Work-Life Balance as a Resident Physician

Post-Call Glow

I promised my next topic would be on work-life balance in residency, so this post will be about how I am currently trying to maintain this balance during intern year with a few tips for those of you who will be in my shoes in upcoming years. Even though I'm only a month into residency, I currently live for my post-call days and the rare times I actually get a day or weekend off. It's during these times that I can actually feel (and look) like a normal human being again while getting caught up. Also, since my daughter usually spends her summers away and hasn't started to miss me yet, I've been able to have some extra fun without worrying about making the flight to see her on my days off.

I had the blessing of not only having a day off during my second week for the 4th of July, but a post-call day that Friday and a full "golden weekend" off. I was definitely excited for the chance to explore the city during the holiday, and what made it even better was having a friend from my GA-PCOM family in town to experience all the fun with. We went to a block party on the parkway, listened to some great music, and ate lots of yummy food from some of the food trucks that lined the street.

As for my Golden Weekend, I was super excited that Atlanta United was coming to town to play, and with tickets only being $29, I was definitely in attendance. Plus, my friend had never been to an ATLUTD game, so it was a good first experience. We had great seats, the stadium was outdoors with a gorgeous view of the Delaware river, we won the game, and although the Philly fans were a bit intense, they were actually pretty nice for the most part. There were even fireworks after the game (pictured above) which we were happy to see since we both had early work schedules and were too tired to stay up for the fireworks that occurred on the 4th of July. Afterwards, we got a chance to walk around the city to check out the nightlife, talk, and have a few drinks. It was much needed, and I felt so alive! The next day, I slept in (so wonderful!) and took a walk to the Spruce Street Harbor Park where I people-watched, ate more food, and enjoyed a day out in the sun.

Hanging out with my mentor

Since that weekend, my only time off has been during my post call days, so I've made sure to take full advantage of making the most of my free time. My favorite post-call day so far was when I got the chance to spend time with my mentor Dr. Velma Scantlebury while helping out with a dinner she was hosting for the Mandela Washington Fellows. This was a group of young African leaders who are only in the US for six weeks, so it was nice getting to meet them and hear their stories. Plus, I'm always up for free food and it was nice having some time out by the pool.

#ATLUTD #UniteandConquer

Right now, I am currently on day 14/19 without any time off unless I am post-call, so it has been extremely important that I maximize my free time to the fullest extent. As a resident, a lot of time is spent in the hospital taking care of everyone except yourself. It's easy to fall into the typical work-eat-sleep cycle, and not making any time for yourself can eventually lead to burn out. Keeping this in mind, I've made a list of things that have helped me stay sane so far. I'm sure this list will change as I get into heavier months, but so far, here are my general tips for post-call and free days:

#1: Try not to waste the day sleeping
This is probably the hardest thing to do on my list. After working 24-28 hours with very little or no sleep at all, the first thing anyone wants to do when they get home is hit the bed! It can be easy to sleep the day away, and before you know it, it's time to go back to work. I refuse to spend my entire time as a resident just working and sleeping, so I make an effort to sleep when I can while on call (even if just a 15-30 minute nap) and set my alarm to wake up when I'm post call. No matter what time I get off work on my post-call morning, my alarm is set to 230pm. So far I've been managing 4-5 hours of post call sleep, but I do have upcoming days where this will be less (such as when I attend morning general surgery grand rounds).

#2: Work tomorrow? Go to bed early
I love sleep, but if I slept all day on my days off, I wouldn't be able to sleep at night. Not a good thing when I'm typically waking up at 330/4am. So, as mentioned above, I make sure to wake up by 230pm on my days off, and I aim to go back to bed by 9pm. On days where I am truly sleep-deprived, I'll go to bed even earlier to ensure I get at least a full 7 hours of sleep (my optimal amount). This allows me to wake up feeling refreshed and ready for a new day.

#3: Have a To-Do list
It helps to have a plan for your days off. I try to keep a list of things I need to take care of, and I knock them out during my free time so I don't start to feel overwhelmed. Even if the list is something as simple as "watch Hulu, read a chapter, call daughter", it helps to have a plan.

#3: Indulge in some self-care
I am all for self-care and sometimes it's the little things that can make a big difference. On my very first post-call day, I went to the movies. Mostly to keep myself awake, but also because watching movies is something I enjoy doing. I even include blogging as part of my self-care, because I find it therapeutic. There's nothing wrong with treating yourself to a massage, pedicure, or even fancy take-out during your time off. I've done all of these when post-call, and it's a great morale boost.

#4: Get the "Adulting" out of the way
Bills and other responsibilities don't stop just because you're busy or tired. The best way to conquer them is to knock everything out when you have time off. I've utilized post-call days for grocery shopping, paying bills, and doing laundry. Things are usually less busy during the week and grocery store lines are a lot shorter. I even meal prepped the other day for my current string of back-to-back call days since I somehow managed to spend my cafeteria meal credit for the month. In the coming months, I'll utilize the time for doctor appointments and such, so that I can use my personal days for other things like making trips to see my little one and (hopefully) interviews.

#5: It's okay to not be productive
There will be some post-call/off days where you just don't feel like doing anything at all, and that is okay. Yesterday was one of those days for me. I was post-call with probably only a total of one hour of sleep in 27 hours, and I just wanted to be in bed all day. I still set my alarm for 230pm, but instead of being out and about, I stayed in bed, ate snacks, and watched Hulu all day. I think the only productive thing I did was wash clothes, and I was asleep by 8pm. Doing nothing was much needed, and I woke up feeling refreshed, and ready for another day on call.

That's all I have for a list right now. I will be post-call again tomorrow morning and Wednesday, and I already have some "adulting" items to take care of. The good news is I'll be off both days this weekend, and I will definitely be taking advantage of it. My motto is "work hard, play harder", so I am very much looking forward to another golden weekend that will only involve fun, self-care, and being around people that make me happy. If you're a resident or attending, I'd love to hear some additional tips, and to everyone else, I hope you have a wonderful week!

Month One of Intern Year: An Update

Official "long white coat" pic

Happy Tuesday! Today marks exactly one month since I made the move to Philadelphia to begin my journey as a resident physician. It's definitely been a month full of ups and downs, but for the most part, I can say that the transition into my new role has been a pretty smooth one. When I wrote my last post, I had just completed my first week of intern year. Now I am in the middle week four (yep, my program started a week earlier than the July 1st start date that most people usually expect), and I'm finally starting to adjust to the new life.

My second week of intern year was a pretty good one. I switched to a much lighter surgery service on July 1st, and after being on acute care surgery my first week, it was a welcome relief. Instead of constant ER consults and emergency cases, this month has pretty much consisted of elective cases and taking care of post-op patients. Plus, during my second week, I not only had the 4th of July off, but a Golden Weekend! For those who aren't familiar with the term, that means I had both Saturday and Sunday off. Plus, I was post call on July 6th, so it was more like having a three day weekend. I've even had time to do my surgery readings. Sooo glorious! I'll be back on acute care at the end of the month, so I'm making sure to take advantage of being able to breathe right now.

Surgery essentials

During week two, I finally had the chance to get back in the operating room. Intern year mostly involves a lot of floor work such as rounding, writing notes, taking calls from nurses, responding to pages, etc., so being in the operating room is a nice treat. My first case was a neck mass excision. Not a long case, but made me so happy! And last week, I had even more happiness, as I got to go to the OR three times! My first case (and my favorite so far this year) was an extended laparoscopic right hemicolectomy. In layman's terms, we took out a person's right colon using a scope. This was my favorite case because the senior residents were away at orientation and I got to be first assist on the case. As a medical student, I never did much outside of working the camera and closing the patient, so it was super exciting being given the opportunity to make incisions, work tools such as the bovie, laparoscopic grasper, and linear cutter, and then do a large portion of the skin closing. My other cases last week were a back mass excision, and then while on call Saturday, an emergency laparoscopic cholecystectomy (ie we removed a gallbladder). Outside of the OR, I've done a few bedside procedures such as abscess incision and drainage, so I'm constantly having little happy moments that remind me why I love surgery.

Outside of the small happy moments, intern year so far has been all about adapting and adjusting to the unknown. It seems that most people tend to struggle with this, but it hasn't been too bad of an adjustment for me (but then again, I also haven't started trauma service yet, LOL). I have this weird theory that being a parent has somewhat prepared me for the year which is why I haven't struggled with the transition as much as I've been hearing other interns in various specialties say they do. Before you brush me off as crazy, just think about it. New parents are constantly sleep-deprived, working to keep their new little person alive, always worrying if they're doing the right things, afraid of failure, on a steep learning curve, and desperately trying to ensure they have a life outside of just being a parent. Starting residency is basically the same thing. The exception being you are now responsible for multiple lives, and the struggle is having a life outside of being a doctor. See what I mean?

On the grind!

With that being said, having went through the struggle of being a single parent and juggling a million different tasks on a daily basis, I've learned a lot about time management over the years and making time for important things. Work-life balance has always been super important to me, so since starting intern year, I've made sure to take full advantage of my post call days and the rare times when I get a full day off. My next post will be all about that balance and life outside the hospital, but for now, I just wanted to let everyone know that I'm still alive, grinding, and trying to learn as much as I can. My next post will have all the fun stuff, so stay tuned!