Resilience in Residency: How medical residents can overcome burnout

May 13, 2019 10:00 AM

Author: Chloe Wilcox


Seeing Megan Fix, MD, an enthusiastic and confident emergency medicine physician and Director of Education for Emergency Medicine at University of Utah Health, you would never guess that she struggled with depression and suicidal thoughts as a resident. On April 17th, she spoke to current residents about the hardships that she faced, and how everything changed when her chief resident asked her a simple question:

“How are you really feeling?”

Fix had been struggling for some time, and had never thought to bring it up to anyone else, especially not the chief resident. “I was crying every night,” she explained. “I just felt like I was drowning in my own self-loathing.” She had even begun to picture herself riding her bike into oncoming traffic during her morning commute to work. Hearing this question and seeing sincere concern in the chief resident’s face allowed Fix to finally escape the tight hold her depression had on her. 

The chief resident referred Fix to counseling, and with the help of the program director they later coordinated a wellness curriculum for her fellow residents. They began having monthly dinners together and brought in outside speakers to work with the residents. Fix soon learned that her peers were going through similar hardships. She realized that she was not alone, and that she never had been.

“Once I started opening up, other people came out with similar issues, and got problems solved by connecting with these resources,” explained Fix. She recounted to the residents that “it’s not ‘if’ your classmates or other colleagues in the hospital will suffer with depression and burnout, but ‘when.’” 

Speaking to her own experiences, Fix explained that during residency she had moved into a new apartment by herself and was often alone with her own thoughts. She felt incredibly inadequate, especially when compared to her peers. “At this time in my life, I was in this sea of feeling terrible all the time, every day,” Fix continued. “It was very miserable, but I thought I just needed to get through it, because I was a resident and that’s what we do.”

Recent surveys show that the demands of the profession are taking a toll on doctors nationwide. According to General Surgery News, 40 to 60 percent of practicing physicians experience burnout. Intense workdays, demanding pace, time pressures, and the emotional intensity of the workspace can lead to burnout. Rates of depression and suicide are around two times higher for physicians when compared to the general population.

Fix spoke to the fact that these issues are extremely specific to the profession. “As physicians and trainees, we are always looking at how we can be better for the outside world,” she insisted. “We have a lot of pressures on us. We are constantly facing negativity, and it is really hard to actually be healing to yourself.”

In order to help fellow residents, Fix demonstrated a simple three-part procedure: ask, listen, and refer. When talking to peers about their struggles, she explained that the residents must clarify by asking direct questions. Asking is followed by listening, to determine their needs. Finally, if appropriate, Fix recommended referring them to resources.

When dealing with their own struggles, Fix urged the residents in the room to begin to recognize when they need help in order to access the resources available to them. “You have to be vulnerable and realize that there are so many support options available to you.”

Fix also explained that being resilient is the key. “There will always be ups and downs, and challenges, but that’s what resilience is. Resilience is being authentic and knowing that you are going to be okay despite the bumps in the road.”

If you are a Resident experiencing burnout, anxiety or depression, contact the GME Wellness Program at GMEwellness@hsc.utah.edu or 801-213-8753. Faculty and Staff in need of assistance can contact the U of U Health Resiliency Center at resiliencycenter@hsc.utah.edu or 801-213-3403. Either group may also contact the Employee Assistance Program at 801-587-8319 or 800-926-9619.