It's Up to You, Will You Thrive or Just Survive Your Residency?

Home / Campus / ( Published on 2015-06-30 )

By Michelle Sokoloff, PsyD
Faculty and Staff Assistance Program

Becoming a skilled physician involves assuming and mastering many professional responsibilities for the proper care of patients, while at the same time taking on and handling many personal obligations. Facing these challenges and developmental tasks can appear daunting and stressful, but it does not have to entail suffering. In order to master these unavoidable challenges, it’s paramount to prepare for the stresses that can be expected in residency, and to learn effective methods for responding to stressful situations.

During residency there are many things you are going to feel you are not doing enough of, such as reading more, performing more procedures, networking with peers, pursuing other professional goals, etc., all of which may threaten your sense of balance and well-being. Residency has stressors that impact this balance, which can produce sleep disturbances, eating problems, depression, anxiety, anger, etc. It’s also important to learn how to balance your obligations while listening to what your body is telling you. For example, the run through the park you used to enjoy is no longer possible in your busy schedule because other demands are of higher priority. In residency your own sense of well-being often is not cared for to the same degree as your patients’ health is further off-setting your balance to where you feel fatigued, stressed out, irritable, and anxious. These symptoms, if not attended to, can lead to more serious effects such as burnout and major depression. Burnout is a syndrome that causes emotional exhaustion, leading to a decreased sense of enjoyment and effectiveness at work. Depression is a disorder that leads to apathy, disturbed sleep patterns, poor concentration, and low self-esteem. To keep this from occurring it is important to not only remember to do things that enhance your sense of well-being, but also to develop a plan for yourself incorporating ways to manage stress, burnout, and depression. Prioritizing your goals will allow you to be more effective doctors, better partners, and bring you a sense of overall happiness.

The Resident Service Committee of the Association of Program Directors in Internal Medicine (APDIM) divides common stressors of residency into three broad categories: 

  • Situational stressors can include excessive work-load, sleep deprivation, insufficient support from staff, difficult patients, etc.
  • Personal stressors include marital or partner concerns, financial problems, lack of support from family and friends, limited free time, and inadequate coping skills.
  • Professional stressors include responsibility for patient care, career planning, supervising, building professional relationships etc.

It is important to identify the types of stressors you are encountering during your residency training. Being prepared for these unavoidable stressors will enhance your overall wellness during your residency training. Furthermore, it is important to carve out time for yourself and to do things that make you enhance your well-being. Identifying your particular set of stressors, along with making time for self-care can produce beneficial effects such as learning how to tolerate ambiguity, emotional resiliency, a sense of professional fulfillment even while still in training, better relationships with peers and friends, greater self-assurance, and a set of skills that are applicable for life.

Suggestions taken from the literature to maximize wellness during residency training:

  • Everyone has their own style for dealing with stress, so don't compare yourself to others.
  • Include one of your hobbies or recreational activities among your priorities. Going on a run, listen to music, catching a movie.
  • Get plenty of rest and exercise.
  • Be mindful of your intake of alcohol or food. Some people increase their food and alcohol intake during times of stress, hoping to relieve the intensity of emotions (anger, boredom, anxiety, sadness, and loneliness). But you will always pay a bigger price for these behaviors in the end.
  • Do not be surprised if your stress reactions are stronger today than they were last week—it may be part of an unanticipated delayed reaction, which is normal.
  • Set reasonable goals and expectations for yourself.
  • Notice and be grateful for your accomplishments during your residency.
  • If you feel overwhelmed by your emotions, ask someone you know for help or contact the Faculty and Staff Assistance Program (FSAP) for a range of support.

At times, we all need to confide in someone and be honest with our feelings. This can be done through confiding in friends, clergy members, colleagues, etc. It is important to take advantage of the resources that are available for you at UCSF, and FSAP is here to support you throughout your training, especially if you find yourself in a position where your stress level exceeds your ability to cope unaided. FSAP services are free and confidential. For more information or to set up an appointment, contact us at 415/476-8279 or visit the FSAP website.