“If you think medical school is hard, just wait until you are in residency.”

I was told this repeatedly during clinical rotations as a medical student, warned by nearly every resident who took me under their wing, but I didn’t realize the excruciating demands of residency until I was knee-deep in my intern year. Somedays, I would wear four pagers, run up seven flights of stairs because it was faster than the elevator, and change out of my labor and delivery gown and gloves in the hall while on my way to admit a patient from the ER; all while sleep deprived, overly caffeinated, and calorie depleted. 

I was chronically exhausted, but everyday, I showed up on time and gave 110% of myself to my patients, and then went home to study. I managed, but it was not easy. I wish I had healthier coping mechanisms and a better support system. And I wasn’t the only one who found residency challenging beyond words. 

 

Balancing motherhood and residency

 

Christina Pedro, MD: “Balancing motherhood and residency is the single-most difficult aspect of training. Organization and designating a set amount of time to both has allowed me to cope. Remembering to be fully present whether at work or at home helps a lot."

I still have guilt about whether I designate the appropriate amount of time to either, but if I set time aside for family I can be assured I've given time to my husband and kids.

 

Being in the midst of a complicated healthcare system

 

Thomas P., DO: “The most difficult part of residency is sometimes feeling like you're part of a system where your work is meaningless. I have been in positions many times where I have seen the healthcare system fail my patient. We overcharge patients for things they don’t need. We make patients follow up in 4 weeks to review labs instead of making a phone call, and we fail to spend even 5 minutes discharging and educating the patient. It’s a wonder patients trust us at all."

I cope by knowing that although I can’t change my duties as a resident, I can strive to make things a little bit better for patients when I become an attending.

 

Succumbing to burnout

 

Kelechi Acholonu, DO: “The single most difficult aspect of residency is burnout. Burnout is inevitable at some point during residency, and genuinely feels terrible. Burnout involves feeling emotionally dejected and detached, often scraping by via an automatic routine. Avoiding burnout is doable, though, and several measures are in place to combat this effect."

Relaxation activities, retreats, exercise, and spending time with family and friends are some of the best ways to fight burnout.

 

Sacrificing personal life

 

Priyanka Moondra, DO: “The single-most difficult aspect is the social sacrifices made due to a grueling call schedule. It becomes easier with each passing year, but I have learned to schedule activities, both big and small, as things to look forward to in my free time."

Creating boundaries as a chief resident has also been beneficial so that it doesn't feel like I am working around the clock.

 

Caring for our youngest patients

 

Ismaeel Bakhsh, MD: “One of the reasons that I chose pediatrics was because children are generally healthy. However, regardless of age, taking care of terminally ill patients is an inevitable part of medicine, regardless of your specialty. The most difficult experience was caring for children with metastatic cancers and witnessing some children succumb to their disease during my hematology/oncology rotation."

I coped by talking to the hospital’s therapists, which greatly helped me.

 

Other difficult aspects of residency

 

• David Vogel, DO: "The most difficult aspect of residency for me is the work-life balance. I started residency two weeks after my wife had a baby, and I had to leave them behind to start my residency in Florida until the baby was old enough to travel. Fortunately, we have a very good support system, and we called on family members to help with the transition."

• Adnan Manzoor, MD: “The hours are difficult, and there’s no time to do anything outside of work. I learned to take an hour each day for personal time.”

• Jigar Patel, MD: "COVID-19 and remote work. I coped by spending time with friends.”

• Chidi Wamuo, MD: “The most difficult aspect of residency is setting boundaries with myself to not bring work home. I try to finish clinic notes before leaving for the day to help with this.”

 

Parting thoughts

 

Residency is beyond challenging, but learning how to navigate these difficulties by setting boundaries and developing healthy coping mechanisms can help you excel in your training. It is important to remember that you are not alone, and there are plenty of resources available to you. I always try to tell medical school students and residents that you must take time to practice self-care, set boundaries, spend time with loved ones, find joy in everyday patient encounters, have fun, nourish your body with food and exercise, and, finally, go to therapy.