lalani
Melody Ong
Mark Taylor

1.
Wiskar K. Physician health: A review of lifestyle behaviors and preventive health care among physicians. BCMJ. 2012;54(8):419-423. http://www.bcmj.org/mds-be/physician-health-review-lifestyle-behaviors-and-preventive-health-care-among-physicians.
2.
Kuhn G. Circadian rhythm, shift work, and emergency medicine. Ann Emerg Med. 2001;37(1):88-98. [PubMed]
3.
Berg S. Snowball Sampling-I. Encyclopedia of Statistical Sciences. August 2006. doi: 10.1002/0471667196.ess2478.pub2
Zafrina Poonja, MD

Zafrina Poonja, MD

Editor, How I Stay Healthy in EM series
Emergency Medicine Resident
University of Alberta
Zafrina Poonja, MD

@zafrinapoonja

Emergency Medicine Resident. Assistant Editor @ALiEMteam. Lover of travel, soccer, and boat shoes.