What are we training medical students for?

depressed young doctor adjWhen young people go to medical school they are called medical students. They know that they are to learn about medicine. Everything about medical school is about learning about medicine. In fact, every waking moment is about learning about medicine.

We learn about anatomy, physiology, statistics, how to read a research paper, how to do a research project, we learn about diseases, pathology, histology, how to examine patients. We learn the right questions to ask in the right way to get the information that is needed.

We endlessly learn about rare diseases, treatment protocols and how to do various procedures and operations.

Our whole lives are consumed with medical information.

But is this all that there is to medical school?

Of what value is all the medical knowledge in the world if the person holding that knowledge is miserable and unwell themselves, struggling to work and struggling to cope with people?

Of what purpose is it learning everything that there is to learn about ‘medical knowledge’ if we are not preparing our students to be well in life? Continue reading

Work-Life Balance for the busy doctor – my top five tips

theatre-doctorsAs doctors and as medical students we hear a lot about this thing called ‘work life balance’. We know that we need it, we are told that we need it but we are not really told what it is, why we need it and how to get it.

By the very notion that it is called ‘work life balance’ we learn that ‘work’ is a harmful thing to be minimised and that ‘life’ is something completely different, something that we are missing out on when we are ‘working’. This actually only compounds the stress that we are feeling when ‘work’ is ‘taking up’ our time!

It’s definitely unhealthy for us to be working all the time, to the extent that we neglect other areas of our health, physical well-being, neglecting exercise, neglecting good nutrition, neglecting our relationships, our emotional health and well-being and neglecting the need that we have for sleep or rest, or even perhaps other aspects of expression that we feel are vital for our health and well-being.

But work itself is not an issue. HOW we work can be an issue.

We are told that work life balance is taking days off, taking holidays, making sure that we have hobbies etc and we might think that it is having time to go out to restaurants for dinner. These things are fantastic and fun, but on reflection, are these things truly what create consistent day to day great health and well-being for us?

We know and we are told that we need ‘work life balance’ to stop us from burning out or from getting sick. It is important for Continue reading

Doctor Burnout. A World Wide Epidemic.

Burnout is the modern day pandemic affecting the medical profession. It is a condition that many of us are still in denial of. After all, it can’t be seen on a biopsy result or under an electron microscope, so how real can it be?!

Very real.

Up to 59% of doctors are burnt out, and the rates of burnout have increased over the last 10 years. It would be unlikely to consider that this is simply because there is greater awareness of the condition.

50% of medical students and 70% junior doctors are reported to be burnt out.

This is staggering, and these results are across the board globally. Not just the USA and not just UK. These are overall global professional rates of burnout and the rates are deeply alarming.

Even if we had 30% of the profession suffering from burnout, this would still be a pandemic, yet there is not the global attention to this matter that it deserves.

If there was an outbreak of influenza or a critical disease globally that was wiping out even 5% of people and removing them from the work force, there would be a world wide inquiry.

Yet here we have matters where there are 59% rates of burnout, over half of the entire medical profession, including students, and there is no world wide inquiry into what is going on in medicine.

Certainly there is no vaccine likely to be available, but the matter is critical.

Ought not the World Health Organisation be taking a key interest in this matter?

Ought there not be a global inquiry into the culture of medicine and the attitudes of medicine towards doctors and health care professionals? Continue reading

The Silence of the Profession

Many of us in Australia will remember an ad for toothpaste in the 1990s where a man (with a great toned and tanned upper torso mind you) has his back to us whilst he is facing the mirror brushing his teeth. We are told they can’t show us his face, because he is a dentist. Apart from learning about this particular brand of toothpaste (?!) we learn from this that medical professionals are not allowed to be seen in public.

For me this is a great adage of the medical profession where there is some strange notion that we should be neither seen nor heard, and this extends to many in the profession who feel constrained to be seen as a person in public, or to have and voice their opinion in public for fear of being hauled before the medical board, or having their reputation as a doctor undermined or destroyed.

Many doctors will not be on social media, have blog sites or websites, and do not want to have themselves in the public eye, lest something ‘go wrong’ and their reputations be destroyed.

But lets consider this.

Does this even make sense?

Why is it that we would feel that being seen as the person that we are would possibly get in the way of people respecting us professionally. And why do we seek so much to separate the two? Are we really such a Jekkyl and Hyde? Are we one person at work and then some strange demonic being in our private lives that we would not want anyone to know about? Surely not… Continue reading

Why don’t we talk about burnout in medicine?

With recorded rates of burnout up to 85% in medical students, nearly 50% in qualified doctors overall, and burnout rates reported to be up to 65% in some specialties our profession is in crisis. We cannot truly serve ill people if we ourselves are ill, and the doctors that are not burnt out are not necessarily truly well either.

In medicine diagnoses are based on laboratory tests. There is this notion that if there is a test for it, it must be real, and if there is nothing showing on a test then somehow it is not so real. Burnout doesn’t show up in a blood test or an x-ray, so how real is it for a doctor? Can we say that we have a condition for which there are no positive tests results? The medical profession has a tradition of dismissing and ignoring symptoms and conditions for which there are no ‘test’ results.

Doctors are not allowed to be sick – in particular they are not allowed to be sick about their work! To be sick about your work implies somehow that you are not good at your work and that you have failed. To fail at your work is a big ‘no no’ for doctors.

There is a culture in medicine that says that doctors have to be superhuman, they have to be masters of everything, know everything and be everything to everyone at all times. They have to be able to survive on no sleep, be courteous and professional at all times, know everything, give the best diagnoses, be able to cure everyone, along with the social expectation they should do it all for free as some sort of charity, simply for the ‘privilege’ of being a doctor, unlike every other profession where it is understood that you deserve to be paid for your expertise…

Doctors are supposed to be ‘the ones’ with ‘all the answers’. If you are a sick person, treating sick people, then how can you possibly have all of the answers?! Well, this is how the culture goes. To admit sickness, is to admit human frailty and acknowledge the fact that you are not the one with the answers.

In medicine, if you show signs of humanity and sensitivity, in particular signs of not coping, or finding things difficult, you are not supported: you are instead at times bullied, mocked, demeaned and labeled ‘impaired’. There is this culture that has you in fear of being bullied, of being thought to be less than capable and less than reliable by your colleagues.

Continue reading