Author: Leena O’Brien
Reviewers: Bridget Johnson, Katherine Spira, Sarah Dalton
Oh boy did I enjoy those marshmallows! One week of sick leave to focus purely on my mental health involved regular 12 hours of uninterrupted sleep, lazy days reading books, a massage and daily walks in the sunshine. It is no surprise that I was feeling significantly more relaxed and refreshed. Relieved, I knew I still had five weeks of annual leave to look forward to, two of which I had planned to spend at the beach alone. The ocean has always calmed me and a change in scenery was just what I needed. I continued to spend these days resting, cooking gourmet healthy meals, exercising, swimming, and reading fiction novels. Physically, I was well on the path to recovery. Feeling more like myself again, I actively decided to face some hard truths during that time. I was aware I just couldn’t go back to the same job and continue the same path anymore.
Over the course of a few weeks, the crux of my dilemma became more and more apparent: I realised I was not living my life according to my core values. I desperately wanted to cultivate a healthier work-life balance, so I had more time to spend with family, friends and one day have a family of my own. My conflict stemmed from feeling so trapped in an inflexible system. I had lost sight of how medicine could possibly fit into the life I wanted to be living and so, I had often thought quitting the profession all together was the only option. However, I also knew that I would regret leaving after all of the hard work and sacrifice. So, now that I had precious time on my hands, I started writing it all down. I analysed my personal strengths, my weaknesses, my life goals and priorities. I wrote down my ideal model of work-life balance. I then looked at whether my specialities of choice fit into this model. I realised that although my interest level might lie in a particular area, I had to be realistic about whether I had it in me to stick out the training, and most importantly whether the final end point would actually bring me both personal fulfillment and a healthy work-life balance.
After a long period of active contemplation and soul searching, I’d reached a decision. I decided to step off the hospital conveyor belt and enter the world of General Practice. This turned out to be an incredibly difficult decision that I battled with for weeks, as the consultants and registrars who I respected and looked up to viewed leaving the hospital system to pursue General Practice as a sort of failing or last resort. They were actively trying to lure me to follow their path. Upon reflection, I realised I was taking on other people’s values and opinions and not listening to my own calling. I personally had always been open to a career in General practice, and once I started to explore it as an option I became more and more excited by my decision. Although it required me to return to the hospital system to complete some core terms, I did so with renewed energy levels and a clear goal in mind and that made all the difference. In fact, I even enjoyed my time in the hospital system again. Taking my journey back into my own hands was the key to feeling hopeful again.
Now, 10 years on, I am a very happy qualified GP fellow. I now reflect on that challenging time in my life as a turning point that I am proud of. I listened to my gut instinct, honoured my personal core values on a quest for work-life balance. I have found a career where I am my own boss, and in essence can control my own hours, earning potential, and my leave. As well as being flexible, it’s stimulating, challenging and rewarding. I have time to cultivate relationships both at home, and with patients and the community. I am valued in the workplace and still feel part of a team. I can honestly say that I now love medicine and am very proud to be part of this profession. Put simply, it enriches my life.
So what is the best path of action if you find yourself struggling with similar issues? In summary here are my top tips and advice on how to survive burnout and cultivate the work-life balance you deserve:
1. Burnout prevention
- regular relaxation
- enhancing your problem-solving skills
- setting stronger personal boundaries
- debriefing with family and friends
I couldn’t agree more. If you start your intern journey being mindful of the importance of these things, you are more likely to have a healthy buffer.
2. Burnout recovery
If you find yourself in my shoes where despite attempts at all these things, the scale remained tipped off centre, the path to recovery from burnout is in essence two-fold:
- restore your energy levels and develop more effective coping skills
- minimise your future exposure to stressors in your workplace (or change your workplace environment if you have to)
As a junior doctor, neither one of these is easy to achieve but it is essential. It means you will need to actively take time out to sleep, eat well, exercise, relax, and spend time with family and friends to restore your emotional and physical balance.
Changing your workplace is a challenge due to long standing cultural expectations placed upon you as a junior doctor to work hard and not rock the boat. Hospitals are understaffed and this results in long hours to provide adequate patient care. You can however, start by learning to delegate and set some personal boundaries. Saying no for me was a learnt skill. Have the courage to speak to your department about your struggles.
With the implementation of better workplace health and safety strategies such as limitations to the hours worked, an increase in staffing, and more junior doctor support programs, my hope is that the hospital work environment will slowly improve. Continuing to speak out to create an increase in public awareness is one avenue to encourage change.
3. Assess your values and create the life you want
The other factor that I believe is crucial for long-term burnout resilience and recovery is living life according your core values. This involves figuring out what these are and then making sure your workplace and career decisions are in alignment with your priorities.
Ask yourself the following questions:
What is most important to you in life?
For example, is it cultivating strong relationships, having a family of your own, having enough time for travelling and relaxing, career advancement, or having financial security? Most people would want to achieve all of the above, but the key is to identify which of these will bring you the most happiness and fulfilment.
What do you need to recharge and how can you ensure you leave work at work?
Having a good work-life balance will never be achievable unless you understand your personality and where you gain your energy. For introverts, regular solitude and meditation might be the key, for extroverts, making sure you spend your free time with others will recharge you for another day. Make a list of the things that relax you the most and create a ‘wind down’ plan.
What is most important to you in a work environment?
For example, consider if you prefer working as part of a large team like a hospital environment or private practice, how much patient contact you’d like, the level of control you want over your hours, holiday schedule, and weekend work, how much time is required away from family, where most of the jobs are located (rural or urban) and your scope of practice (very focused or broad).
And what does your ideal work-life balance picture look like?
Is it working 10 hours a day 5 days a week, or is it more like 3 days per week? How do you feel about weekends and shift work? Would you sacrifice some income for more free time or is financial wealth or career advancement more important to you?
Where do your interest areas lie? Is your chosen speciality in alignment with your life priorities, personality, preferred work environment and work-life balance goal?
If there are serious conflicts here, then you may need to look at your options again and consider a change in direction. No career in medicine is likely to be 100% perfect, so you need to be able to willingly acknowledge and accept the consequences and personal compromise that a career path will require.
It’s all food for thought. I hope that sharing my journey will empower you to realise that you are in control your own destiny. Doctor burnout is real, and very common. We all need to speak out about our experiences so our fellow peers will feel less alone and seek help early. I implore you to regularly recharge your energy levels. Achieving a healthy work life balance is not an easy feat, and there will be times when your balance will be temporarily lost. However, through practice and commitment, you will become more resilient. So instead of giving up on medicine please know that once you learn the art of recharging, and manage to find a niche that is in alignment with your values, I promise you, the rewards will follow. After years of sacrifice, you will finally get to eat all of your marshmallows. And life will taste a little sweeter.
- Reachout.com article titled “Burnout and Chronic Stress”. Available from: https://au.reachout.com/articles/burnout-and-chronic-stress
- Avant.org.au article titled “Dealing with Burnout”. Available from: http://www.avant.org.au/member-benefits/doctors-health-and-wellbeing/your-health/physical-and-mental-wellbeing/dealing-with-burnout/
- Mindtools.com article titled “Burnout Self test”. Available from: https://www.mindtools.com/pages/article/newTCS_08.htm
- Mindtools.com article titled “What are your values?”. Available from: https://www.mindtools.com/pages/article/newTED_85.htm