To the Editor:
As a first-year medical student returning to school after several years in the workforce, I often think about the meaning of “work–life balance” in medical school. Exploring burnout among resident physicians, McKenna et al1 recently argued that the new resident work hours restrictions, which center on this notion of “work–life balance,” may paradoxically contribute to burnout by framing “work” and “life” as mutually exclusive—as work versus life. The emphasis on “work–life balance” and its resulting shift work, the authors argue, means that “residents are encouraged to get out of the hospital so they can finally enjoy life, rather than actively seeking joy and fulfillment while at work.”1 I wonder if a similar phenomenon is occurring in undergraduate medical education.
In college, it never occurred to me to think about my daily activities as either “work” or “life,” or to count hours in an attempt to equalize time spent studying versus other activities. Yet as a medical student, I often catch myself internally narrating my daily activities in terms of work versus life—for instance, thinking while walking home from the library, Well, there goes another 16-hour workday; so much for having a life.
I do not know whether this thought process results from returning to school after being in the workforce or from the “work–life balance” conversation currently permeating medical education. I do know that this hour-counting frame of mind makes me less happy with my identity as a medical student. In contrast, when I deliberately think about medical school as part of my life, rather than as something that steals hours away from me, I feel energized and happy with my career decision.
Of course, it is not quite that simple; we medical students do need substantial time away from our studies, just as residents need time away from clinic. Reframing the “work–life” issue with a better phrase will not fix the underlying human need for recuperation. Yet at the same time, this “work–life” framing is about more than semantics. The words we use to frame our lives affect how we think about our lives, which then influences our productivity and happiness. Re-framing the “work–life balance” issue is not sufficient for solving the medical education burnout problem, but it is a necessary component.
Hanna M. Saltzman
First-year student, University of Michigan Medical School, Ann Arbor, Michigan; [email protected]
1. McKenna KM, Hashimoto DA, Maguire MS, Bynum WE. The missing link: Connection is the key to resilience in medical education. Acad Med. 2016;91:11971199.