{"id":2231,"date":"2017-03-20T11:15:15","date_gmt":"2017-03-20T15:15:15","guid":{"rendered":"http:\/\/blogs.nejm.org\/general-medicine\/?p=2231"},"modified":"2017-03-20T11:15:15","modified_gmt":"2017-03-20T15:15:15","slug":"resident-wellness-in-graduate-medical-education","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2017\/03\/resident-wellness-in-graduate-medical-education\/","title":{"rendered":"Resident Wellness in Graduate Medical Education"},"content":{"rendered":"
\"Kashif<\/a>

Kashif Shaikh, MD, is the 2016-17 Chief Resident in Internal Medicine at the University of Central Florida College of Medicine.<\/p><\/div>\n

Happy Endings:<\/h5>\n

Living in Orlando, one cannot escape Disney. Disney movies are\u00a0a delight,\u00a0because one\u00a0subconsciously anticipates that the happy ending is going to make up for the rest of the characters’ struggles. It works for me!<\/p>\n

Be it Simba, Cinderella, Snow White, Belle,\u00a0or\u00a0 Elsa, every Disney fairy tale gives us the desired ending of a happy and prosperous life. These characters\u00a0go through many adversities,\u00a0and new pages turn in their stories, but there is always a ray of light at the end of the tunnel.<\/p>\n

\"Simba<\/a>

By Loadmaster (David R. Tribble) (CC BY-SA 3.0 via Wikimedia Commons)<\/p><\/div>\n

So, without a predestined Disney ending, how do people in healthcare professions cope with the daily stress? For me, music and movies allow me to recover and recuperate.\u00a0For others, the escape might be sports, arts, travel, music, family or social time, or something else that provides social support. Life is full of challenges and surprises, but it\u00a0would be absolutely boring without any challenges, right?<\/p>\n

The beginning of the story:<\/h5>\n

The first and the last day of medical school are unforgettable experiences for most of us. We are anxious, nervous, and terrified on day one,\u00a0because we don’t\u00a0know what the future will bring. But that last day makes up for it \u2014\u00a0we look back and smile \u2014\u00a0we have made it and can embark on our next adventure (residency).<\/p>\n

As they say, success is not a destination. It is the direction in which one is traveling. First, let me describe my own situation: During the first month of my internship, I went through a big learning curve, like most of us do. (Just for context, I\u00a0was in the last batch of interns who were allowed to\u00a0work 24 hours shifts. When I became a second-year resident,\u00a0the ACGME decreased the maximum work hours to 16 for the interns.) Long hours are stressful, even under the best of circumstances.<\/p>\n

\"graduation<\/a>

By Joe Hall [CC BY 2.0], via Wikimedia Commons<\/p><\/div>I have supportive family and friends, and I found a little group where I could share my problems and support others — bottling up frustration does not help! My colleagues gave me perspective on handling stressful situations or scenarios. As I advanced, my friends were one of the reasons that I looked forward to going to work every day.\u00a0My biggest support groups during residency were my patients (who made me feel tremendously happy and fulfilled, because I was taking care of them), my colleagues, and my wonderful medical students.<\/p>\n

\"doctors<\/a>

[CC BY 4.0 ], via Wikimedia Commons<\/p><\/div>Healthcare is, no doubt, one of the most stressful professions. It requires utmost dedication. As residents, we make sacrifices in our social lives, like missing holidays with our families and our best friends\u2019 birthdays and weddings. (Not to mention the obligation to work on presentations and\u00a0research projects and to study for ITE exams and boards.) Residents must apply for fellowships and jobs after graduation. All of this happens at such a fast pace that we barely keep our heads above water. So how does one find a balance when one works so much and socializes so little?<\/p>\n

Achieving Resident wellness:<\/h5>\n

Most medical graduate programs struggle with promoting resident wellness.\u00a0In a 2016 systematic review by KS Raj, resident well-being was lower than that in the general population (J Grad Med Educ 2016; 8:674<\/a>). Notably, PGY1s reported less satisfaction with their lifestyle than did PGY2s and PGY3s. However, the reviewer also noted that resident autonomy, competence, and social relatedness was associated with greater resident well-being:<\/p>\n