The demands of medical residency can leave anyone feeling drained at some point, but burnout, which stems from chronic, mismanaged work pressures, goes beyond periodic fatigue to a sense of persistent and total depletion that causes one to question if they are even in the right profession. Medical resident burnout can seem particularly daunting at such an early career point, but knowledge, awareness, and a commitment to action provide hope against this catastrophic condition. 

Residents face an uphill battle in the fight against burnout. The very nature and elements of the program are risk factors, such as high caseloads, long hours, and emotionally taxing work. They must fulfill their responsibilities as both physicians and students, two demographics already at an increased risk of burnout. Combine this with doctors facing increased regulations, administrative obligations, bureaucracy, and not to mention the strain of covid. The residency years are notorious for excessive workloads, high-stress scenarios, long shifts with little time for sleep or relaxation, and even berating treatment from attendings and senior residents. 

What To Look For 

Medical resident burnout can manifest in emotions, behaviors, physical symptoms, and lowered performance. It often starts small and builds gradually, making detection difficult without ample knowledge and a keen sense of self-awareness. While burnout can be an all-consuming condition, the warning signs are often subtle. But, knowing what to look for sets the stage for timely action against burnout. Some of the tell tale signs of medical resident burnout are: 

• Emotional detachment – Caring for others is a driving force for many behind the very decision to attend medical school. In contrast, burned out physicians feel apathy towards patients, which can surface as sarcastic remarks, cynicism, or indifference to their experience and prognosis.
• Dissatisfaction with career – Medicine is often more than a career, it’s a life mission. But, burnout can cause a person to question if they are even in the right line of work. While all jobs can be burdensome at times, burnout prevents feelings of reward and fulfillment from work. 
• Inescapable thoughts of work – Personal time away from work is key to finding balance with all the things important to you. Thoughts of work often pervade the physician’s mind, even after hours, on days off, and vacation, leading to and signaling burnout. 
• Physical exhaustion – Medical residents need adequate rest to recover from their intense, draining work, and sometimes this simply isn’t possible with the demands of a residency. However, exhaustion stemming from burnout is not remedied, even with sufficient sleep.  
• Increased physical illness – Burned out individuals are pushed to their maximum capacities, compromising the body’s ability to fight off infection. Lowered immunity can be a sign that the body needs more care. 
• More medical errors – All medical professionals make mistakes, and acceptance of that reality is key to survival in the field. However, burnout, which can compromise an individual’s ability to think, reason, and remember, can lead to a greater number of errors. 
• Substance use – Burned out individuals are at an increased risk of substance use, as it provides an immediate, albeit unhealthy, relief from stress. If you find yourself relying on alcohol or other substances to cope with work stress, burnout could be the reason. 
• Suicidal thoughts – Suicide is the ultimate cost of burnout, as the feelings of hopelessness can leave one feeling as though there is no other option. Having thoughts of taking one’s own life is a definite sign it is time to seek help, and possibly emergency care. 

The causes of burnout are complex and multifaceted, and the best remedies are comprehensive and consider all of these factors. Truly getting to the heart of burnout requires a collective approach from the individual, their support system, and the residency program itself. 

Preventing Burnout as a Medical Resident

As a resident, there are proactive steps you can take to manage the inherent stresses of residency and lower your risk of developing burnout. 

• Take time for relationships – Spending time with loved ones will help nurture social connections that are vital in navigating any stressful situation. 
• Keep things in perspective – Remembering the temporary nature of residency and knowing there is an end in sight can help alleviate feelings of being stuck.
• Stay connected to your mission – Remembering the reasons one got into medicine and the importance of the work can help restore feelings of fulfillment. 
• Focus on learning and professional development – Meeting the basic human need of learning and growth by studying something of interest will challenge one intellectually and help achieve fulfillment. 
• Seek mental health care – Seeking the help of a skilled professional can help develop an individualized strategy to cope with the incredible mental and emotional strain that residents must learn to navigate. This article provides support options that cater exclusively to physicians.
• Spend time outdoors – Taking even a small amount of time to step outdoors offers proven benefits, including improved cognitive performance, mental health, mood, and overall well-being. 

How Spouses and Support Givers Can help

Being the spouse or other supporter of a medical resident is not an easy job. You are in a unique position to give needed support, but the role can drain you as well. It’s important to take care of yourself first, so that you can support your partner. 

• Practice self-care – Simply put, self-care is placing oneself and one’s health as a priority. This could be anything that gives you rest, rejuvenation, and makes you feel like “you” again. 
• Seek social support – Strike up a friendship with other residents’ partners, or even look for a support group, to find support from others who are in the same place as you.  
• Assure them you are there for them – Burnout can leave an individual feeling alone. Make sure your actions show them explicitly that you are there to support them as a partner on this journey. 
• Ask what they need – The needs of burned out individuals can vary widely, and may be different than what one would assume. Asking what your partner needs ensures that you are not only on the same page, but is a sign of your support and solidarity.
• Be a sounding board – Verbalizing thoughts and frustrations can help your partner process what is going on in their life. Listen, actively and without judgment, to what they need to say. 

Your role as a Residency Program Director 

As an administrator, you have the power to address the systemic changes needed to prevent medical resident burnout. 

• Recognize the need for change – Many are recognizing the need for changes to the archaic training schedule of residents that has not evolved along with changes in medicine. Resist the urge to stay with the status quo and embrace change. 
• Listen to your residents – Authentically listening to resident feedback is the first step in both making changes and showing support. This includes creating an environment that encourages and facilitates open communication between residents and faculty. 
• Institute a mentorship program – If your program does not have a mentorship program in place, look at starting one. A mentor can guide residents from a place of experience with a unique understanding of emotions involved and what works versus what does not. 
• Respect time off – Residents need time to focus on themselves and their personal lives. Allow them to do that when they are not on call, and encourage them to take their vacation time.  

There is no universal burnout remedy, and the most effective prevention comes from a collective effort from the resident, their partner, and the residency director. If you are a resident, pay attention to your own health, and reach out for support when you detect something amiss. If you are a partner and sense burnout in your companion, communicate your support and then genuinely be there for them. If you are a residency director, take the lead to implement systemic practices and policies that support the mental health of residents.

Too much is at stake for burnout to take a backseat. With its prevalence, chances are you will be affected by its ravages either directly or through knowing someone you could potentially support.