I was a 22-year-old intern, just about to finish my public health internship. I had an ambitious career ahead of me. I was trained as a public health educator. I was doing wellness fairs, writing newsletters, and excited to get to the next stage of my life. I wasn’t yet certified, however, so when all of a sudden a job opportunity presented itself to me and gave me a chance to stay at the same hospital where I interned — with a decent entry-level salary, benefits, and a pension — I couldn’t pass it up.
I was now 23 years old, and back then, the pressure was on to get out of your parent’s house and start your independent life. I had to do it. This was the jackpot. I was going to take a position that would help resident doctors graduate into the attending world. I would have the opportunity to have an impact on their growing career, put my health educator skills to use, and help them as they graduated from a training program into the job of their dreams. I was to be the residency coordinator.
At first, I admit it was pretty cool. I mean, who doesn’t want to help a doctor? I didn’t even know a doctor aside from my primary at that stage of my life. Soon I became the “go-to gal” to get all things done. Then I graduated to confidante as I learned to listen to their concerns and fears as they grew closer to graduation. I listened and listened some more. I created rotation schedules around their needs — not wants — each year.
Let’s face it — you have to be at your brother’s wedding and at the birth of your own child, right? So I played the genie and made sure all of my residents were at those important moments and milestones.
It was so rewarding. Appreciation and kindness flowed freely. These residents valued me. They invited me to their child’s bris or baptism — even weddings — especially when one of them married my sister.
I got an even more in-depth view of what it was like to contribute to a resident’s wellbeing. I mean come on … I introduced him to the best sister in the world. And the reward of that action so long ago continues to be one of the greatest requests for help I have ever asked for.
As a slightly overwhelmed coordinator, I began to recognize the fact that I needed a bit of help. This led to my younger sister coming to work with me on our interview season recruitment days to help lighten the burden. Little did I know that this would result in two of the greatest joys of my life — my nephews. I still look at them in awe and thank God that I asked for help when I did and secretly think that maybe somehow I had a hand in how they came to be. They have my heart and my wallet, and I can’t imagine my life without them. Then I go on to think: “Wow, what if I never took this job, and my sister never met this resident?” You get the gist.
Fifteen years later, I am living a different story. Yes, my nephews, my sister and “my resident” are still going strong, but my role as program coordinator is no longer one of a confidante, counselor, friend and “schedule genie.” This role has ended.
Bogged down by the new accreditation system and increasing administrative demands, time has prevented me from being that genie that I once was. Yes, I know the age gap may have a part in this now – I am 45 – but my desire to make that connection and a resident’s time with us in training a little more bearable has not waned. A piece of me dies when I can’t honor a resident request because mandates are now different. My heart breaks a little that I now need to be less involved in the day-to-day lives of my residents. I spend my days tending to the growing credentialing responsibilities of our residents and graduates, the increasing ACGME demands of the CCC and the PEC, taking meeting minutes, completing paperwork, data entry that goes on for days and the resident milestones — unlike the ones I was trying to honor — that programs are now required to report. The irony of this term is not lost on me.
And at last, attending to the most recent standard core wellness requirements that have surfaced for our programs. I now also spend my time concerned with healthy breakfast for a resident conference, stocking our resident room with endless snacks so that they can have food readily available 24/7 and completing more forms than one can ever imagine, as to lessen the residents’ administrative burden, all so that they can be well.
But at what expense, I ask? The residents’ expense? At my expense? Should my wellness — and ironically theirs — suffer at the expense of carrying out these new requirements? I sometimes don’t have time for breakfast. I don’t sleep most nights. I lie awake worrying about how I will accomplish all of this. And I am tired. I no longer approach my days with as much vigor and enthusiasm as I once did. I am now a snack genie, a form completer, and a meeting planner. And I am sad. And I grow more somber each year as we graduate a group of residents that I never got the chance to know. I ache for them as they will not know to turn to me now and years from now as their colleagues before them always did and still do.
My excitement at the opportunity of this position 22 years ago has dissipated. This is not the career that I once jumped at the chance to take. This is no longer rewarding — or dare I say “well.” Are readily available snacks more important than a five-minute conversation with a resident reassuring them that they’ll get through this? Is typing a resident’s birthday into yet another form better than taking the time to wish them a happy birthday? Is my time better spent grocery shopping for snacks for the resident lounge than planning a schedule that works for a resident’s life? I think not. I have two nephews that prove otherwise.
Lori Berryman is a residency program coordinator.
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