{"id":2540,"date":"2019-01-05T11:46:03","date_gmt":"2019-01-05T16:46:03","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2540"},"modified":"2019-01-03T13:46:54","modified_gmt":"2019-01-03T18:46:54","slug":"i-call-bs-on-work-life-balance","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2019\/01\/i-call-bs-on-work-life-balance\/","title":{"rendered":"I Call BS on Work\u2013Life Balance"},"content":{"rendered":"
\"Ellen<\/a>

Ellen Poulose Redger, MD, is a Chief Resident at Stony Brook University Hospital in Stony Brook, NY<\/p><\/div>\n

Physician wellbeing, burnout, and \u201cwork-life balance\u201d are pretty common topics in training.\u00a0 We start at intern orientation,\u00a0discussing how to work 80 hours a week, eat, sleep, exercise, and still have some semblance of a social life.\u00a0 It\u2019s like we\u2019ve forgotten the origins of our job title: \u201cresident\u201d or \u201chouse staff\u201d \u2014 implying that, until recently (and even now, in places outside of North America), we, the physicians-in-training, lived at the hospital.\u00a0 And that sometimes (often times), we still spend more time at the hospital or clinic than we do anywhere else in a week.\u00a0 There are 168 hours in a week, and just under half of them are considered reasonable for us to work.\u00a0 That\u2019s double a \u201cnormal\u201d full-time job (40 hours\/week).\"\"<\/a><\/p>\n

I\u2019m definitely not saying that medical training, should be shorter or encompass fewer hours.\u00a0 If anything, sometimes it feels like it should be longer (or maybe that\u2019s just the slight fear of my first \u201cattending\u201d shifts coming up \u2014 because now it really is my call<\/em> on things).\u00a0We have huge responsibilities, and that responsibility\u00a0requires intensive training.\u00a0 In all honesty, another key component of medical training is the lesson that we are all life-long learners \u2014 that our education cannot and does not stop simply because we graduate, get an attending job, and go into practice.\u00a0 There it is again \u2014 a word that, if we look at it, reveals the origins of medicine.\u00a0 We practice.\u00a0 We try things, we learn new things, we keep working at getting better.\u00a0 This is not to say that the first patients I see on my own will be poorly taken care of, but just that (as with many professions) we all get better at our jobs over time.\u00a0 We hone that sixth sense, trust our guts a little more, get better at pattern recognition, and know when to call other experts to help us and our patients.\u00a0 We keep practicing, trying to make perfect.<\/p>\n

That search for perfection is inherent to many physicians.\u00a0 As a group, we are type A, driven, competitive people.\u00a0 It is one of the things that allows us to give nearly a decade of our lives to school and training to do our jobs \u2014\u00a0prime years,\u00a0usually in our 20s and 30s.\u00a0 Those same years, though, are the ones when other people are starting\u00a0careers, developing hobbies and interests, buying first homes,\u00a0and starting a family.\u00a0 When we do go looking for our first jobs (as residents, fellows, and first-time attendings), we are expected to be ambitious, well-rounded, compassionate, and well-developed people, not automatons.\u00a0 So, during our medical training, we have to fit a life into the 88 hours per week when we are not at work.<\/p>\n

This brings me back to the idea of balance.\u00a0 I take issue with the phrase \u201cwork\u2013life balance.\u201d\u00a0 When I picture\"balance<\/a> a balance, I picture something where the two sides offset each other, like old-fashioned scales.\u00a0 With this picture in mind, then, work\u2013life balance would mean that the two sides are equal.\u00a0 In my 88 hours of \u201cpersonal\u201d time each week during residency, I drive to and from work (round trip totaling at least 1 hour each day), sleep (hopefully at least 7 hours each day), shower\/get ready for the day (and, since I\u2019m a girl, that realistically takes an hour each day), and cook\/eat\/do laundry\/clean my apartment\/see my husband.\u00a0 That doesn\u2019t really leave a lot of time for any sort of a life, hobbies, research, or anything else that would help me to be a thriving and well-rounded person.\u00a0 Something always gives when people are busy (regardless of their field), and it is usually their personal lives.\u00a0 \"\"<\/a><\/p>\n

I don\u2019t necessarily have a way to fix this: We need long and intensive medical training to be good at our jobs.\u00a0 We need to find time to sleep and take care of ourselves so that we can first do no harm<\/em> (to ourselves).\u00a0 I just don\u2019t think it is fair to say we are striving for balance, because we aren\u2019t.\u00a0 We are striving for survival, until the next step in our careers,\u00a0when we might get more time for ourselves.\u00a0 We are putting off relationships, families, houses, retirement funds,\u00a0and many other things\u00a0while we train.\u00a0 Maybe one way to help with this is to develop robust programs at every institution to help trainees (and honestly, all physicians) accomplish some of these life tasks (e.g., laundry, food, cleaning services).\u00a0 But I think one (free) thing that would to help with this is to just stop calling it \u201cwork\u2013life balance\u201d and admit that it will always be unequal and weighted toward work while we are in training, and perhaps for a large part of our careers.\u00a0 One of my husband\u2019s attendings once told him that you can have two out of three: family, fame, or fortune \u2014 but not all three.\u00a0 Something will always give in medicine.\u00a0 It\u2019s just easier to accept that we’re giving up something if we don’t\u00a0pretend we can have it all.<\/p>\n

\"NEJM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Physician wellbeing, burnout, and \u201cwork-life balance\u201d are pretty common topics in training.\u00a0 We start at intern orientation,\u00a0discussing how to work 80 hours a week, eat, sleep, exercise, and still have some semblance of a social life.\u00a0 It\u2019s like we\u2019ve forgotten the origins of our job title: \u201cresident\u201d or \u201chouse staff\u201d \u2014 implying that, until recently […]<\/p>\n","protected":false},"author":1296,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[72,33,34,37],"class_list":["post-2540","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-medical-education","tag-reflections","tag-residency","tag-resident-experience"],"yoast_head":"\nI Call BS on Work\u2013Life Balance - Insights on Residency Training<\/title>\n<meta name=\"description\" content=\"Dr. Poulose Redger doesn\u2019t think it is fair to say that residents are striving for balance, because they aren\u2019t. 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They are striving for survival.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2019\/01\/i-call-bs-on-work-life-balance\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2019-01-05T16:46:03+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2019-01-03T18:46:54+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/07\/AU000_epouloseredger.jpg\" \/>\n<meta name=\"author\" content=\"Ellen Poulose-Redger, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Ellen Poulose-Redger, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2019\/01\/i-call-bs-on-work-life-balance\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2019\/01\/i-call-bs-on-work-life-balance\/\",\"name\":\"I Call BS on Work\u2013Life Balance - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2019-01-05T16:46:03+00:00\",\"dateModified\":\"2019-01-03T18:46:54+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/9582a49f225d70a7043e5aad25bfd855\"},\"description\":\"Dr. Poulose Redger doesn\u2019t think it is fair to say that residents are striving for balance, because they aren\u2019t. 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