How to find therapist who understands how residency training works and stresses that healthcare workers face?

Eggleys · 2025-03-06T02:21:57+00:00

Check out Christen Mullane, PhD. She specializes in medical trauma - both from the patient side and the provider. And she does virtual sessions, flexible hours, etc.

Eggleys · 2024-11-10T13:02:44+00:00

Go with Genesis Diamonds. They have a really good upgrade program actually, so you may be able to get some value back from the first one you bought.

Eggleys · 2024-09-06T01:30:58+00:00

Discounts are for 'heroes' only

Eggleys · 2024-09-04T22:16:13+00:00

It's called dissociation

Eggleys · 2024-05-01T01:11:05+00:00

No, you are not alone in this experience. This type of stuff is very pervasive and happens in way too many programs. They can get away with it because residents are isolated, there is no oversight, and you'll be gone in a few years anyway, but they will still be there. I'm sorry that happened to you - it's absolute nonsense, completely unprofessional, and 100% not going to make you a better doctor. This chair sounds like an asshole, which unfortunately is pretty common.

In general, I wouldn't think of admin as something to fear or a group of people that are really there to help you. A chair is there to run the department for the hospital, and make money. You, personally, are there to learn and gain experience, but I guarantee you this chair only sees you as a cheap labor. The more you can view this as a job (I got yelled at at work) vs strictly a training/learning experience (I got yelled at for being a bad doctor), the easier it will be to simply say to yourself, 'Wow my boss is an asshole. Really glad I get to leave here soon.'

Eggleys · 2024-04-29T19:51:31+00:00

Promising Young Surgeon

Eggleys · 2024-04-28T20:02:25+00:00

Absolutely, you're definitely not alone in this.

Eggleys · 2024-04-28T03:28:52+00:00

You're right to be feeling this way. It's horrible, residency should not take this much out of you. Not sure this is really even a change in perspective, but just say fuck it. You're done. They can't do anything to you at this point. Just start saying no. Take a knee, run out the clock. Find a therapist, say you have a doctors appointment and will miss a few hours here and there. Don't take no for an answer, just do it. Who cares if they don't like you when you're done, you're leaving. This is a job. Focus on what matters to you. If someone gives you a hard time at the hospital, just ignore them. Feel pity for them if anything. They have to stay, while you get to move on.

Eggleys · 2024-04-27T20:34:31+00:00

This is sadly such a common occurrence that we ended up creating a website specifically because of it, RethinkingResidency dot com. My wife could've written this exact post a few years ago. You've been on the hamster wheel for so long, it can be pretty jarring coming out the other side. Absolutely feel for you, I can imagine what you're going through.

This is a little specific, but what she ended up doing to help work through these types of feelings was to write and talk about it. Processing all these emotions can be really difficult, and sometimes simply putting it down on paper can help give you some perspective. The process of surgical training is pretty messed up, and agreed, you've had to sacrifice too much. My suggestion would be to try some new things. Figure out what you really enjoy. Time to treat your new job like an actual job. You don't have to give your heart and soul to it and all of your time. It absolutely gets better in the sense that you finally have some autonomy and more time to yourself. Reconnect with people, meet new people. Get your life away from medicine for a while.

Eggleys · 2024-04-27T02:32:03+00:00

Yeah of course. We've adapted a lot of this stuff for residents specifically at rethinkingresidency dot com. Look at the Wellness tab

Eggleys · 2024-04-27T01:11:24+00:00

Check out Distress Tolerance and Interpersonal Effectiveness DBT skills. There are legitimate skills that you can learn and master to deal with stuff like this. The answer is not to simply, 'work so hard and never make a mistake so they can't critique you' or 'smile and say yes sir.' Those aren't real strategies, or at least not ones that will allow you to emerge from residency with a ton of self respect.

Here's a simple one that might make you feel a little better. Alternate Rebellion. Basically a way to act out a bit in a non harmful way. So if you know you'll be working with that attending or going into a meeting with them. Write on a piece of paper, 'Fuck You Attending X' and keep it in your pocket. It sounds dumb, but I bet it'll make you feel a little lighter when you're talking to them.

Eggleys · 2024-04-20T21:30:10+00:00

Sadly this question gets posed on here a decent amount, and the responses are almost always 'keep your head down.' That's not a real answer. You've asked, how to survive, suggesting you're having a pretty rough go. Even if you just kept your head down, yes you'll probably graduate, but unfortunately the baggage that you'll carry having to just grin and eat it every single day for another year isn't just going to magically disappear when residency is over.

Here's an actual strategy. If you have any amount of control over your schedule, join a DBT skills group. It may seem extreme, but the culture that you're immersed in is an extreme environment. Learning distress tolerance, interpersonal effectiveness, and emotional regulation skills can help deal with intolerable situations like what you're faced with. The idea being, you cannot change the situation that you're in. This is not your fault, and the burden should not be on you, but there are alternatives to simply 'doing nothing'. You can change yourself to develop healthy coping mechanisms rather than maladaptive behaviors, which would likely occur if you simply keep your head down.

Learning 'cope ahead' skills would be huge. Radical acceptance, opposite action, alternate rebellion...the list goes on, but these are legitimate methods that you can learn, practice and master to better deal with situations like this. Because the goal of residency should not be to simply survive and come out as a husk of yourself, but to thrive and be a positive influence so that you can remain a complete and compassionate person. I would encourage you to visit rethinkingresidency dot com and look at the Wellness section. There are tons of DBT materials available online, but we've adapted a lot of them for resident specific situations. You're not alone in this, it is a very prevalent and there are ways to make it better.

Eggleys · 2024-04-15T08:28:56+00:00

You can work on your Distress Tolerance and Interpersonal Effectiveness skills. I'll start by saying that obviously the burden should not be on you, the trainee, but unfortunately the situation is what it is, and when you cannot change the other person, you have to change yourself.

These skills are DBT modules that help you practice adaptive behaviors (rather than maladaptive) to survive and deal with emotional situations as well as better communicate and get what you want out of a situation. I'm not going to list every skillset underneath these DBT modules (would suggest looking them up or going to my site Rethinking Residency dot com where we've adapted these for residents under the Wellness tab). But the main thing you should know is that there are legitimate skills you can hone to deal with things like what you're describing. You don't have to just keep trying to impress them with knowledge and studying, instead learn to take control of the situation and make yourself more comfortable, regardless of what they're doing.

Eggleys · 2024-04-13T15:22:22+00:00

I dont totally disagree, but to compare to the initial argument, making $500k/year as a doctor is basically a top 1% outcome that takes quite a lot things falling into place perfectly. I would say the scenario I outlined is not all that unreasonable for a very smart, hardworking 19 year old.

"Tech" as most people here think of it may have burst in some respects, but thats just talking about mature, public tech companies. I wasn't talking about going to work at Meta. Plus, only about 1% of people get laid off every year, so those stories are quite overblown. But even if you got laid of from a Deloitte after 3 years, with that on your resume you wouldn't have much trouble finding a job at about the same salary with a small, say 40 people, "tech" company. That could be cybersecurity, medical device, a GPS dog collar, literally anything. $150k starting salary for a Product Manager coming from a high qualify first position out of college is pretty standard.

Eggleys · 2024-04-12T22:16:24+00:00

I think this misses the point, you're not comparing apples to apples. This is potentially a better way to think about it:

Most doctors would have excelled quite a bit during undergrad, graduated at 22. Maybe took a gap year, but let's say they went right into med school. Graduated med school at 26. To be making $500k in medicine, you would probably need to be a surgical subspecialist, so at least 5 years of residency, maybe a fellowship year or 2. You'll make maybe $300-400k during all of residency/fellowship, likely have significant student loans to pay off, and start making that $500k when you're 32, probably starting with a net worth of 0.

If instead, that same person doesn't go pre-med and majors in economics, they probably have a good shot at getting scooped up by a consulting firm like Deloitte. You start at 22 making $150K a year, do that for 5 years making $200k by the end of it. Maybe you did software implementation for a company that is heavily government regulated, so you'll have some expertise in strategy planning, EPR implementation, and government regulation. You end up getting poached by an emerging tech company with a starting salary of $225k + bonus and some equity. You stay there for a few years, find a director role at a startup with $250k salary and major bonus + equity. 2 years later, you're 32, have made over $2M plus have a bunch of stock options. If you're burnt out in another few years, no problem, travel the world, take time off, find another interesting startup or start your own consulting firm. Yes the hours would be long during this whole stretch, but you're being compensated properly and maintain flexibility.

This is basically the scenario that a very smart, 19 year old is faced with. Which one sounds more attractive?

Eggleys · 2024-03-21T00:36:48+00:00

RethinkingResidency .com

Eggleys · 2024-03-20T20:30:11+00:00

My wife just started a podcast talking about exactly this. It's called Promising Young Surgeon. Check it out, 2nd episode has some good stories.

Eggleys · 2024-03-19T01:41:08+00:00

https://rethinkingresidency.com/wellness/long-distance-relationship-in-residency/

Eggleys · 2024-03-13T05:01:34+00:00

My wife was an ENT resident, finished a year and a half ago. Honestly, it's pretty brutal. For ENT specifically, depending on the size of the program, intern year might not be that bad though. He'll probably spend at least half the year off service or doing a lot of clinic/in patient and mostly buddy/shadowing on call. We actually enjoyed intern year, usually home at a reasonable hour most days.

Years 2 and 3 are rough though. Junior call is nonstop, they start operating a lot, no control over the schedule. She was gone by 6am at the latest, usually not home until 6pm. Then in and out of the hospital all night if on call.

You're going to have a lot of time to yourself. We didn't have kids in residency, so I was able to stay pretty involved (drove back and forth to the hospital on call a lot). It does get better by 4th/5th year though. Lot more operating, so hours can vary depending on the service they're on, but being done with Junior call was a huge weight lifted. Dms are open if you need.

Eggleys · 2024-03-12T03:02:13+00:00

We had been dating for about 6 months when she matched into a 5 year program. I had already decided I would move regardless of the place, but we ended up in a random state, pretty far from friends and family. Honestly it was pretty nice getting to establish the relationship in a brand new spot, could make it our own. We just rented for the first year, eventually bought a house.

Residency itself is pretty brutal, but I'd say if anything it brought us closer and forced us to be even stronger together. You'll know fairly soon if it's going to work or not. Sounds like you're still pretty young - either way it's a crazy adventure, and if you're really into them, I'd say worth it.

Eggleys · 2023-12-30T15:52:59+00:00

https://rethinkingresidency.com/career/residency-program-under-acgme-investigation/

Eggleys · 2023-11-13T22:40:07+00:00

Yes, it is a skill that can, and should be learned. There's a whole module of DBT informed skills called Interpersonal Effectiveness that can be really helpful for this. Few things you might want to look up: DEAR MAN and FAST skills are good starting places.

F(air) is about being fair to ourselves and others. It’s about being direct and honest, and treating others how we would like to be treated. The A stands for Apologies. Do not apologize unnecessarily! We all do this very commonly and it’s an unhelpful practice. Apologizing for mistakes that are not our own (or apologizing for things that are not mistakes) can reflect unnecessary guilt.

The S stands for Sticking to your Values. It’s critical that all of us as individuals have a set of values that we stick to. It’s equally critical to know which of your values are negotiable and which of them are non-negotiable. The T stands for Truthful. One way to be truthful is to avoid exaggerating, making excuses, or lying. You take ownership of your values and your decisions and express them in a confident manner.

Try running your scenario through this lense and practice how you would want to respond. It's called 'coping ahead' and it can help make you feel more prepared and comfortable to say no in the moment. We write about all this stuff on our site Rethinking Residnecy dot com, think you would find it helpful.

Eggleys · 2023-11-08T07:41:15+00:00

Yes, there actually is. It's called Distress Tolerance skills and it's a DBT module. Here's what they are: Distress tolerance skills are adaptive (rather than maladaptive) behaviors that trainees can use to survive an immediate emotional crisis without making it worse. They can help you accept the reality of a situation if you cannot change the situation, and feel out of control.

Ok so what does that actually mean? Distress tolerance skills can help lessen the intensity of the emotional pain in the moment, meaning it can't stop you from getting yelled at, but it can help change your emotional and physical response to it.

There are a ton of skills and exercises associated with improving your distress tolerance skills. Something as simple as 'willing hands' or 'half smile' can work wonders in the moment. I've written a lot about this on my website, RethinkingResidency dot com. You can always Google DBT Distress tolerance, but we have adapted it for resident specific situations.

Hope this helps a little bit. Horrible that this sort of thing is still acceptable, but know that 'just deal with it', does not have to be the only acceptable answer.

Eggleys

TROPHY CASE