A Burnout Story and What You Can Do to Avoid It

Session 243

Today, we’re talking about burnout, which is something very personal and very important in the medical world and the premed world. Allison joins us to talk about her experience with burnout during residency, and we talk about how you can cope during your own stressful times along the path to becoming a physician.

I’ve talked to a burnout expert before back on Episode 47, and we went through some free dance exercises and some other things. But I wanted to talk about burnout from a personal standpoint, too. So I’m having Allison on the show to talk about her experience, what we learned going through that together, and then how you can deal with whatever you may be going through.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[02:02] A Personal Experience: Burnout in Residency

Allison was going through a neurology residency—which wasn’t very easy—at Massachusetts General Hospital, a big, academic medical center. Even though we were married, at that time we were living apart. She was working 80 hours a week.

She had to do her one-year internship, and then the following year was her first year of neurosurgery residency. Allison was on call every fourth night for about 32 hours. She describes it as a crazy and very intense experience with very sick people.

Days off would be spent on sleeping, eating, and not much “me time,” which is apparently important. She realized something wasn’t right once she noticed she had trouble concentrating. It was very disturbing for her. She always had to rely on her brain, and she felt like she couldn’t rely on it anymore. For example, she would be at work and she’d have trouble getting her work done. It wasn’t bad enough that it was apparent to everybody else, but she felt like she was moving like a tortoise.

I just didn't feel like myself. I felt like I couldn't recognize myself in the mirror. I was really down, super down, depressed.Click To Tweet

Not Having Any Work-Life Balance

This happened during her first year of neurology residency, which was her second year of residency as a whole. Allison says her first year of neurology was 100 times busier than internship. It was month 7 and she just felt like it was starting to eat at her. She was just tired.

Allison was living in cold Boston, and she was practically working all the time. She had no work-life balance. She was back living with her parents after she recently got married, and she found it very hard. I was back in the Air Force and busy doing my own stuff, too.

[07:05] Not Having Anyone to Talk To

Allison and I would get on the phone, and Allison would just say she was fine because she didn’t want to burden me. Her friends in residency were all going through the same thing, and her friends outside medicine couldn’t relate to what she was going through. So she felt there was nobody she could talk to about it.

The residency program talked about burnout, but it was also a well-known fact that the first year of neurology residency was brutal. There was a light at the end of the tunnel, and you just had to get there because the second and third years were much more manageable.

As a physician, you're very focused on taking care of other people, sometimes to the detriment of your own health.Click To Tweet

Allison didn’t know what was happening except that she felt bad. She didn’t have time to sit around and feel sorry for herself. She was dealing with trying to take care of really sick people and didn’t have time to focus on herself.

[Related episode: How Can I Relax and Destress for the MCAT?]

[10:02] Premed Burnout and How to Avoid It

As a premed, you may not be taking care of patients, but you’re studying organic chemistry, physics, biology, chemistry, biochem, and MCAT prep. It’s kind of the same as you’re trying to power through that. You’re sacrificing sleep, exercise, and eating right. So students go through this as well, not just physicians. There’s also the possibility of rejection, and that’s very stressful for many premeds.

You can try “decreasing the dose.” It means decreasing the amount of work. Although you can’t always do this overall, you can structure your breaks so that you don’t hit a wall and feel like you have to push through that wall and then hit another wall. So it’s like breaking the cycle. You take smaller doses to do the same overall amount of work.

Exercise is another important thing. When she got burned out in residency, Allison wasn’t doing any of it other than running around the hospital. Sleep is also huge. When people get nervous, stressed, and burned out, they don’t sleep well, and that’s terrible for your brain. Not sleeping won’t help you in terms of studying or learning, and it makes you feel more depressed.

Depression feeds on itself, so it's hard to convince yourself that things can be okay when you're feeling really depressed.Click To Tweet

Another important piece is talking to somebody. Sometimes that may not be your friends or family but a professional who can help you through it with different strategies.

[13:14] Breaking the Stigma Around Burnout

Acknowledging burnout is the first step. Burnout, as rampant as it is, is almost stigmatized. Nobody really wants to have a medical student or a physician hanging around a resident who’s burned out, since you have to be able to function and do your job.

So, as much as we say “it’s common,” if you start advertising that you’re really burned out, it’s not a welcomed discussion for a lot of people. We need to break this stigma. If you feel you can’t get the help you need or you’re embarrassed, don’t let that get in the way of you getting help.

We need to break the stigma around burnout in medicine.Click To Tweet

[Related episode: Another Student Fights Mental Illness Stigma.]

[14:20] The Constant Need to Do More

As a premed, there’s this constant need for doing more and getting great grades, doing the extracurriculars, clinical experience, shadowing, and whatever else you need to do to get into medical school.

In residency, there was always a lot to do, too, and you’re also expected to be reading, which you won’t have time to do when you’re working 80-plus hours a week. You’ll just want to sleep with your time off.

If you're really going through burnout, take a couple of days off. Click To Tweet

If you’re really going through burnout, take a couple of days off. If you’re a premed, give yourself some respite. Take two to three days off, or a whole week if that’s possible for you. Give yourself a breath of fresh air.

[16:05] Decreasing the Dose

As a premed, you can “decrease your dose” by dropping a class or taking a semester off or a year off. This is okay. I would rather see a premed who’s on the verge of burnout take a semester off than to see a full semester of C’s and D’s because they were burnt out and couldn’t handle it. If you’re in that spot, take the time off. Volunteer, go work with a hospice, or get a scribe job. Do something out of academia for a little bit to recuperate and fix yourself.

I would rather see a premed who's on the verge of burnout take a semester off than to see a full semester of C's and D's because they were burnt out and couldn't handle it.Click To Tweet

Also, as a premed, getting that time with patients reminds you of why you’re doing this in the first place. This can help you feel refreshed. If you’re feeling burned out, you’re not alone. It’s a huge problem for physicians and if you’re dealing with it as a premed, it doesn’t mean you’re a weakling.

It’s something to practice dealing with early on. Prevent yourself from falling down the rabbit hole. Learn the skills now, so when you get to be a physician you’re able to better manage it. Neurology has some of the highest rates of burnout and job dissatisfaction. As a physician, Allison had a recent burst of burnout, and she had to do all these things—decrease the dose, get help, talk to me, lean on friends and family.

The demands in medicine just grow more and more all the time, and that’s not going to change. You need to figure out how you can protect yourself and take care of your own self.

[19:45] Final Thoughts

If you’re feeling signs and symptoms of burnout, if you’re not happy with what you’re doing, it’s okay to take a break. Make sure you’re eating right. Make sure you’re exercising. Exercise has been shown over and over again to be a cure for everything.

Get sleep. Go talk to somebody if you need to. Stress can lead to autoimmune problems, so protect your physical health. Take care of your mental and emotional health.

Exercise has been shown over and over again to be a cure for everything.Click To Tweet