Dr. Ambrose Wong (@ambrosehwong) is a healthcare simulation educator and researcher, with a passion for teamwork and collaboration across professions and disciplines. He grew up in Vancouver, Canada and moved to the United States for medical school and residency, but now calls New England his home. He recently completed his simulation fellowship at NYU School of Medicine, and joined the brand new state-of-the-art Yale Center for Medical Simulation as a budding educational researcher. Wellness is especially important as a junior faculty member, and he’s excited to share his experiences. Here’s how he stays healthy in EM!
- Name: Ambrose Wong, MD
- Location: New Haven, CT
- Current job(s): Director of Simulation Research, Yale Center for Medical Simulation. Instructor of Emergency Medicine, Yale School of Medicine. Adjunct Assistant Professor of Emergency Medicine, NYU School of Medicine.
- One word that describes how you stay healthy: Mental breaks!
- Primary behavior/activity for destressing: I find that chatting openly and frankly about my work with my partner, Vince, and my friends/family keeps me level-headed and helps me process both the positive and the negative aspects of academic emergency medicine. I think it’s especially helpful if you can do it with those that are not in the healthcare field – they really help me keep things in perspective.
What are the top 3 ways you keep healthy?
- Family. Family has become more and more important for my physical and mental health as I’ve progressed along my career. My partner keeps me grounded and ensures that I stay balanced between my work and personal lives. My brother Francis is a great sounding board for big decisions that I have to make for my career. Interestingly, NPR just had a wonderful article reviewing the literature on siblings. Apparently the evidence supports the fact that a healthy, supportive relationship with adult brothers/sisters is key to a long, happy life.
- R&R. Shift work in academic medicine is sometimes a blessing in disguise. Although it allows your schedule to be flexible for meetings and academic responsibilities, it can also make it really tough to plan out your personal life or schedule large projects. When I’m not working, the line between “working from home” and actual free time is often questionable. One of my mentors, Adina Kalet, taught me to specifically schedule in time for R&R in my calendar. She also advised me to block off chunks of time for writing (and to block off more time than anticipated), a crucial part of academic promotion and career development. That way, I have a global view of the amount of actual time I have for family and relaxation versus time budgeted for answering work emails, writing, and work-related projects. During the time that I’ve designated for R&R, I spend 100% of my time, focused and guilt-free on my favorite hobbies.
- Sleep. Sleep is much needed, and unfortunately often neglected in our profession. ACEP has a great article on strategies for individuals to maximize rest based on evidence from circadian rhythms, including a split sleep strategy and using blackout curtains. A recent Hopkins study also stressed the importance of uninterrupted sleep on mood and cognitive performance. I found it interesting to see that a number of highly successful people sleep for at least 6-8 hours a night, although the Forbes article didn’t really talk about their study recruitment strategy. I personally feel much more productive and healthy when I’ve slept well, and I check my calendar daily to consider my schedule and budget in adequate sleep before the next day’s activities.
What’s your ideal workout?
I love long hikes up mountains, with a beautiful view at the top as my reward. Unfortunately, I didn’t have access to high elevations when I started medical school in the Midwest. So for the past decade or so, I’ve aimed for three, 30-45 minute visits to the gym/week, come rain or shine, post-overnight or not, to maintain a regular workout routine. Having a routine has helped me maintain my physical and mental health all through my medical training. At the gym, I have a set list of lifts for core, upper, and lower body.
Do you track your fitness? How?
I don’t have a wearable health monitor, but I have tried a friend’s Fitbit a couple months ago, and thought it was pretty neat. I can tell pretty quickly when I’m behind on my fitness. I usually struggle with concentrating or focusing on tasks. That’s when Vince becomes my voice of reason to get me back on track. I’m very grateful for a wonderful life partner.
How do you prepare for a night shift? How do you recover from one?
Night shifts are so difficult for maintaining personal health. I often envy my colleagues who either prefer to work nights or switch their sleep patterns so easily and effectively. Anecdotally, many of my friends and co-workers lament that night shifts get harder as we get older, and I have also felt the same myself. During residency, I used to stay up the night before my string of nights to “get ready”, but now I’ve mostly adopted the split sleep method where I get some shut-eye for a couple hours right before my first overnight, go home to sleep right away after the shift for another couple hours, and then wake up to do some work or spend time with my family during the day. Melatonin unfortunately doesn’t seem to work for me, but a lot of my friends swear by it.
How do you avoid getting “hangry” (angry due to hunger) on shift?
I remember as an intern getting light-headed, or irritated about 5-6 hours into a 12 hour shift, and quickly realizing that I haven’t gone to the bathroom, drank water, or eaten anything. On every shift now I make sure to check in with my residents to make sure they’ve had a brief break. I always pack a big “snack bag” with me on every shift, including plenty of water, some sort of granola bar, a main meal, and a Greek yogurt. As soon as I feel a moment of reprieve, I stop for a quick snack break while I check in with my residents and nurses. When I have time, I also bring a bag of snacks for my team as well. I strongly believe that wellness needs to come from top down, and it’s so important that we maintain situational awareness of our fellow team members’ well being with so much external pressures and stress on shift.
How do you ensure you are mentally in check?
I was perusing the responses from fellow EM physicians on the blog, and I really agree with arriving a little early to get mentally and physically ready. There are some shifts where I anticipate that it will likely be very busy, and will require 110% focus (Wednesdays after residency conference, Mondays, etc.). For those shifts, I arrive even earlier to get my coffee, make sure that I have easy access to my water and snacks, and look over the board in advance. Sometimes the ED is unexpectedly busy for unanticipated reasons, and giving myself a little breathing room before I start my shift helps me get in focus and ready to go. When I’m finishing up my shift and my colleague comes in prepped to take over and already aware of the sicker patients, it gives me such relief and gratitude. I think it’s a big win for everyone to budget in a little time before a shift to do this.
What are the biggest challenges you face in maintaining a longstanding career in EM? How do you address these challenges?
A recent article on Medpage re-cited the 2012 JAMA study that “front-line” physicians, including the field of emergency medicine, have the highest rate of burnout, which is probably not a surprise to any of us. The reasons for this are long and heavily debated, but I do strongly believe that an active academic interest outside of clinical medicine is the key to a long productive career. I was just discussing a qualitative study that was recently published in Academic Medicine investigating factors to career success for clinical researchers in academic medicine. The study found importance in both personal factors (work-life balance…my chair calls it “constant juggling”, networks, resilience) but also in organizational factors (mentorship, institutional support). I got great advice from many of my mentors when I was job-hunting. They advised that I pay close attention to not only to the salary and benefits, but also to the departmental culture and happiness of the faculty and administrators.
Best advice you have received for maintaining health?
My program director, Jeff Manko, advised me that my career decisions are not only my own, but are also my partner’s and my family’s decisions. I am very grateful for his advice because it has helped me in more than ways than I had anticipated.
Who would you love for us to track down to answer these questions?