Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How do we best handle the health concerns of our residents?

Katie Fortenberry, PhD
Education
November 7, 2017
Share
Tweet
Share

A resident suffering from depression drinks too much and sleeps through a hospital shift the next morning. Another resident walks out of a patient room in the midst of a panic attack.

As family medicine educators, how do we best handle these health concerns in our residents?

The pendulum in medical training can swing in two directions. At one end, residents are indoctrinated into a macho mentality, where the need for self-care is a sign of stigmatized weakness that must be hidden. At the other end, where rejection of this mentality and fear of the physician suicide epidemic intersect, faculty may diagnose or treat their own residents in hopes of preventing bad outcomes.

Unfortunately, pain and suffering, both in residency and in life, are inevitable. We know that medical residents experience rates of depression at twice the population average; given high caseloads, sleep deprivation, and constantly changing schedules, this shouldn’t be a surprise.  Even among residents (and medical educators) who do not experience diagnosable depression or anxiety, difficulties in life are unavoidable. We will all face heartbreak, and we will all lose someone we love. We may experience life-changing car crashes, or be diagnosed with cancer. Life challenges are a certainty.

As medical educators, it should not be our job to diagnose, treat, or (as much as we would like to) prevent mental health concerns in our students and residents. However, it is our job to teach professionalism. And a critical component of professionalism is to accurately assess one’s own ability to meet work and personal responsibilities in the face of these life challenges.

A pragmatic approach may be the best way to teach professionalism in the face of life challenges. A panic attack during a clinical shift is, in many ways, no different than an unexpected bout of diarrhea – unpleasant and time consuming, with a strong potential to throw off the rest of one’s day. A matter-of-fact approach from an attending physician could involve reminding the resident of effective grounding techniques, then helping the resident evaluate their options. Should they find a replacement? Take 10 minutes to gather themselves and continue focusing on the patients? No overreacting on the part of the attending physician is needed, as the panic attack is just another professionalism hurdle to navigate.

We can coach residents that, when considering the challenges of maintaining professionalism in the context of severe life stress, they should always keep their goals and values in mind. Patient care must be a top goal.  Sometimes optimal patient care will involve treating the patient despite the resident’s own challenges; sometimes it will involve recognizing that the resident can’t do it. Self-care, and care of loved ones, must also be a top (and often competing) goal.  There should be no shame in taking the time that we need to care for ourselves and our families.

As medical educators, let’s try to view helping residents cope with mental health and life challenges as a critical teaching opportunity. We can help residents learn how to self-evaluate and determine how to best maintain self and patient care in the face of significant challenges. How terrible it is that residents must deal with these concerns at such an already difficult time of life, but how fortunate that they can do it in a supportive environment with caring educators walking them through the next steps.

Talking about how to cope with life challenges early in residency won’t prevent the challenges from coming, and may not even prevent depression or burnout. But we can help residents to embrace a proactive stance, where mental health concerns are embraced as just another of life challenges. And this may be one of the most important parts of professionalism that we can teach.

Katie Fortenberry is a psychologist and an assistant professor, division of family medicine, University of Utah School of Medicine, Salt Lake City, UT.  This article originally appeared in Family Medicine Vital Signs.

Image credit: Shutterstock.com

Prev

The painful side of positive health care marketing

November 7, 2017 Kevin 2
…
Next

#MeToo shows why women must learn sexual self-defense

November 7, 2017 Kevin 6
…

Tagged as: Psychiatry, Residency

Post navigation

< Previous Post
The painful side of positive health care marketing
Next Post >
#MeToo shows why women must learn sexual self-defense

ADVERTISEMENT

More by Katie Fortenberry, PhD

  • There’s no such thing as work-life balance

    Katie Fortenberry, PhD
  • Sleep deprived and exhausted? These tips will help.

    Katie Fortenberry, PhD
  • a desk with keyboard and ipad with the kevinmd logo

    Seeking help for mental health problems: Change the culture for providers

    Katie Fortenberry, PhD

Related Posts

  • Are negative news cycles and social media injurious to our health?

    Rabia Jalal, MD
  • How social media can help or hurt your health care career

    Health eCareers
  • Sharing mental health issues on social media

    Tarena Lofton
  • The new mental health education mandate doesn’t go far enough

    Brandon Jacobi
  • 3 ways to advance the credibility of online health information

    Robert Pearl, MD
  • Teaching residents to teach will improve medical education

    Kristin Puhl, MD

More in Education

  • How I learned to stop worrying and love AI

    Rajeev Dutta
  • Why medical student debt is killing primary care in America

    Alexander Camp
  • Why the pre-med path is pushing future doctors to the brink

    Jordan Williamson, MEd
  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • 2 hours to decide my future: Why the NRMP’s SOAP process is broken

    Nicolette V. S. Sewall, MD, MPH
  • What led me from nurse practitioner to medical school

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How do we best handle the health concerns of our residents?
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...