Work Life Balancing © Can Stock Photo / Gajus“The hardest thing for me was trying to find time to do things aside from being a resident. When you’re working six 12 hours shifts in a week, there’s only so much time left in the day to do anything else. Especially in the winter, you wake up, you get to work before the sun comes up, you work a 12 hour shift, you leave, and the sun’s gone. By the time you get home, you have enough time to wash the grime off, shovel a sandwich in your mouth, and pass out. And there was nothing else except for that.”

– Anand Swaminathan, MD

Residents Work (A Lot)

Even with duty hour restrictions (flexible or otherwise1), residents still work long hours. Tally up 6 twelve-hour shifts, 6 hours of conference, 6 hours of sleep a night, and that leaves the typical EM resident both sleep-deprived and having only 49 hours of “life” in a week. Late charts, long commutes, showers, and mealtimes all eat into those 49 hours too, until sometimes it can feel like there’s no free time left at all. I’m sure more than one resident has considered re-wearing their clothing inside out, sleeping in the hospital, or living on non-perishable bulk quantities of box macaroni and cheese, just to scrap together a few more hours of free time.

Contrary to what you might expect, promoting work-life balance as a solution to burnout can actually backfire badly with the tight schedules typical of residency training. The basic problem lies in the fundamental assumption that life is good and work is bad, which is the main reason that doctors need to find work-life balance in the first place.2 In order to make up for all our time stuck at the hospital, it can sometimes feel like we need to do something amazing, like backpack across Asia, in order to compensate, when all we really want to do is crash on the couch after a shift with some corn chips. The fact that we can’t find the time to exercise 4 days a week, eat our vegetables, and meditate for an hour every day can make us feel like we’re somehow failing at achieving the mythical work-life balance and therefore can’t possibly have a shot at being happy and well.

Towards A Better Work-Life Integration

In reality, many of us will spend more time at work than with our friends, our partners, or in bed. Perhaps we need to restructure our thinking in a way that gives back the meaning to what we do whenever we step through the doors of the ambulance bay. We have the opportunity to save lives and change our patients forever. That’s an unbelievably worthwhile endeavor. We all have an intrinsic desire to create, to build, to leave our mark on the world, and to share our accomplishments and experiences with others. We can consider our time at work as just that. Not all wellness happens outside of the hospital walls. And on the flip side, sometimes it’s okay to just eat corn chips in our free time.

So what can you do? Think of residency as just another part of your already amazing life. Keep a list of things for which you’re grateful. Try staying mindful and grounded at work. Foster great relationships with your co-residents, nurses, consultants, and attendings.

Want an even better solution?

If you are an EM resident, join us on May 15th, 2017 at the 16th annual Essentials of Emergency Medicine (EEM) Course where residents from all over the country will be coming together for the first-ever Resident Wellness Consensus Summit (RWCS) in order to innovate real-world solutions to physician wellness issues just like this one. The Consensus Summit is jointly sponsored by EEM, Emergency Medicine Residents’ Association (EMRA), and ALiEM. If you are an EM resident, go to the EMRA website for discount details.

Featured podcast with Dr. Rob Orman and Dr. Anand Swaminathan

Listen to Dr. Rob Orman and Dr. Anand Swaminathan of EM:RAP podcast fame talk about feeling overwhelmed in residency, dealing with the expectations of others, and trying to find time to decompress with family, friends, video games, and bad television reruns.

What’s Coming Up in the Wellness Think Tank?

 

James Dahle, MD
January 16th at 7:30 pm EST

Our superstar line-up of Wellness Think Tank strategists (Dr. Jason Brooks [podcast], Dr. Scott Weingart [podcast], Dr. Zubin Damania a.k.a. ZDoggMD [video, podcast]) will next feature Dr. James Dahle, the acclaimed book and blog author of the White Coat Investor. Don’t forget that wellness also includes an intricate understanding about your finances during residency and beyond. Knowledge is power. Keep a lookout on Twitter (@ALiEMteam) for more details.

1.
Mirmehdi I, O’Neal C, Moon D, MacNew H, Senkowski C. The Interventional Arm of the Flexibility In Duty-Hour Requirements for Surgical Trainees Trial: First-Year Data Show Superior Quality In-Training Initiative Outcomes. J Surg Educ. 2016;73(6):e131-e135. [PubMed]
2.
Schwingshackl A. The fallacy of chasing after work-life balance. Front Pediatr. 2014;2:26. [PubMed]
Arlene Chung, MD

Arlene Chung, MD

Chief Strategy Officer,
2016-17 ALiEM Wellness Think Tank
Assistant Professor of Emergency Medicine
Assistant Program Director
Mount Sinai Emergency Medicine Residency
Editor, AKOSMED (EM wellness blog)