The role of resilience in medicine

“Sometimes people think of resilience as I can go harder, I can push through. That’s not what resilience is. Resilience is recognising your boundaries, finding time for self-care, knowing what your own personal needs are so that everyone can benefit.”

Dr Zoe Williams, GP and TV presenter, shared this advice for new doctors in a recent interview hosted by MDDUS. Meeting foundation doctors Dr Mel Azate and Dr Vinci Pabellan, it was a chance to open up about her own experiences during training and to find out more about the challenges facing foundation doctors today.

In a profession where up until the 90s resident doctors routinely worked more than 100 hours a week, there can still be an expectation that doctors just need to knuckle down and get on with it. An MDDUS survey found that 68% of doctors felt there was a stigma if they struggled with their mental health, expressed emotions or needed to take time off work to recover.

The impact of pushing to the point of burnout can be detrimental – not only to the doctors themselves, but also for patient safety. Evidence shows that when doctors are well, patients receive better care. Doctor’s wellbeing is a necessity, rather than a nice-to-have.

Dr Mel Azate, who is in her first year of foundation training said:

“Looking after yourself – it’s a responsibility to your patients and to yourself, because you can't be that good of a doctor if you're running on fumes.”

But the factors which contribute to doctor’s burnout – like staff-shortages, patient abuse, or poor infrastructure - are often systemic rather than individual. Leading to some doctors questioning whether more yoga or mindfulness is really the answer. That’s why last year, MDDUS joined other doctor’s organisations in calling for government action to factor doctor’s wellbeing in as a key indicator of a flourishing healthcare system.

However, for doctors on the ground, what can they do right now to make things a little bit easier?

When it comes to finding work-life balance, Dr Williams suggests keeping in mind what you say ‘yes’ to when you say ‘no’:

“At this stage in my career it’s about prioritising family and not always saying ‘yes’ to things.

“Sometimes you’ve got to say no, and to put aside the guilt that comes with that. Instead, think about what you’re able to say yes to because you said no. Which for me might be putting my son to bed.”

Without the structure of medical school, Dr Azate has had to learn to set her own routine on the ward to make sure she gets the self-care fundamentals right:

“As a medical student, you have a lot of gaps in your day where you can take your breaks. They're pretty well structured. But as a doctor, nothing is structured. And if you go the entire day not getting up from the desk and doing notes, no-one will say, “did you stop for lunch?”

“I think that's something I had to learn to put in as an alarm. Like, 12 o’clock: if you haven’t eaten, maybe do that and take a bit of a moment for yourself. It's very easy to forget that.”

For the full conversation, covering both the challenges and the achievements of starting out as a doctor go to: 

https://youtu.be/9kpP8VNMkCw

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