Changes in Personal Relationships During Residency and Their Effects on Resident Wellness

[brady23]

A very interesting article about the impact of residency on the personal lives of students done by UofT. Even though residency is a very short period of life, I feel like the late 20s is one of the most eventful periods of your life. What are your thoughts? 

Interesting Points:
- Maintaining personal obligations and relationships, while not compromising one’s professional identity, was important to all the residents. However, many residents explained that being a doctor superseded their personal relationships and suggested that residency was all-consuming (time, emotion, motivation, energy). As their professional identity developed and strengthened, residents seemed to forfeit or relinquish their personal relationships.
- Poor work–life balance seemed to result in relationship problems. The disproportionate amount of time participants spent on work, compared with the time spent on personal relationships, seemed to diminish residents’ wellness and to manifest in a range of emotions, including anger, anxiety, fear, frustration, guilt, loss, regret, sadness, and self-doubt.

Some interesting quotes by residents: 
- "my role with respect to the type of friend or their expectations of me have changed because of how busy I am … I think that a bit of my relationships have suffered, but just because I’m not as available as I once was before I started medicine."
- "I think it would be hard for me to explain to someone who wasn’t in medicine. They could be an accountant, an economist, or in any other profession, but maybe if there was a difference in the degree of responsibility. It would be harder for me to explain why I have to do certain things the way that I do it if there was a difference in the degree of responsibility"
- I think my friends are used to it. I try to keep in touch with them even though I may not meet with them or see them face to face as often as I’d like."
- "Maybe, from medical school to, now, residency, people have gradually adapted to me not being around, anyway. So, yes, it is just a step further. But maybe the change is so gradual that no one really notices."
- If you want to call me up then, I could go for lunch, whereas now it’s very structured. I will have dinner with you two weeks from now on a Tuesday because I know that I have my half-day and I’ll be out early. So it’s much more structured, much more organized and much more planned. Nothing is spontaneous.… I think people have to accept [it] because otherwise they’ll just be disappointed a whole lot. It’s not like I can modify things to accommodate other people. It’s like this is my schedule and if you are unhappy then wait five years until I graduate.
- It’s just impossible to be a good friend to anyone, you know, I just don’t have the time or the energy.
- I never really call my parents. I call them once a week. You know, I don’t think I can say I’m really a contributing family member. I’m just not there.
- When I talk to my friends who are in Internal [Medicine] residency, they think I have this great life, less than 90 hours a week. And they think they have a good balance but they’re working 90 or 100 hours a week. Um, [laughs] and they still have time to do fun things too, but you know when I hear them talk it sounds like it’s taken over their life too.

http://journals.lww.com/academicmedicine/Fulltext/2017/11000/Changes_in_Personal_Relationships_During_Residency.30.aspx

[Lactic Folly]

You could probably say the same for good chunks of clerkship and life as an attending physician, depending on what you do.

[goleafsgochris]

People should definitely look at this when picking specialties.  Like Lactic Folly says, this is true for basically everyone in (non-elective) cherkship and PGY-1 (so really about 2+ guaranteed terrible years).  But you can basically determine if its like that for longer than that.

Some specialties are life consuming for all of residency, and some are for your whole career.  You need to individually decide how much you can tolerate.  In most surgical specialties youre more or less committing to a lifetime of that.

[Lactic Folly]

This may be unique to those who do an off-service PGY-1 year, but it was overall the most free time I've had since entering clerkship. If not on call, I went home when the OR or ward work was done - everything was handed over. Now with greater responsibility, work comes home with me all the time.

I suspect there is probably as much variation in practice options *within* a lot of specialties, as there is between specialties. Positions which allow more of a work-life balance are the type you often see occupied by those closer to retirement. Of course, there will be tradeoffs in terms of income, job security, and career building, which is why fewer new grads will seek them.

[feversugar]

2 hours ago, Lactic Folly said:

This may be unique to those who do an off-service PGY-1 year, but it was overall the most free time I've had since entering clerkship. If not on call, I went home when the OR or ward work was done - everything was handed over. Now with greater responsibility, work comes home with me all the time.

I suspect there is probably as much variation in practice options *within* a lot of specialties, as there is between specialties. Positions which allow more of a work-life balance are the type you often see occupied by those closer to retirement. Of course, there will be tradeoffs in terms of income, job security, and career building, which is why fewer new grads will seek them.

Oh man, my off service PGY1 year was great. No expectations, no studying, just showing up and going home. I felt like I had tons of time!

[hkmedic]

On 1/15/2018 at 5:56 PM, feversugar said:

Oh man, my off service PGY1 year was great. No expectations, no studying, just showing up and going home. I felt like I had tons of time!

In a way, I would agree with this statement. PGY1 is like a glorified medical student, who can sign orders and prescriptions.

[A-Stark]

In PGY1 I was occasionally alone on CTU with 15-20 patients for weeks at a time. Then came night float. So it was tough at times but it gets better (at least in part because you do actually get better at what you're doing). 

[psychiatry2017]

12 minutes ago, A-Stark said:

In PGY1 I was occasionally alone on CTU with 15-20 patients for weeks at a time. Then came night float. So it was tough at times but it gets better (at least in part because you do actually get better at what you're doing). 

I can echo the feelings of managing 15-20 patients when your senior is away for vacation, your junior resident is unexpectedly sick. It eventually gets better!

[Mithril]

I would definitely say that my personal relationships suffered quite a bit during residency. I rarely saw my family or friends. It was also hard to juggle work and a romantic relationship which eventually resulted in that relationship's demise.

But even as a staff it's still hard to find proper work-life balance because now you have new headaches and obligations.

[Birdy]

10 hours ago, A-Stark said:

In PGY1 I was occasionally alone on CTU with 15-20 patients for weeks at a time. Then came night float. So it was tough at times but it gets better (at least in part because you do actually get better at what you're doing). 

Well, this is just a bit terrifying as a soon to be PGY1.