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Trainee-Authored Letters to the Editor

Avoiding Resident Burnout: Moments Throughout the Day

Orlovich, Daniel S. MD, PharmD

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doi: 10.1097/ACM.0000000000003259
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To the Editor:

Resident burnout is an epidemic. This letter shares the first time I realized the power and ingenuity that I possess to outmaneuver burnout. A point at which my initial assumption that “trainees don’t have a choice” proved to be wrong.

Sitting in the men’s locker room, I flick my black clogs off and place my feet on the cool linoleum floor. I tap my finger on the wooden bench, where I sit alone. Something has to change. This isn’t sustainable. I’m not burned out. But I acknowledge how the training environment could gradually overcome anyone. I don’t want to go down that path. I find deep meaning in what I am privileged to do.

I realize that the training system will not change tomorrow. It is complex and not agile. I ask myself, “Daniel, what can you do today within your control?”

I start simple.

I want to drink more water throughout the day. I buy a water bottle. I drink from it before walking into the hospital, around midday, and again as I am leaving. When I sign out after a 24-hour shift, my lips are less chapped, my calves are less achy, and the pounding in my head has vanished.

I want to move more throughout the day. I park farther away, ensuring I add, effortlessly, another 26 minutes of walking. To boost my step count, I choose the stairs instead of the elevator. After a few weeks, my face is slimmer, and I pull the strings on my soft turquoise scrubs tighter.

I prefer dedicated time to study throughout the day. On the drive in, I listen to an educational podcast about a particular disease. As I walk in, I complete 5 study questions on my phone. Later, when I see a patient with the same disease, I am more certain of the diagnosis as I can almost hear the host’s voice and see how it would be worded in a multiple-choice test question.

The system is the primary driver of resident burnout—burnout is not a personal failing. There are many valuable concerted efforts to address and improve the system. My focus, however, isn’t on the system. It is on what is within my control and what I can change today. These tiny actions may not change everything, but they are a place to start. They ignite larger initiatives, unlock new perspectives, and power me through the day. And as a trainee, in these moments throughout the day, I exercise my autonomy.

And this is transformative.

Daniel S. Orlovich, MD, PharmD
Fourth-year resident, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California; [email protected]; Twitter: @SolvngResBrnout.

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