To the Editor:
My education in medicine and science was arduous but enjoyable. I had a fair amount of free time, I loved the learning, and the limited amount of meaningful responsibility was at least subconsciously comforting. Now that I am in a surgical residency, the demands on my time are greater, and knowing the potential consequences of my actions is simultaneously exhilarating and sobering. It is this realization that frequently tempts me to have a singular focus on my work, but this can come at the expense of a well-balanced lifestyle. Is this healthy for me? Is it fair for my wife and baby at home? Is it good for my patients?
In his recent editorial, Dr. Sklar1 discusses how we, as medical students, residents, and practicing physicians, have the tendency to ignore the need to care for ourselves. I frequently hear resident colleagues lament how long it has been since they last had time to exercise. Sleep deprivation has known negative side effects on performance and mental health,2,3 but avoiding it can be a challenge. Alcohol abuse can become an issue, and the data concerning its prevalence among medical trainees are not surprising.4 Those in the medical community often have great intentions, but this is accompanied by a propensity to become burned out.
I applaud the active discussion surrounding wellness, as well as the active role that residency programs are taking to promote it.5 This should be the norm as opposed to the exception. Camaraderie is a crucial element of wellness, and the culture of a program and an institution is paramount to creating a milieu where faculty, residents, students, and ancillary staff have collegial relationships. Importantly, patients are at the center of most of what we do, and it is helpful to remind ourselves of the impact we are having on them each day.
Though periods of discouragement, anxiety, and exhaustion are inevitable in medical training and practice, it is the perpetuation of these feelings that we must strive to avoid. I have found that in order to be “well” I need faith and family and exercise. Each of us must find the unique things that engender wellness in our lives. Our patients, colleagues, families, and friends, not to mention we as individuals, deserve nothing less.
Peter Mittwede, MD, PhD
Resident, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; [email protected]
1. Sklar DP. Fostering student, resident, and faculty wellness to produce healthy doctors and a healthy population. Acad Med. 2016;91:11851188.
2. Rosen IM, Gimotty PA, Shea JA, Bellini LM. Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy, and burnout among interns. Acad Med. 2006;81:8285.
3. Weinger MB, Ancoli-Israel S. Sleep deprivation and clinical performance. JAMA. 2002;287:955957.
4. Jackson ER, Shanafelt TD, Hasan O, Satele DV, Dyrbye LN. Burnout and alcohol abuse/dependence among U.S. medical students. Acad Med. 2016;91:12511256.
5. Eckleberry-Hunt J, Van Dyke A, Lick D, Tucciarone J. Changing the conversation from burnout to wellness: Physician well-being in residency training programs. J Grad Med Educ. 2009;1:225230.