Residency Trauma

I really had a hard time in residency. One of the big reasons I imagine was that I did not go into medicine for the right reasons. I went into medicine becuase I thought I should to meet expectations of my family and society. I chose OBGYN because it was the best specialty I had experience in from medical school.

My ‘why’ was weak, so I crumbled and thought about quitting often. I did not have suicidal thoughts yet, but I did have thoughts about getting sick or injured, so I didn’t have to go to work the next day. I wanted to seek professional help, but I felt overwhelmed with the thought of trying to schedule an appointment. Doing anything extra took so much out of me. I was so exhausted physically and emotionally after work (but the work actually never ended because there was always more to do), the thought of adding anything else drained me.

For my own processing, I wanted to document my experience and traumas in residency. I need to get it out and validate my own experiences and feelings. At the time it was hard to express this fully because I was afraid of how others would view me. I felt like I could not let them down or appear too weak.

First of all, the amount of hours working and work load was taxing. Typical days would be 10-14hr shifts, with a 24hr shift almost every other week. We would be on night rotation for a month at a time. The day at work could be nonstop, seeing patients, charting, calling attendings or patients, speaking with nurses, answering pages (oh that pager traumatized me), and alarm bells. There are days I felt like there was not enough time to sit and breathe. There would be shifts when I didn’t have time to go to the bathroom, sit long enough to finish a note before I got called to do something else, and eat. Some rotations like labor and delivery and gyn onc would be non-stop the majority if not all the days on rotation. You would typically only have one day off a week, which usually was spent recovering from a 24hr shift the day before. While that is happening, you were somehow responsible for doing research, trying to publish papers, reading to enhance your knowledge (you never knew enough especially when you’re starting out), preparing a presentation, preparing for journal club that week, teaching medical students, or preparing for a end of unit exam during your downtime or when you got home from work. Most days on the hardest rotations I barely had enough time to do basic self care (eat, shower, brush my teeth) before I had to keep working, and then worry about going to sleep in time to get enough hours to sleep. Even though your shift was “only” 10hrs, you would have to get to the hospital before your shift to round on patients, sometimes an hour before depending on how many pts you were responsible for. There was a time when I got so annoyed when the program asked us to volunteer to do an event, or when another assignment was added on.

Second, the acuity and emotionally draining cases weighed on me. Not only was the work load hard, but many of them took a lot of emotional energy out of me. Whether it be a difficult diagnosis you had to disclose, or manage an emergent case, most times you did not have time to process what happened and move on to the next patient about to deliver their happy baby as if nothing happened and be present for them. On labor and delivery in particular, there are many emergencies that have to be responded to within minutes.

Third, the socially complex patients weighed on me. Many of the resident patients had social issues, whether it be complex family life, drug abuse, poverty, a language barrier, psychiatric issues, we learned on the job how to navigate their issues let alone any medical issues.

Fourth, I wanted to do a good job and always leave a good impression. I didn’t want to ask for help and say I was always ok. I felt ashamed to admit I was struggling beneath the surface. I didn’t want to take more leave than the program alotted us (3 weeks a year) to because I didn’t want to let my team down.

I slowly started to realize my care for others and patients slowly diminished. I started to feel like the patients and the cases were just a task to accomplish and finish. My empathy was sucked out of me. Any negative critique or moment of improvement crushed me internally. I had a deep imposter syndrome complex.

My dreams to find a husband and family seemed to feel impossible. I had no bandwidth to date or care for another human.

The people in my program were nice and none were toxic, but I still had all these feelings. I just needed to get out. I have mixed feelings because the training and experience I had felt necessary to be a good OBGYN looking back. I mean, it’s good to be exposed to as many cases as possible under the legal protection as the role of the resident before you’re out on your own, as well as socially complex patients, but I really suffered because of it.

In the end, I’m glad I stuck with the program and just finished. I took a 3 month break before starting my first real job, which was absolutely necessary. However, unfortunately, I started to feel similar negative feelings about my job as I am out in the real world. The best times in my career were the breaks. Patients deserve better, and don’t deserve a physician who is in the state I am in mentally.

I am on the process to improve my inner thoughts and mindset, but also having strong feelings I should look to another career.