Feeling burned out?

[marigold60]

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I feel like I'm getting burned out in my Psychiatry residency program and not learning due to my own fault of keeping quiet in fear of getting on my PD's bad side. He is a sweet guy but the place is very busy and I am not getting enough supervision or guidance with a lot of what I am doing. I am constantly looking at uptodate articles while taking a majority of my work home with me. I know that I am working 3X as hard as the folks in other programs from med school and have completely neglected my duties as a parent as my kids are asleep by the time I come home from work.

I just feel like I am not cut out for this much volume and I would like to go to a smaller program as I cannot multi-task several things at once at this age. I was wondering how should I word my desire to go to a PGY2 position for this reason? I really get along great with everyone, but due to the constraints of my health and my obligations as a parent, I truly cannot afford to be a social worker, nurse and resident all in one. I feel like a big part of my problem is that I can never refuse work no matter how bizarre the demands are, I just always fear of upsetting someone or someone taking an administrative action against me.

Thanks for any tips

 

[Bacchus]

I feel like I'm getting burned out in my Psychiatry residency program and not learning due to my own fault of keeping quiet in fear of getting on my PD's bad side. He is a sweet guy but the place is very busy and I am not getting enough supervision or guidance with a lot of what I am doing. I am constantly looking at uptodate articles while taking a majority of my work home with me. I know that I am working 3X as hard as the folks in other programs from med school and have completely neglected my duties as a parent as my kids are asleep by the time I come home from work.

I just feel like I am not cut out for this much volume and I would like to go to a smaller program as I cannot multi-task several things at once at this age. I was wondering how should I word my desire to go to a PGY2 position for this reason? I really get along great with everyone, but due to the constraints of my health and my obligations as a parent, I truly cannot afford to be a social worker, nurse and resident all in one. I feel like a big part of my problem is that I can never refuse work no matter how bizarre the demands are, I just always fear of upsetting someone or someone taking an administrative action against me.

Thanks for any tips

Residency programs inherently, at least from what I have seen as a PGY in FM at my program, get the shaft on their clinic sites. I am a SW, nurse and resident all rolled into one. During night hours if I want to leave on time, I room some of my patients. Otherwise, the 1 MA there for 4 residents (while a nurse is doing triage) will do it but I'll be very far behind. The paperwork SW helps with and the auths nursing helps with is appreciated, but there is still a great deal. I don't think you'll be able to get away from this.

 

[Crayola227]

You're doing this with right attitude as far as not making any waves with admin. And neglecting your kids. You're doing it right, keep up the good work and you'll finish.

Try to go somewhere else, and you might end up with no residency slot and then I guarantee your kids won't be better off.

Read the other threads about the grass is greener mentality.

 

[Shikima]

It doesn't get any easier and you can't leave. Just keep working forward and think ahead only 1 day at a time. Be sure to plan vacations around your children for you to be able to recharge with them. When you finish in a couple of years, you'll have a lot more freedom - will take you a year or 2 to decompress from Residency, and you'll be spending that time in learning how to live a more balanced and healthy life.

 

[j4pac]

Parental guilt and medicine go hand and hand. Welcome to the club.

 

[Crayola227]

Leaving or even ATTEMPTING a transfer could spell a total career ender (maybe not, risk is there).

I would only do it if I thought burn out was going to lead to death by suicide, medical error (both can be career enders so in that case nothing to lose trying to get out) or you hate the specialty. Switching from one program to another w/in specialty is a big no-no, especially PD to PD (they have a code not to poach residents from each other).

The fact that you're afraid to upset admin is a great attitude!

You could try resident swap, but you'd have to come up with a compelling reason that has nothing to do with the program personally "Aunt Jemima is getting on in years failing health, need to try to go back home" and even that could make enemies.

Also wherever you go may be worse, even if it's not you'll be learning a new system and being a new PGY2 at non-advanced position residencies, you're new kid on the block, likely subject to increased scrutiny, and no established comraderie with seniors and peers (all uppers are new to new interns). You will be clueless to the sociopolitical issues and will not know how to navigate the attendings there, who may have less patience with you because they subconsciously are wondering why you're not as on point as the PGY2s who have the advantage of experience with them.

No one feels supervised enough (and you may not be) everyone feels overworked, everyone does more social work than they should (although some places are better about this than others).

Smaller programs do not necessarily lead to less work. In fact, I would argue more. Often the teams have to be smaller meaning less able to spread the work to faster peers to help a lagging one, if anyone is sick or goes out more slack for the ones left to pick up. Smaller programs can mean less money in institution = less ancillary staff, and can mean higher volume as well as they work each meager resident to the max (could be less work if private service is well staffed, cherry picked patients), and can be worse if the private side of things likes to dump social nightmares and poor patients with crap insurance to your service/clinic. I don't know how psych programs work anyway.

Also my understanding is psych intern year looks like most medicine intern years, AKA massive suck. Things may get better as PGY2 but you may not reap that benefit if you go elsewhere new.

Everyone has a fantasy intern year, hell, the whole residency, of escaping to somewhere better. You're a resident. For all intents and purposes there is no better. There is only suckitude.

 

[Doctor Bagel]

Also my understanding is psych intern year looks like most medicine intern years, AKA massive suck. Things may get better as PGY2 but you may not reap that benefit if you go elsewhere new.

Everyone has a fantasy intern year, hell, the whole residency, of escaping to somewhere better. You're a resident. For all intents and purposes there is no better. There is only suckitude.

In my program, PGY1 and PGY2 years were way more intensive in terms of hours than PGY3 and PGY4 years. PGY2 was actually a bit more intense than PGY1 but maybe better because it was all psych and nothing horribly painful like emergency medicine (you could not pay me enough to ever repeat that month). PGY3 might have been as stressful because we worked at a lot of different sites, but the hours were way better with generally free evenings and weekends. PGY4 was ridiculous -- like I think I maybe worked 30 hours a week or something. So yeah, it gets better. I agree that I wouldn't necessarily transfer based on intern experiences. It might be worth talking to upper levels to see what they think about work after intern year.

 

[marigold60]

I guess i needed to just vent, I feel like I'm only 1 person who has to do multiple roles. I wish I could get away from this.

 

[Arcan57]

I guess i needed to just vent, I feel like I'm only 1 person who has to do multiple roles. I wish I could get away from this.

That painful stretching feeling is called personal growth. It's perfectly appropriate to vent about it as long as you're careful who you're venting to. Stick with it and you'll be surprised how things that seemed ridiculously hard a year ago are second nature. Having a mother with a successful career who is able to support herself and her family to use as a model for who to be (girls) or how women should be (boys) has value that's significantly greater than being able to tuck them in every night.

 

[dozitgetchahi]

Also wherever you go may be worse, even if it's not you'll be learning a new system and being a new PGY2 at non-advanced position residencies, you're new kid on the block, likely subject to increased scrutiny, and no established comraderie with seniors and peers (all uppers are new to new interns). You will be clueless to the sociopolitical issues and will not know how to navigate the attendings there, who may have less patience with you because they subconsciously are wondering why you're not as on point as the PGY2s who have the advantage of experience with them.

You bet. The thought of leading up a handful of new interns on night float in a new system with zero supervision as a fresh PGY2 with no knowledge of the EMR/way the hospital works/etc is utterly terrifying. It's tough enough to evolve into that role after having had a year to know the lay of the land etc.