A Slice of a Postgraduate Medical Resident's Life

Abstract

I attempt to detail some of the journeys, both emotional and physical, that an average postgraduate medical resident undertakes. Medical postgraduation is an ultimate test of patience, perseverance, and unflinching passion. I am sure the medical fraternity out there would certainly not disagree with my musings. Entry The entry itself involves a certain degree of compromise for most — in the kind of branch they get into. For those who just get carried away by the flood of fate (their performance in the entrance tests) and land into the branch that chose them (unlike otherwise) it may be totally uphill from then on. A few might embrace the perks and the apparent greatness they find in that particular branch, but the rest would have to just drag, till the end, an unhappy marriage with their career. Long Hours and being ‘Punch-Bags’ The impossible working hours (most residents work well over the official limit) drain one's spirits, inviting unwelcome guests – sleeplessness, anxiety, and adjustment disorders. There is a remarkable attenuation of performance and thought processes, which are by-products of such relentless tiresomeness and chronic sleep deprivation. Universally, the superiors rarely understand this. Only the combatant handful can handle the intense peer pressure and the constant need to meet or exceed the colleagues’ standards. Most residents are ‘punch bags’ for the attending consultants — over trivial issues that warrant nothing more than a friendly discourse. Being at the receiving end all the time, lapping up the mood displacement, definitely blunts one's loyalty to one's career. Credit for Literature Most postgraduates would not mind the unrelenting workload, and in fact could shoulder more. However, most of the time, the start-to-finish incessant hard work they pour into writing journal articles, presentations, and seminars does not get the appropriate credit. Many institutions have egotistic seniors who cannot stand not getting credited for corresponding authorship, although their contribution might be nothing. This only begs the postgraduate to probe into his/her heart to know if he/she would do the same if in their shoes. Being ahead of Times Being right when the superiors are wrong is another arena that demands oodles of patience — to extinguish the fire originated from the disconnect of practicing the right way. Especially superiors who do not update their clinical knowledge and are enslaved by commercialization deter the residents’ fervour to be in sync with advancing medicine. Patients, as well, are blinded by convention and resistant to change. Any attempts at leading them to brighter, righteous, and ever evolving care might not be well-accepted. Occupational Hazards The job invites perils that could pounce in from any direction — ranging from needle stick injuries, deadly contagious infections, facing angry unthinking mobs of expired patients, and the like — to the psychosocial lethalities resulting from working in a heavily female populated workplace (getting lured into affairs, etc.). The shift work sleep disorders, the highly underrated vitamin D deficiency states, are just a few among the numerous disorders that mushroom in a resident's life. A considerable group of residents succumb to introjections of the patients’ sufferings, which only further fuels the misery. Financial Issues Most resident pay scales have not been revised for decades, nor adjusted for inflation. The meagre pay is another significant factor that exponentially amplifies all other stressors. Means of entertainment and ‘getaways’ that help recharge one's mind might not be affordable most of the time. Maladaptation The stressors might lead to bad adaptive mechanisms resulting in overeating, poor motivation for exercise, and substance abuse, which only further jeopardizes physical and mental health. The vicious cycle that develops as an altered mental state reflects on the performance and patient care, which in turn amplifies the resident-bashing. Clouded Decisions A number of decisions that are of paramount importance in one's social and personal life — career choices, for example, the choice of further specialization, in those bent on such pursuits — may be clouded by the already bombarded mind, and decisions taken might actually stem from desperation. Spouse Factor Above all, spousal pressure is a cardinal stressor that could make or break a resident's career. The long work hours, and the virtually non-existent together-hours, and the consequent physical and mental stress, are highly exhausting, and may fracture the spousal bond. A considerable percent of separations / divorces are known to occur during residency, especially in its first year, for obvious reasons. Light at the End of the Tunnel However bleak and gloomy my description of a resident's life may sound, I beckon the current crop of residents to discover in it the ultimate spring of knowledge and skills. This shields them from adversities and propels them to shine through and come out with flying colors. The undying fervour to embrace and master the subject of medicine and the relentless, persistent, and ever-focused passion is gargantuan in thwarting such stressors of residency. To achieve, they need to believe in themselves, and absorb the concept that the subject of medicine is bigger than the murky rungs of hierarchy and bureaucracy. Embracing inspiration regardless of the source, caution in clinical procedures, developing endurance, inculcating magnanimity, and putting patients’ care first while perpetually updating themselves with advances in medicine, help residents gain focus and stick to ideals in an unencumbered manner. Exercising religiously, austere discipline in time and finance management, displaying adequate gratitude, and acknowledgment for spousal / partner support, spreading cheer, unwinding in a responsible manner, proper sleep hygiene, and staying away from any kind of substance abuse are some of the ways residents can fight the formidable strain of residency. A Request to Senior Colleagues I would also request senior colleagues out there to understand that the output / performance from a resident is exponentially amplified if given that ‘supporting shoulder’ they need, while pardoning their mishaps, most of them unintentional. This only thrusts the harmonious juggernaut of medical care forward, into progress. More than ‘We’ve been there, we went through it too’, the need of the hour may be to think ‘It's all right, we are here for you’. Postgraduation, in that case, will not be a path of thorns, but a catapult projecting one's career to the heights, as it was intended to be in the first place. Questions the Paper Raises Is there a need to understand the degree of stress medical postgraduates go through? Do ideals and aspirations change in such settings of stress? Are there ways to remedy such stress? About the Author Having done MBBS from Osmania Medical College, Gude completed postgraduation in Public Health from Northern Illinois University, USA. He is currently finishing Internal Medicine residency at Medwin Hospital, Hyderabad. He considers the very practice of medicine as nirvana and is ever elated to be a part of it. Apart from medicine he is a literary, poetry, painting, photography and art-in-every-form enthusiast.