Staying Well While Treating the Sick

06 Jan 2022

By Dr. Brienne Ryan

Trying to stay well is no easy feat in the time of COVID, for both those in the medical field and those not. Many of us who have weathered the oscillating storms of this virus over the last two years find ourselves entering the New Year with yet another wave of nauseating apprehension and dread. What will the next few months look like? Will elective cases be canceled again? Will I graduate with enough cases? How will I deal with another COVID variant?

Even before COVID descended upon our lives, surgical programs across the country had started to adopt a wide range of policies embracing “wellness.” With its ambiguous definition, wellness remains an elusive concept in the surgical world, often eliciting a clash of opinions between the new generation of surgeons and the old. Gone are the days of the 100-hour work week, long stretches of back to back call shifts and post-call operations. One of the earliest manifestations of modern residency wellness may be the transition to an 80-hour work week and the acknowledgement that residency could provide adequate training without the grueling hours and harsh teaching environment. More recently, wellness initiatives across surgical programs have included things such as complimentary meals, group events, access to therapists, and time off. What impact these initiatives have on overall wellness within a given residency is variable. And this may be the nature of wellness itself. Highly variable. It is by no means a “one size fits all” concept. More importantly, it is a work in progress – being molded and contoured by each successive surgical class, impacted by the environmental and social challenges of a given year. For those of us who have endured nearly our complete residency being intermittently interrupted by COVID restrictions, wellness may simply be a return to normalcy.

As the leader of a residency program wellness committee, I find myself constantly struggling to conceive new ideas for wellness initiatives. The most meaningful and successfully implemented policies developed organically. As an intern, I suffered a profound personal loss. Mixed in with feelings of grief and shock were guilt, fear, and disappointment. Guilt when my fellow interns had to pick up an extra call shift. Fear of asking my chiefs for more time with my family. Disappointment in myself for not being able to recognize or express what I needed most while mourning. A few months later when the opportunity to participate in a committee dedicated to implementing wellness endeavors was presented, I eagerly volunteered. I wanted to enact changes that would allow subsequent residents to feel that they could voice their concerns, feelings, and challenges without the stigma of weakness that has become woven into the fabric of surgical training. As surgical residents, it is a deeply ingrained habit to keep our heads down and plow forward with persistence and resilience. Generations of surgeons before us cultivated an environment that emboldened fatigued, burnt-out residents to stay a little longer…work a little faster…be a little tougher. Those of us who have embraced wellness are aggressively fighting this narrative, but it often feels like an up-hill battle. The pushback can come from all sides – and sadly, from within ourselves.

I am proud to be part of a residency that has embraced wellness as an important educational tool. Initiatives have ranged from wellness days off after weekend shifts, to dedicated debriefing sessions after emotional encounters, and of course, all the gatherings that COVID will allow. We listened to each other when we said what was most important in our lives, and we changed our policies to reflect that. Whether it be including significant others at all work-related outings or changing the framework of teaching sessions, the changes enacted reflect the concerns and wishes of our collective group, because the most important concept of residency wellness is listening to the residents.

Mastering wellness is an ongoing task. If you are interested in developing a wellness program at your residency, there are numerous resources available through AMA, AAMC and even a cursory search of PubMed will supply you with jumping off points.

Stay well in the New Year.

Brienne Ryan is a current PGY3 surgical resident interested in pursuing a fellowship in Vascular surgery. She completed her undergraduate degree at Syracuse University followed by a Master’s degree at Roswell Park Cancer Institute. She obtained her M.D from the University at Buffalo. Her interests include surgical education, surgical wellness, and research focusing on quality initiatives and pre-operative optimization.





Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.


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