What is Medical Burnout?

Several years ago, when I was still in college, I remember being on the plane back home when I picked up a magazine and flipped to a random article. It was about doctors, and I was pre-med after all, so I read it. That was how I learned for the first time about high rates of career dissatisfaction, mental illness, and cynicism among physicians, extending to the level of residents and med students. I remember thinking, “Is this real? Would this happen to me too?” I pushed the thought to the back of my mind, because it was easy to dismiss—I had MCAT classes, summer vacation and a busy upcoming semester. Bottom line,  it wasn’t relevant to me at the time.

However, it is relevant now. I became a med student and am starting to see elements of the future more clearly. “Burnout” is a word I hear all of the time—everyone seems to be saying it. Physicians are burned out. Med students are burning out. Levels of burnout in health careers are rising, leading to a decrease in quality of care.

I looked up burnout in the dictionary, and the first definition is: “the reduction of a fuel or substance to nothing through use or combustion.” The second is: “physical or mental collapse caused by overwork or stress.” The similarity these definitions share is interesting—they both have to do with overuse, exhausting a resource.

To be more precise, “burnout” in medicine is characterized by chronic stress, emotional and physical detachment, and exhaustion. There are many factors that can contribute to this feeling—being overworked, losing faith in the field of medicine, financial burdens, lacking time to maintain close relationships, losing motivation to take care of oneself, ect.

I recently read an article on NBC about physician burnout and its consequences, including medical errors. One dire quote from the article that struck me, stated by an emergency room physician: “I went into emergency medicine because I wanted to help people…And we’ve created a system that’s taking people who care a lot, and who really feel passionately about this, and making them angry, and apathetic, and depressed.”

I can’t speak as much to resident and physician burnout, but I am certain that these issues exist among med students. These are feelings that I’ve grappled with myself, and at my own school, last year faculty were shocked when a survey revealed that a significant percentage of the student body was struggling with mental illness.

I’ve had a lot of questions. First of all, why do these kinds of feelings arise? My best guess is that there are a number of great pressures and challenges associated with a medical career—which, no matter what you say in your med school admissions essay, you cannot be completely prepared for—and these pressures can frequently lead us to believe that taking care of ourselves is not the priority, that we’ve chosen a field where we must subjugate our needs to those of others.

Second, what could we do about this?

I don’t know. But I strongly believe that you must take care of yourself as someone who has chosen a career in medicine. You cannot take care of others, you cannot be empathetic and engaged with the world around you, if you push yourself to the point of hurting yourself. As my colleagues stated in our class oath: “To heal others the healer must be well.”

The predominant culture in medicine right now does not always seem to be one where the well-being of the individual is valued. Talking about your struggles, admitting that things aren’t going well—this isn’t the norm. If anything, we need to encourage a different kind of culture, where we’re comfortable discussing harder topics.

It’s not easy for me either, but I’ve spent a lot of time thinking about this, and I’ve come up with some important areas that I think are important to focus on, regarding being well as a person in medicine. I’d like to end by sharing some of those areas:

Balancing your schedule

There are only 24 hours in a day. As silly as it may sound, my life changed at one point when I came to a realization: when I didn’t get enough sleep. I ended up wasting more time overall because of constantly feeling tired and not being able to concentrate. When I did sleep enough, I was actually more productive in the long run, even if it meant not finishing an assignment on a given night. So after that, I started to make sleep one of my priorities.

The point that I’m trying to make is: we have a limited number of hours, and while it doesn’t always seem like we have a choice, we do choose at the end of the day what we do with those hours. Make choices that are right for you. Know your fuel and energy levels. Know that you cannot spend your days draining your fuel, constantly working, and not spending any time recharging.  

Prioritizing your priorities

Something I like to ask myself is: “Is the ladder up the right wall?” We spend a lot of time working on climbing up our personal ladders—without checking if the ladder is placed against the right wall. Once we get up there, we realize that we spent all that time climbing to just end up in the wrong place.

Make sure you know what your priorities are, and that the choices you make are in line with those priorities and values—that you’re climbing up the right ladder every day. For me, mine are not necessarily grades, evaluations, or salary. Mine are the people in my life, my well-being, and retaining the curiosity and empathy I need to contribute meaningfully to the causes I care about.

Seeking help when needed

Take care of your mental and physical health. Be aware of what your mind and body are telling you. When you need it, do not hesitate to seek professional help. Anyone—and I mean anyone—can benefit from professional guidance. This can be something as simple as speaking to an anonymous counselor through your school. There is no harm or stigma to asking for help when you need it.

And in the realm of academics and education, ask your professors. Talk to your classmates. You are not here because you’re expected to know everything already. You are here to learn.