I am an Olympian. I am a retired All-American student-athlete.  I am a resident.  I am burned out.

Let me be clear: I love medicine and the opportunity to have privileged relationships with patients and their families.  I thrive on the fast-paced environment, growing to-do lists, and the chance to work in a field with endless learning.  I love working in team environments to provide optimal care for patients and their families.  The most rewarding point in residency training has been the transition to a senior resident where I can create positive learning environments for other learners.  Practicing medicine is an extremely fulfilling career that I am very fortunate to have pursued, and I will never regret that choice.

The demands of patient care and the number of hours residents work is not the primary reason for my burnout.

I am burned out because of all of the mixed messages I’m receiving as a medical learner.

As a previous elite team athlete, I have been a leader, coach, teammate and role player.  I have experienced excellent leadership and mentorship.  I understand the importance of accountability, selflessness, and teamwork as the cornerstones to goal attainment.  I’ve grown up in an environment where leaders arise naturally.  In medicine, I keep hearing the importance of leadership skills and teamwork, but I’m seeing it in action less.  Can I really blame them? A lot of people in medicine have never been in leadership roles or ever worked in team environments before medicine.  Don’t get me wrong; there are some excellent leaders in medicine.  However, being a good clinician doesn’t make someone qualified to be a leader.  Advertising to people that you’re a good team player doesn’t make you a good team player.  It all goes back to the simple rule we learn in childhood, “actions speak louder than words.”  It is disheartening to watch people without strong leadership or teamwork skills move up the ranks and become models of these skills for the future leaders in medicine.

Wellness has become an important area of emphasis in residency.  In the same hour, I’m being told my wellness matters; I’m also being denied the opportunity to be treated with the respect of a colleague by my preceptors.  The free ice cream is great, but the feeling of being supported and appreciated is what really matters.  It seems simple, but it’s actually a novelty.

Medical learners are constantly on edge about being told something they did, whether intentional or not, was unprofessional.  Yet, I have often been the direct target or witnessed unprofessionalism by an academic faculty.  We are being taught the importance of professionalism while having unprofessionalism modeled; I think they call that the hidden curriculum.  Among the medical community, medical learners sit at the bottom of the hierarchy.  We have been taught to accept being treated by other healthcare staff as though we are not adults, and advised that we “don’t want to get on their bad side because it will only get worse.”  I didn’t realize 8+ years of postgraduate school wouldn’t afford me the right to be spoken to respectfully.

I never bring issues forward without trying to propose solutions because that doesn’t lead to any productive change.  I’m not sure if I have the solutions, but I can emphasize the impact of simply treating a colleague with respect, support, and appreciation.  At the end of the day, we don’t need to like one another, but we need to respect one another in order to provide excellent patient care.  As preceptors, we need to treat our learners with the respect that we longed for in that stage of our training.  We need to be honest about our shortcomings and be humble enough to seek opportunities to build those skill sets.  At the end of the day, a lot of us are on some spectrum of burn out, and we should be coming together to persevere.

The author is an anonymous medical resident.

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