Motivation in Residency
by Roberto De Los Santos.
When it comes to medicine, you will deal with a lot of stress, overwhelming decision making and failures in your life. There will be times when you second guess yourself, or may even think of quitting. This lifestyle is temporary, residency isn’t forever. to get through the rough times you will have to find your own purpose in your specialty field of medicine and use it for daily motivation.
Residency, The Next Chapter
As a podiatry resident you will incur and endure a lot of disappointment. There will be moments where you will be frustrated; you are going to feel down; and feel like you are not moving forward in your life. The truth is, residency is not only the next stage of your education, it’s your JOB. You must treat it seriously because this will forever be your job. You will have deadlines, projects, file data, meetings, paperwork, track your surgery numbers, wake up early, and stay up super late. If you are looking for a moment when you are able to say
“Yes! I finally made it, all my hard work has paid off, now I can relax”,
… then residency isn’t it.
It is only the beginning of a much harder chapter in your life.
This is because in residency, everything is more hands-on and a wrong decision can have a severe cost. You are expected to learn the NEW language of hospital medicine, the NEW language of computer charting system, the FLOW of the operating room, the CRAFT of doing surgery, and the DISCIPLINE to have your personal paperwork and portfolio completed for you to graduate from residency. You are thrown into the ocean and expected to learn how to swim on your own. Yes, there will be mentors and co-residents to help at times, but in the end, you are THE DOCTOR. You have to learn to either sink or swim.
With any new chapter in your life, you will face personal emotional investment. When things don’t go according to plan, you will meet anxiety, burnout, and depression first-hand. Anxiety comes from fear, panic, uncontrollable care, trauma, or a level of high burden (1). Burnout is physical exhaustion from giving it your all in your residency training (2).
These are all negative words, and too much negativity in your work will affect your personal life. Many residents don’t talk about it, some hide it, and others work through it. The reality is that you are expected to make medical decisions for the treatment of others, but live in the denial of trying to diagnose and treat yourself. With an increase in suicides seen in residency from all specialties, we have failed as a medical profession to acknowledge and treat this topic.
What is Motivation?
Motivation is a word we have all heard, but don’t know how to really define it. If you look in the Merriam-Webster dictionary,
the definition of motivation is the act or process of motivating.
Motivating is defined as to provide with a motive.
Finally, motive is something that causes a person to act.
It’s hard to describe it, but you see it in other people. You may have even listened to quotes or inspiring words from others or purchased a book on motivation to help you during your tough times. Influencers such as Les Brown, Tony Robbins, Michelle Obama, and the Dali Lama to name a few, are constantly delivering a path to self-guidance and powerful sentences that propel many people to continue.
Can the words of the Dalai-Lama really help me perform better surgery or finish this PowerPoint presentation? Not directly, but the continued work of “Motivation” has gained popularity and shows that YOU ARE NOT ALONE. At one point, we will each reached rock-bottom. The good news is that someone has already written about it or wrote a speech about it to help others.
Finding a Foundation
If I can sum up Residency in one word, it would be this – chaos.
Some rotation months will be easy while others will leave you feeling extremely overwhelmed. It is up to you to learn how to control your emotions during this chaos so you can adapt, gain patients’ trust, have respect from your peers, and perform effectively. For the next 3-4 years as a podiatry resident, you must always be prepared for endless adaptation and transformation. You have worked hard for 4 years of podiatry medical school, and you will quickly realize that the textbook answer may not always be the best answer. But now you will need a solid motivating foundation as you learn through trial and error. You need to be able to look into the mirror and:
1) Know your self-worth
2) Find a support system
3) Find your pulse, your purpose
1. Know Your Self- Worth
Like a circus trapeze artist diving into a small cup of water, you have to decide if you are ready to jump knowing you have a small chance of successfully landing.
In your time as a resident, you will meet both hard-working and lazy doctors. Happy and angry surgeons. Helpful and thrown-you-under-the-bus nurses. Good and bad residents. You see the entire spectrum, and all instances are just as important in your overall education.
You have to be able to look into the mirror and realize what you CAN and CANNOT do on your own. You need to learn to accept that you don’t know how to successfully do surgery, don’t know how to successfully write notes and that you are NOT 100% ready to take on the medical field on your own. If you are humble enough to realize that you are not as smart as you thought and you still have a lot to learn, someone will teach you. Yes, you are a doctor, but you still have a long road ahead of you.
“When the Student is Ready, The Teacher Will Appear” – Lao Tzu
2. Find a Support System
It’s amazing how far you can go just because someone believes in you. You need a support system for advice, moral support, mental stimulation, emergencies, and being social. If you want to keep your sanity, you need to find someone to talk to, to vent to, and to pick you up when you are down. No matter what life throws at you, this would be your rooted support in the long run.
“My model for business is The Beatles. They were four guys who kept each other’s kind of negative tendencies in check. They balanced each other, and the total was greater than the sum of the parts. That’s how I see business. Great things in business are never done by one person, they’re done by a team of people.” – Steve Jobs
3. Find Your Pulse
I am not talking about your dorsalis pedis artery. I mean finding your purpose, finding your WHY, your heartbeat. What got you into podiatric medicine in the first place? What is your passion? What do you envision yourself once residency is over?
Just remember, it may feel like your whole world is falling apart, but there are very sick people in the hospital that would do anything to be in your shoes. Getting a bad test grade, getting yelled at by your attending, being punished by the chief resident, or forgetting deadlines are small things compared to a life-changing illness. Thousands of other podiatry residents who are now doctors have been through what you are going through.
Your education is largely affected by what comes through that emergency room at your hospital. You may not appreciate it now, but all those new consults and emergency surgeries will pay off in your education in the long run. Guess what, all those young doctors have witnessed some sort of tough time during residency and all managed to overcome it. Hold on to your WHY and have it in the back of your mind during the stressful, difficult times. Residency is tough, but it’s doable. Don’t give up.
“If you can’t fly, then run. If you can’t run, then walk. If you can’t walk, then crawl, but by all means, keep moving” – Martin Luther King Jr.
by Roberto De Los Santos
(1) Bandelow et al. (2017) Treatment of anxiety disorders. Dia Clin Neuro. Jun; 19(2): 93-107.
(2) IsHak et al. Burnout During Residency Training: A Literature Review. J Grad med Ed. 2009 Dec; 1(2): 236-242
Special Edition, Medical School, Literature Review
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