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Devina Wadhwa, a psychiatrist, shares her personal journey through burnout and the challenges of navigating systemic pressures in health care. From recognizing subtle signs of burnout to setting boundaries and redefining resilience, she offers valuable insights on reconnecting with purpose and advocating for meaningful change in the medical field.

Devina Wadhwa is a psychiatrist.

She discusses the KevinMD article, “How physician burnout silently creeps in and takes over.”

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Transcript

Kevin Pho: Hi and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Devina Wadhwa. She’s a psychiatrist, and today’s KevinMD article is “How Physician Burnout Silently Creeps In and Takes Over.” Devina, welcome to the show.

Devina Wadhwa: Thank you. Thank you.

Kevin Pho: So let’s start by briefly sharing your story and journey.

Devina Wadhwa: So I’m a psychiatrist, and I work up in Northern Ontario in a smaller town called Thunder Bay. I also do a bit of work up in Northern Canada, in the Arctic, in Nunavut, and in some smaller northern communities as well. I was trained previously as a pharmacist at the University of British Columbia. My journey sort of moved me to Toronto, where I completed a residency in psychiatry and then became very interested in rural psychiatry, essentially in underserved areas. That’s how I ended up here in Northern Ontario.

Kevin Pho: Tell me about some of the things that you see in those rural areas, in those Indigenous areas, from a psychiatry standpoint. What are some typical things that you’re seeing?

Devina Wadhwa: Working in a place like Thunder Bay—which we call underserved—there is so much mental health need and oftentimes not enough psychiatrists or mental health clinicians overall. So, on a day-to-day basis, I see lots of clients. You essentially come across individuals that struggle with significant amounts of trauma, and intertwined in that trauma history comes mental illness, substance use, and overarching psychosocial difficulties. Many individuals struggle with homelessness and live in low socioeconomic conditions.

It’s very similar in many parts of the country, but the more rural you are, the more people struggle to get the services they need. They often wait a lot longer than they should.

Kevin Pho: You wrote the KevinMD article “How Physician Burnout Silently Creeps In and Takes Over.” Before talking about the article itself, what led you to write this one in the first place?

Devina Wadhwa: I had a good dose of burnout that really shifted my perspective. It crept in probably two years ago in my own life. Coming out of that, I’ve really reflected on creating more awareness in a vocal way around how real it is. We use this word a lot, and that’s where the article struck me. I hear “burnout” all over the place—burnout, burnout, burnout—but actually stopping to think about what it feels like and the impact was quite profound for me.

I struggled with a sense of hopelessness around the work. There was this feeling of not achieving or making a difference in the world, which is what I set out to do in medicine and in mental health. That’s the inspiration for the article: wanting to write and share with clinicians and learners. I teach a lot of medical students and residents through NOSM University, and I’m quite open about my own journey and struggles. I find it de-layers a sense of shame that we all have as clinicians, where we feel we need to push hard and act like nothing affects us. But burnout is real.

Kevin Pho: Tell us your story. Tell us about some of the challenges that you faced.

Devina Wadhwa: As a new grad—I’m seven years into practice now—my first five years, I was very keen to help, for lack of a more sophisticated way of describing it. But in the last few years, that feeling started to degrade. I felt like I wasn’t making a difference. I felt bad about myself and my work. I didn’t feel fulfilled or like I was helping anyone.

It started to creep into my home life. I was more irritable, and my partner was the first to notice, asking, “Do you think work is really affecting you?” My first defensive answer was, “No, I’m fine. Everything’s good.” But reflecting and going back into psychotherapy for myself—a practice I started in residency—was eye-opening. I realized I wasn’t immune to challenges, even as a staff clinician.

I became more anxious, doubted myself, and berated myself after bad outcomes. I lost confidence as a clinician. It forced me to stop and think about what I could do differently. I still love the work, but I needed to approach it differently. Working less and incorporating creativity, such as mindfulness and teaching, became essential. Wellness has become important to me.

Kevin Pho: What kind of changes specifically did you make? Did you work less? You said you worked in other settings. What specific changes did you make?

Devina Wadhwa: I scaled back my time in acute care settings. Instead of working in those settings for 10 months, I reduced it to six months. I started to travel more and engaged as a speaker at continuing medical education conferences. I also began teaching yoga and mindfulness courses and working in even more rural areas, which I found fulfilling.

Talking about the struggles of burnout and moral distress has also been part of my approach. Our health care system—speaking about Ontario—faces pressures that aggravate feelings of hopelessness. As clinicians, we often feel helpless to do the best we can for patients.

Kevin Pho: So just to be clear, this was intentional on your part to address the burnout symptoms you were feeling. Did your job itself make any accommodations to help you address your burnout?

Devina Wadhwa: In terms of the actual job, working less was an accommodation. I expressed that I couldn’t sustain the intensity of my previous schedule, so I proposed a way to do it better, and that was accepted. It was challenging for a team already stretched thin in terms of human resources, but it was necessary for my well-being. However, the broader system and environment didn’t provide much support. We’re navigating a health care system with significant gaps—there aren’t enough family doctors, and “hallway medicine” is becoming the norm. These systemic pressures compound the challenges we face as clinicians.

Kevin Pho: Can you explain what you mean by “hallway medicine”?

Devina Wadhwa: Hallway medicine refers to the lack of space and resources to care for patients properly. When I started in Northern Ontario, patients were seen in proper spaces and admitted to rooms within 24 hours. Now, it’s common to see patients in emergency room hallways waiting for beds for three or four days.

These are individuals suffering from emotional distress and mental illness, and there’s no private space to speak with them. You’re constantly negotiating discharges and trying to make room for more patients. Our infrastructure often feels like it’s crumbling under the weight of demand, making it harder to provide the care we’re trained to deliver.

Kevin Pho: In your case, you cut down your work schedule and pursued passions outside of medicine. What commentary do you have about our health care system, given this reality? Is it sustainable for physicians to practice full-time patient care?

Devina Wadhwa: It’s very difficult, and I’m a prime example. When I graduated, I aspired to be a clinician, teacher, educator, and researcher. But I quickly realized that full-time clinical work wasn’t sustainable for me. It was disheartening to accept that, because we’re subtly trained to believe that success as a physician requires wearing multiple hats and working at full capacity.

Many clinicians around me are choosing not to work full-time because it’s just not possible. In psychiatry, I’m seeing more new grads opting for locum positions to sustain their practices. Full-time clinical work has become increasingly difficult for many of us.

Kevin Pho: How long did it take you to accept that you couldn’t practice the way you initially envisioned without burning out? Was that a difficult process?

Devina Wadhwa: It took about two years. My article highlights how burnout slowly engulfs you. Initially, I didn’t believe it was possible for me to burn out. I thought I was doing all the “right” things for wellness. But eventually, I accepted it, and that brought a sense of liberation. Now, I’m not ashamed to share my experience. I talk openly with my junior colleagues, encouraging them to recognize that it’s OK not to maintain a certain intensity for extended periods. It doesn’t mean we’re failures or bad clinicians.

Kevin Pho: Are you starting to see that trend shift? Are your colleagues beginning to accept less-than-full schedules to prevent burnout?

Devina Wadhwa: Absolutely. It’s a trend I’m seeing more frequently. Is it good for medicine overall? I’m not sure. We need more physicians to meet society’s needs, but I do believe it’s a positive step for individual well-being. When clinicians are emotionally, physically, and mentally well, they’re better equipped to care for patients.

Kevin Pho: You mentioned you work with medical students and residents. Given your experience with burnout, what advice do you offer to future physicians?

Devina Wadhwa: At NOSM, psychiatry rotations for medical students occur in their fourth year, so they’ve often already chosen their career paths. What I emphasize is that delayed gratification—the idea that balance will come once they become staff—is misleading. Many of us graduate without the tools to maintain balance because we’ve spent years living unbalanced lives.

I encourage students to prioritize small wellness practices during training, like taking 30 minutes during a call shift to recharge. These habits build the foundation for well-being throughout their careers. Patients shouldn’t have to wait longer because clinicians need breaks, but clinicians must be well to provide their best care. It’s a delicate balance.

Kevin Pho: We’re talking to Devina Wadhwa, a psychiatrist. Today’s KevinMD article is “How Physician Burnout Silently Creeps In and Takes Over.” Devina, let’s end with some take-home messages you’d like to leave with the KevinMD audience.

Devina Wadhwa: Thank you. My message is simple: look after yourself. By caring for ourselves, we’re better able to care for our colleagues and, ultimately, our patients. Medicine is a beautiful profession, but it often comes at the cost of our own well-being. Don’t lose sight of yourself in the process.

Kevin Pho: Devina, thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Devina Wadhwa: Thank you very much.