When most people think about the grief endured by physicians in training, they often think of the emotionally taxing nature of patient care — sudden illness, rapid decline, untimely death, unforgettable errors and irrepressible uncertainty. Beyond the inevitable patient tragedies physicians-in-training encounter, there are many more often-ignored issues that affect medical providers' psyche.
In an article recently published in JAMA, Jennifer A. Best, MD, who works in the Office of Graduate Medical Education at the University of Washington School of Medicine in Seattle, describes the numerous other factors that culminate in emotional fatigue, burnout and depression among young physicians.
"We enter the field of medicine steeled to the fact that some of our patients will die," wrote Dr. Best. "However, many of us may be less prepared for the reality that parts of ourselves will also die in the process. Although we may not recognize these sacrificial 'deaths' as such in the moment, these losses are deeply visceral and their effects additive."
Here are nine commonly experienced but often unaddressed factors of physician fatigue and burnout, according to Dr. Best.
1. Forming close-knit clinical teams that split up each month without formal acknowledgement or proper goodbyes.
2. Being asked by family and friends to provide medical advice for an ill relative, leaving no opportunity for personal sadness and dealing with the intense anxiety of "imposter syndrome."
3. Difficulty dating and having enough time to spend with a significant other.
4. Trying to get pregnant but being assigned to a week on night rotation while ovulating.
5. Absence from important, "unrepeatable" events, such as weddings, funerals, birthdays and holidays.
6. Dealing with situations at the bedside that challenge one's core ethical, moral and spiritual framework.
7. Strained friendships as a result of years of sustained unavailability and often geographic distance due to taking residencies in other states.
8. The sad recognition that one may have given up his or her favorite pastimes.
9. Physical deterioration as a result of sleep disturbance, rushed meals and little exercise or health maintenance.
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