Residents' Page - Alberta Doctors' Digest

Burnout: Is it happening to you?

July 14, 2017

Contributed by: Shannon M. Ruzycki, MD | PGY 4, General Internal Medicine; University of Calgary

Dear Colleague:

I hope you're doing well. No, really. I’m worried about you. Evidence consistently demonstrates that about half of resident physicians will suffer from some form of burnout during training.1,2 The main symptoms of burnout are emotional exhaustion, depersonalization and a reduced sense of accomplishment.2

Though not unique to medicine, physicians are much more likely to suffer from burnout than professionals in other high-stress careers such as law or business.2 In fact, higher education is generally protective against the development of mental illness – in every field except medicine.2 Physicians are more likely to suffer from depression and other types of mental illness than the general public. Though first-year medical students have similar depression and burnout scores to students entering other professional programs, by the beginning of residency training, these rates are much higher than those of other students in advanced degree programs.2 Burnout and depression peak during residency with rates nearing 60% and reach a low point of just under 50% of all practicing physicians.2 These numbers worry me.

Medical students and resident physicians are amazing individuals who are ambitious, goal-directed, intelligent and altruistic. We start medical school like most other students, but something happens the longer we are immersed in the culture of medicine – many of us develop emotional exhaustion and self-doubt that dramatically reduce our satisfaction from our work.

What can we do about burnout?

Evidence suggests that the most effective interventions to reduce burnout are at the systems level.3 Examples include scheduling changes, increased physician autonomy and “no-page” time periods at night for residents.3 We need to work with our colleagues and our training programs to make changes that enhance wellness. Fortunately, the University of Alberta and University of Calgary, along with the Professional Association of Resident Physicians of Alberta (PARA), recognize the stress of residency training, and they are actively working to help resident physicians recognize burnout and prioritize well-being.

But there is still much we can do as individuals. We need to support ourselves and one another. If you recognize burnout in yourself, please invest in yourself. Purchase some free time by hiring a cleaning person, having your groceries or meals delivered, or hiring someone to do any task that is not making your life better. Use your newfound free time to exercise. Find an activity you enjoy. Encourage your partner or best friend to attend with you. Force yourself to go. Avoid the reduced sense of accomplishment by celebrating your successes, no matter how insignificant they feel. Consider taking a flex day and seeing a movie or going for a hike. Consider a journal.

Look out for your colleagues and role model a culture where we prioritize our own wellness. Do not complain if a colleague takes vacation or a flex day during your rotation. Send a congratulations card to a colleague to celebrate accomplishments. Be kind. Do not berate. If you think a colleague is struggling, reach out.

PARA is actively working with our partners on resiliency training and wellness initiatives. We also provide presentations on fatigue management during academic half-days. PARA’s Community and Wellness Committee is a group of resident physicians from across the province that organizes activities to promote resident physician well-being as part of its mandate. From runs and bowling to hockey games and dinner theatre, PARA sponsors social and recreational events throughout the year, supporting resident physicians in spending time outside work with friends and family. In addition, one week each year is designated Resident Physician Wellness Week (RWW). This year it was held from May 14-20.

Each year, RWW provides opportunities for resident physicians to partake in well-being activities and serves as a reminder to staff and resident physicians of the importance of finding the right balance between our personal and professional lives. Less explicitly, it broaches the often swept-under-the-rug issues faced by resident physicians – stress, burnout, relationship strain, depression and anxiety, amongst others – and helps resident physicians recognize that they are not alone in these experiences and that support is available in addressing them.

You deserve to enjoy your life. If you are so far into burnout that you cannot imagine mustering the energy to re-invest in your well-being, please tell someone. You can contact the AMA Physician and Family Support Program toll-free at 1.877.767.4637 or visit the program online.

I am thinking about you. I hope you are doing well.

Sincerely,

A colleague

For more information on the annual Resident Physician Wellness Week, visit para-ab.ca/news-events/resident-physician-wellness-week/.  

References available upon request.

The Alberta Medical Association stands as an advocate for its physician members, providing leadership & support for their role in the provision of quality health care.