Resident Roundup: Preyanka Makadia, DO

Preyanka Makadia
By Preyanka Makadia, DO


As the end of residency draws near, I have been reflecting on the experiences and lessons I have learned over the past three years that I will carry throughout my career as a family physician. I expected residency to be challenging; I was expecting the long hours, the steep learning curve, and added responsibility of being the primary provider for patients.

Much like medical school, residency is a consuming experience, and I expected to have little free time. For example, on some days I would get to the hospital at 5:30 a.m. and arrive home after 7:30 p.m. After spending the day taking care of other people, the decisions for self-care became more challenging. Cook a meal or exercise? Stay up and read about my patients or try to get a reasonable amount of sleep? Spend time at home watching TV to unwind or go out catch up with friends? Or work on the research project?

There is never enough time to do it all. My co-residents and I also learned that aside from direct patient care, there were many administrative tasks for residency that we needed to use our free time to complete. Recent studies show that burnout among young physicians is on the rise, with these types of tasks as one of the leading causes.  

There has been some movement at the organizational and institutional levels to address resident burnout. Duke Graduate Medical Education and Accreditation Council on Graduate Medical Education both initiated efforts in the past few years to study and help decrease burnout among trainees. Furthermore, the April 2017 issue of theJournal of Graduate Medical Education addresses the topic of reducing burnout. 

Personally, I discovered that an important part of preventing burnout is creating work-life balance. I learned that by creating some structure to my free time and scheduling activities that I looked forward to, both work and my personal life became more fulfilling. Recently, I read "The Happiness Equation" by Neil Pasricha, which outlined “7 ways to be happy right now.” I realized that I had intuitively been practicing some of these steps to manage stress and maintain a positive attitude throughout residency. Pasricha notes that doing even one of these things for two weeks can increase personal happiness. Here’s the complete list:  

  • Three Walks: Research shows that physical health is linked to emotional health, and that just 30 minutes of brisk walking three times a week can help create positive feelings.  
  • Twenty-Minute Replay: Writing for 20 minutes about a positive experience can create happiness by replaying the experience in our minds, which helps us remember things we like about people and experiences in our lives. Journaling about positive interactions with patients or colleagues can help us focus on what we enjoy about work.
  • Random Acts of Kindness: Carrying out five random acts of kindness a week, such as writing a thank you note or purchasing a friend’s coffee can help improve happiness by helping us feel good about ourselves and feel appreciated by others.  
  • A Complete Unplug: This means not checking work emails when away on vacation, or spending a day on the weekend without doing job-related work. This allows us to disengage from stressors periodically and seek renewal. Pasricha also writes that studies have shown that complete down time after work can allow us to recharge and be prepared for the next day.  
  • Hit Flow: When we’re completely engaged with what we are doing, we are being challenged and demonstrating skill at the same time. When our full attention is on performing an activity for its own sake, unattached from any negative reactions, we can find more fulfillment in it. For example, on a busy clinic day with lots of curveballs being thrown, finding a flow and not getting flustered makes the day run more smoothly.  
  • Two-Minute Meditations: Research shows that practicing mindfulness can increase our compassion and self-awareness, and decrease stress levels. Meditation can permanently rewire your brain to help raise levels happiness.  
  • Five Gratitudes: Pasricha writes, “If you can find happiness with simple things, then it will be simple to be happy.” For example, this can be appreciating a beautiful flower or enjoying your favorite snack during the day. Reflecting on these experiences at the end of the day can help improve our moods.  

As I am gearing up to finish residency, I am reminded that practicing medicine is a journey rather than a destination, and finding balance is a fundamental part of developing a sustainable career.  

Preyanka Makadia is a third-year resident with the Duke Family Medicine Residency Program. Email 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.