The views and opinions expressed in this collection are those of the authors and do not necessarily reflect the positions of the Association of American Medical Colleges.
Anastasiya (Stacy) Haponyuk
University of New Mexico School of Medicine - MS-IV
Stacy is an upcoming IM-Psych intern at UC Davis and is passionate about reinvigorating the medical field with humanism, optimism, and collegiality. "I hope to use combined training to provide compassionate care to people going through their greatest struggles, whether that’s substance use treatment or palliative and oncologic care. When I am not 'doctoring away,' I enjoy looking for the best tacos, sipping some strong espresso, and practicing yoga handstands."
I remember going to the pediatrician as a child and being in awe of the sterile clinic and the kind, yet daunting man in the white coat that would let me play with his instruments while he snuck in an exam maneuver. I would watch as my mother listened to his every word, entrusting her child’s well-being to this single person. Embarking on my journey as a new intern, I cannot help but remember this dynamic between patient and physician. The immense trust that our patients put in us is stirring, humbling, and nerve-racking. When taking care of people during their most difficult times, the margin of error is minimal. It becomes easy to forget that we physicians are also fallible people, who need respite and above all, self-forgiveness.
When we fail to remember our own fragile humanity, is when we are most prone to burnout. My hope is that by raising awareness of the subtle signs of burnout, physicians will not only be introspective of their own “internal battery”, but also unfaltering advocates for the mental and physical health of their colleagues. Without further delay, here are three subtle signs of burnout I have recognized throughout my medical training.
Sign #1: Emotional Lability
If you notice yourself getting easily irritated, lashing out at friends and family, or feeling defensive about constructive feedback, you may be experiencing the initial signs of burnout. As you become emotionally exhausted, small triggers like your upper level asking you to improve your note-writing or a friend cancelling your lunch at the last minute can easily trigger negative emotions. When you notice these feelings entering your mind, write them down along with the trigger. This allows you to become more aware of your emotions while simultaneously releasing these negative thoughts.
Sign #2: Increasing Cynicism
Throughout training, you may run into medical professionals who present as overly cynical. In their eyes, patients with chronic pain and severe substance use disorders become “drug seekers” and “frequent fliers” as opposed to people requiring even more compassion, care, and understanding. This cynicism is never appropriate when caring for others, and it is important to examine the emotional lens that providers with this viewpoint look through. From my experience, cynical providers are experiencing burnout and have lost the purpose behind their initial career choice. They are no longer able to identify clear reasons for entering the demanding yet rewarding field of medicine. The next time you notice cynicism in your thinking, write down one reason why you entered the medical field and one act of kindness you experienced throughout your workday for a week. Sometimes, returning to your “why” is exactly what you need to regain perspective.
Sign #3: Falling Behind on Household Chores and Self-Care
I think we can all remember a moment during finals week when the only thing in our fridge was milk, and there was a pile of laundry haphazardly strewn in a closet. While momentarily living with a pile of laundry in your closet is understandable, note if you are repeatedly ignoring these responsibilities. When we become burned out and overwhelmed, it is tempting to retreat inward and ignore our surroundings. If you notice yourself procrastinating chores and self-care, consciously set aside 15-20 minutes of time at the end of your day to tidy up your house, take a bath, or prioritize yourself. Make sleep a priority and force yourself to get 7-8 hours of shuteye each night.
These three subtle signs of burnout are based on my own personal observations and are not meant to be comprehensive. They are the initial signs I have noticed in myself and my colleagues when the stress of the medical field becomes paralyzing. It is my hope that by recognizing these initial signs, you can reach out for help from licensed professionals to diminish burnout and decrease the devastating prevalence of depression, anxiety, and suicide within the medical profession. While our patients look to us for guidance, we must care for each other as much as we care for them.