Residency Should Be Limited to 40 hours Per Week

Residency should be set to a maximum of 40 hours per week.  The idea that a person can be productive, efficient, and offer their "best" selves for 80-100 hours per week is false.  By allowing a normal schedule for doctors in training, this will allow for balance in their lives and ultimately better care for patients. 

Residents will be happier and nicer to patients. The majority of residents who are apathetic, short with staff and patients, and visibly burnt out are in specialities where they work more hours per week.  One of the greatest gifts an MD can give to patients is truly listening and understanding their patients.  When you've only slept for 3 hours last night, this is impossible. 

"But we did it, so you have to do it too." I understand that before residency work hours were set to 80 per week, prior MDs' routinely worked 100-120 hours.  But times have changed.  We are busier than they were 20-30 years ago.  Before they probably got more sleep and had less patients in the hospital.  The number of patients seen in ED and hospitals has increased each year.  More hospitals are shutting down and the hospitals that are open continue to see more patients. 

"We won't get enough training."  During residency, I noted there was a lot of downtime and a lot of "non-clinical" activity.  For example, waiting for attendings in clinic to present, hunting down an old CT report that was done at an outside hospital, or faxing paperwork.  Residents spend time doing miscellaneous activities, not relevant to their clinical skills. Residency should be like an espresso of information. The rest should be delegated or deleted.

Less depression, anxiety, and alcohol/drug abuse.  Every year, 300-400 doctors commit suicide. That's almost an entire medical school.  I believe that one of the contributors to this is being overworked and burnout.  Since residency and medical school sets the foundation for our clinical careers, we need to get the right habits from the start. 

Doctors are human and need balance.  The way we treat and respect our residents will be the way they treat and respect their patients.  And sooner or later, we will all be patients.

6 Tips to Get Inspired for Burnt Out MDs

So, how can you get inspired if you're burnt and crispy?

1. Change your job. Go academic if you're a community doc or vice versa.  Work locums tenens in Australia or New Zealand.

2. Take some time off to recharge. Relax in your favorite country. Maybe someplace where you're currency will stretch much further.

3. Add to your expertise. EMS, U/S, Critical care, or whatever niche you choose

4. Be the change at work.  Try to associate with positive people and avoid negative people.

5. Remember your purpose in being a doctor.  Dig out the files and re-read your medical school application essay, residency program essay, and even college essay.

6. Consider a life coach. Three MD life coaches to check out are: Dr. Heather Fork, Dr. Philippa Kennealy, and Dr. Michelle Mudge-Riley.

5 Stages of Physician Burnout

I was reading Dr. Graham Walker's article, Operation Burnout. It made me ponder, why do nearly 70% of emergency physicians feel burnt out?  Even more concerning, ER docs also have the highest burnout rate of ALL specialties.

Burnout is contagious. It's like MRSA and should be called a "staff infection" because it has a tendency to spread.

Ruptured MRSA abscess (via Wikimedia)

Haven't you noticed that when negative people are around you, it has a tendency to bring your energy down as well?

Jerry Edelwich, author of Burnout, writes that there are 5 stages of burnout:

1. Enthusiasm - When you first start the new position, you are super excited and everything is fresh.

2. Stagnation - Things become routine and everything becomes boring.

3. Frustration - By now, the new car smell has worn off and you see the imperfections. The frustration builds at work.

4. Apathy - It feels like you have no power to change anything, and you decide to go with the flow. The longer you stay in this stage, the harder it is to get out.

5. Inspiration - If you're able to get out of apathy, then you realize you can change or change your environment.

Have the courage to be happy and inspired.