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MEDICAL STUDENT

PERSPECTIVES

BEST TO ADDRESS THE THREAT OF PHYSICIAN BURNOUT
EARLY IN YOUR CAREER

By Lorelle Knight

Most practicing physicians are familiar with the threat of physician burnout. Most know
of a colleague who quit their career or have been required to attend lectures and discussions
about avoiding compassion fatigue. Perhaps they’re even overly familiar with the thought:
“would I do this all again, given the chance?” To a preclinical medical student trying to decide
what specialty she might go into, however, the honest details of physicians’ satisfaction with
their career choice can be difficult to figure out. And to some physicians, it can be difficult
to admit to aspiring doctors what they wish they’d done differently.

Before beginning medical school, I had the opportunity to scribe in an emergency de-
partment in north Texas. For one year, I got to know these physicians, and at the end of my
time there I asked a dozen of them individually: “Would you go into emergency medicine
again if you could do it all over?” I received candid, heart-felt answers, and throughout my
preclinical years I have made a point to keep in mind what they said.
To my surprise, about a third answered some version of “no” and let me write down their reasoning. Dr. “D,” for example, would
choose medicine again but not her specialty. “My husband and I decided we were going to raise our kids ourselves and not get a nanny,
and it’s been exhausting,” she told me. She explained that she was very career-oriented before having kids, but since having children
she’s wished for much more time with them. She also mentioned that, in another life, she would have been a “dean of students or
something” because she missed teaching. Since I myself am interested both in having children and in academic medicine, I highly valued
her honesty.
Dr. “T” wasn’t sure if he’d even choose medicine again. “I feel like I would have liked to invent things. I miss being able to create
and design stuff,” he told me. In his opinion, his field did not have enough creative opportunity, and while he was aware of that potential
while in medical school, he didn’t appropriately consider how much it mattered to him before applying to residency. Because of him,
I’ve thoroughly thought through how much I value room for innovation in my own future.
Others mentioned the emotional toll of certain aspects of medicine, the feeling that they were treating patients who were “just going
to go home and not take care of themselves,” and the frustrations of trying to achieve a good patient satisfaction score from a patient
whose first words were “I just need Dilaudid.” Their honest remarks have benefitted me more than these physicians likely ever predicted;
rather than dissuade me, they’ve enabled me to address these issues now and have prepared me to face similar ones in my future.
Most of these doctors spoke very positively about their decisions. The aspects of their careers that made them happiest included
feeling like they were well taken care of by their institution, feeling like their peers were satisfied, having enough time to take family va-
cations, appreciation from their patients, and the ability to maintain their hobbies outside of medicine. Dr. “P,” in particular, told me:
“I think I get even more satisfaction out of it now than I did when I got out of residency,” just after suggesting that I never quit setting
goals for myself.
Talking openly with these physicians about their personal experiences was one of the most important things I could have done to
prepare myself for deciding on a specialty. I’ll be pursuing emergency medicine even after everything I learned, and because of our
conversations, I feel my decision was wholly educated. I’d like to encourage all physicians, whether they interact with aspiring doctors
regularly or only on occasion, to be as candid as possible with us. We look up to the generations ahead of us, but we also want to learn
from any regrets and hear about any difficulties as well as thrills. I’ve been fortunate to have these doctors’ honest perspectives in mind
during my preclinical years, and I charge all physicians to speak openly with my peers and myself when given the chance.

Lorelle Knight is an MS2 at UTHSA

28 San Antonio Medicine • January 2018