My interest in understanding burnout among medical trainees started during my second year of medical school. With Step 1 nearing, I noticed a dynamic shift in my classmates. The growing tension, petty arguments, and constant worry surrounding our futures took over. This led to a research project assessing burnout risk factors that stood out like a red flag on my application for residency. I found most of my interviewers were on the extremes of the spectrum: Either they were all in or overly skeptical. I began to expect the all too common question, “If a medical student is already experiencing burnout, how are they going to survive residency?”
The use of the word “survive” is always an interesting choice. To survive, as in, “continue to live or exist in spite of danger or hardship.” We are expected to survive our medical training; fighting to reach the other side, well trained but likely scathed. The road to becoming a physician is difficult, as it should be considering the powerful responsibility we take on caring for the lives of others, but no one should have to just “survive” their career choice. We should question what dangers we are forced to face.
One interviewer chuckled. “There’s no way medical students are experiencing burnout. They just can’t handle stress,” she stated.
I can not convince anyone of what they do not believe in or have no interest in understanding. Medicine is a field based on evidence and the literature for burnout is vast and growing. The experiences my peers describe of inadequacy, of failure, of broken relationships are real. Forums like Reddit that highlight the depression, anxiety, and suicidal ideation that students across the country experienced during Match week are real. As you sit across from me with a list of required questions to ask, I can see you are tired; that dull look in your eyes, perhaps contemplating who you once were when you were in my shoes. How can it be so surprising that burnout starts as early as medical school?
As many of my interviewers reminded me, medical training has changed a lot. However, that does not eliminate the continued need for change in medical education. Burnout, moral injury, or whatever other term you prefer is a byproduct of a system that forces you to believe that your health does not matter and further should be sacrificed in exchange for practicing medicine. You may not have experienced it, but choosing to ignore the existence of burnout amongst medical trainees ensures that this cycle continues. Do not question our lived experiences, help us to challenge the system that is responsible for them or move out of the way. Let us ensure those behind us do not have to focus so much on just surviving.
Misha Armstrong is a medical student.
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