Recently, a friend sent me an article titled "The 6 Things Millennials Bring Up the Most in Therapy." It was easy to identify with most of the issues brought up in the article, and I found myself relieved to see that these challenges were common among people my age. Some of these topics felt even more pressing for those of us in medical training, so I decided to add a few reflections below specific to medical students and residents.
"I can't make a decision. What if I make the wrong decision?”
For fourth year medical students, it's interview season! That means there are hundreds of decisions to make during these important months. What should I wear to the interview dinner? How do I approach the residents? Did I like the program? Where should I put it on my rank list? We all want to be in the right place for residency and take advantage of opportunities for learning, jobs, maybe fellowship. Over the past year and a half, I have realized that there is no wrong choice for residency. Every residency program has its strengths and its weaknesses. Residency is a challenging time no matter where you go, and making a rank list comes down to optimizing the degree to which each program fits your priorities.
My top priority in picking a residency program was fit. Even though my career goals have been in flux since starting residency, I feel strongly that I made the best choice for myself. I love living in Durham and I am grateful to have formed deep friendships with my co-residents and with friends outside of the hospital. These relationships have been a crucial support system for me during residency.
Now that I have started thinking about my next steps after residency, I feel confident that the same applies to us when we graduate and move on to jobs and fellowships. Especially for those of us in family medicine, there are so many directions our careers can take. I am optimistic that I will have two or three different emphases during my career. I have enjoyed things as varied as OB and geriatrics. I want to spend time on advocacy and public policy. Ultimately, I don't think I can go wrong regardless of which job or fellowship I pursue next. There is plenty of time in my career to spend in each of these areas, and if I don't get to all of them, I know there are incredible opportunities awaiting me.
"I have difficulty saying no, especially to my parents."
It is particularly challenging to protect your personal time during residency when you are demanded to do a seemingly impossible amount of work. As a family medicine resident, I often feel pulled in many directions—juggling inpatient rotations, clinic, and non-clinical responsibilities. Ultimately, there are only 24 hours in a day. In residency, it often feels like I have to eke out every last minute and I still cannot get to the bottom of my to-do list. The days when I protect the time in my day to do things like meditate, exercise, eat a home-cooked meal, or catch up with a friend are usually days that I feel better overall. Meditating at bedtime has been the most helpful strategy to improve my focus the next day. When I can manage it, protecting my personal time means staving off burnout and exhaustion in the long run.
"Will I ever make enough money to start a life with my partner?"
If this is you, don't worry! If you aren't already budgeting on Mint or a spreadsheet, both are straightforward ways to keep track of your money.
"I feel helpless about all that's going on in the world."
As a resident, if you want to be involved in something outside of your program, coming up with a time management strategy will be really helpful. But recognize that there is a limited amount of time during which you are not working. There is a lot of room in medical school to work on projects outside of the clinical curriculum. Residency is a time to focus on clinical learning.
"I feel like a fraud."
This is one of the trickiest aspects of being a trainee. The culture of medicine values confidence over medical knowledge and assertiveness over emotional maturity. We are told to ask for help, and then chastised when we do so. Over the past few years, I have slowly learned the importance of patience. We are in training to learn and because we improve our skills through practice.
Turn off social media, go outside, meet people in person. Turn your phone off entirely if you have to. Work out. Do the things that make you feel good about yourself, and count small victories. Even if it is not clear on the surface, everyone is struggling with something. Be compassionate toward your own struggles and you will become more compassionate toward others, as well.
Each of my co-residents has various strengths and weaknesses to offer, and we learn from each other. Part of being a team player means recognizing that we come from varied backgrounds and playing to each other’s strengths. When we complement each other, instead of competing or comparing amongst ourselves, we can see the extraordinary wealth of knowledge we share.
"My anxiety is interfering with my life."
I started my first day of residency with extraordinary expectations for myself and for what residency would entail. I constantly felt like I should have been doing more than the required responsibilities. I had to remind myself many times over that residency was in itself a job and a half, and that focusing on residency responsibilities gave me more than enough things to do. Letting go of that internal pressure and sense of urgency has reduced my stress level enormously.
Residency comes with a very particular set of challenges. Being a resident has led me to prioritize my emotional well-being over the past year and a half more intentionally than I ever have before. Forming a community both inside and outside of residency has been instrumental for me to survive these challenges and thrive. I hope that my reflections from the past few years are helpful for medical students and residents encountering similar experiences.
Mansi Shah is a second-year resident with the Duke Family Medicine Residency Program. Email mansi.shah@duke.edu with questions.
Editor’s note: Duke Family Medicine residents guest blog every month. Blogs represent the opinion of the author, not the Duke Family Medicine Residency Program, the Department of Community and Family Medicine or Duke University.