How to Have a Balanced Life From Residency and Beyond

Perhaps you’ve dreamed of becoming a doctor for as long as you can remember. Now that you’re in medical school, the finish line is in sight. But what happens after you finally cross it and are a practicing doctor? What can you expect and how will the demands of healing others affect the rest of yourprofessional life? 

Residency is the toughest time of a doctor’s life, said Anjali Bharati, DO, an attending physician in the emergency department at Lenox Health Greenwich Village in New York City. 

“Your time is spread so thin. You have so many responsibilities in addition to learning the art and craft of medicine. It’s a very stressful and rigorous time,” she said.

Maddie Mitchell, DO, a first-year resident in the emergency department at Long Island Jewish Medical Center, Northwell Health in New Hyde Park, New York, agreed and said it can be exciting and overwhelming, especially at first. 

“You are in charge of your patients, you call the consults, you put in the orders, you admit or discharge the patients, you explain lab and imaging results — good or bad,” she explains. 

You can’t escape the stress of the job, said Sanjay Desai, MD, chief academic officer for the American Medical Association. But it’s part of the privilege of being a physician. 

“No matter how much medical training you’ve gone through in medical school, for the most part, you have not had the experience of what it is to be accountable for the health of that patient sitting in the bed or chair in front of you,” Desai said. 

Finding ways to manage it early on will set the foundation for a healthy work-life balance throughout your career.

Strike a Healthy Balance

Medscape’s Physician Lifestyle & Happiness Report 2024 looked at how physicians try to do this. 

Over 9000 doctors in more than 29 specialties completed the online questionnaire. It asked how they mind their mental and physical health and keep a good work-life balance: 

• 78% spend time with friends and family
• 71% do activities or hobbies they enjoy
• 67% exercise

About half said they also try to eat well and sleep more. 

Younger doctors tend to prioritize personal and family time more than their older colleagues: 78% of those under 45 say it’s very important; whereas 67% over 45 said the same. 

“I think for these younger physicians coming in, it is not a secondary priority. It’s a major part of what they are looking for in their careers,” said Dan Shapiro, PhD, executive director of the Chartis Center for Burnout Solutions, a Florida company aimed at helping hospitals lessen burnout and high turnover rates among doctors and other healthcare providers. 

Younger doctors are having “as much of an influence on the field as the field is having on them,” Shapiro said. They emphasize work-life balance, self-care, and mental health. Medical schools and residency programs are responding, Shapiro said. 

Learn How You De-stress Best 

Mitchell, 27, said she makes time to see friends for dinner in New York City at least once a week. She keeps in close contact with her family in Marietta, Georgia. After a long day, her pets keep her grounded as well. “My two cats are always so excited to see me!” 

Take a cold hard look at what helps you de-stress and brings joy, Desai said. Maybe it’s dance, playing in a band, spiritual or religious beliefs, or something else. 

When you’re matched into a program, you’ll know where you’ll be living — which could be in a place far from home. Do the work to build your support community before you arrive for your first day on the job, Desai said. 

For instance, if attending a particular house of worship is what keeps you grounded, look into which ones might be a good fit for you beforehand. 

It’s likely you won’t be alone. In the Medscape survey almost 70% of physicians said they have a spiritual or religious belief. 

Get to Know Yourself 

Residency is a time to get to know yourself: the time of day you are at your best and brightest, the things that energize you, and the things that make you stressed, Bharati said. It’s also the time you can figure out how your medical career fits into the kind of life you want to lead in the future, she said. 

“From my personal experience, I knew early on I wanted a flexible schedule,” the married mother of two said. “I wanted to be able to travel and to have days on and days off. I knew that if I did 12-hour-long shift work, I would be around for my ‘potential’ family and friends for longer stretches.” But, on a workday, she knew she would be completely consumed by work. 

She said having longer stretches of time off restores her soul. “In the ER, we call it ‘work hard, play hard.’”

Voice Your Concerns 

To head off potential problems that could stress you out even more, communicate your personal issues to the residency director right away. Many young doctors don’t reach out until they’re in a crisis, Desai said. That’s too late. Your director can steer you to support available before you need them. They can put you in touch with others in the program who have similar needs or come from similar backgrounds. 

Don’t stop yourself from sharing because you fear it will make you look too vulnerable, Desai said. “You’re joining a family that wants to help you succeed. The more they know about you, the more they are able to help. That first few months as a resident is a very lonely time,” he adds. 

“Talk to your co-residents and the seniors (in the program). It will help you feel less alone. If you don’t know something, ask for help,” Mitchell said. 

Fight Burnout 

Burnout is a reaction to chronic stress. It’s a problem that hits doctors particularly hard. You may feel: 

• Emotional exhaustion
• A lack of empathy or negativity toward patients
• Dissatisfied with your work

You also could experience physical problems, such as headaches or changes in diet or sleep patterns. 

Shapiro said a number of factors can predict burnout later in a doctor’s career. He suggests taking these steps to head it off: 

• Don’t rack up debt. Being in a financial hole “drives a constant chase of salary downstream which can be enormously stressful.”
• Don’t ignore your own health. Get a good primary care physician and see them regularly. Ask for a referral to a mental health professional if you need it.
• Connect with others. “I originally thought that young parents would be worse off in terms of burnout” because they are pulled in many directions. But it’s really physicians who are isolated and lonely that struggle, Shapiro said.
• Protect time off. In the Medscape survey, 73% of doctors said taking vacations are keys to happiness and good mental health. But doctors often aren’t truly “off” when they’re on vacation. They spend a lot of time calling into the practice, checking in on patients, and more. Try to get someone to take over your patient load when you’re off, if that’s possible.

The patient portal is another thing that can cut into doctors’ time and add to stress. Delegate patient questions or other “paperwork” associated with the portal to assistants or others who can do it. 

Find Meaning 

Most people go into medicine because they treasure the patient-physician interaction, Desai said. “That’s what easily gets lost when we are sitting in front of a computer a lot of the day or we have busy schedules and we’re tired.” 

Find small moments to find meaning. Leave the computer outside the patient room and talk to them about their fears. Hold their hand. Go with them for a test or procedure. 

“These are the very human moments that can get lost in the busyness of the process. But they can be powerful antidotes to burnout,” he adds. 

Even at her young age, Mitchell has figured this out. “Being able to comfort patients on their worst day is very rewarding. Oftentimes patients are very thankful for your help — not all the time, but those thankful patients stick with you.”