Working in biotech and healthcare analytics, I happen to know his boss’s boss, and began contemplating giving him a call about his rogue resident. I pondered, observed, and sat in introspection. My distaste for him as a physician evolved into mercy, as I became mindful of what this young man had endured, and probably goes through on a daily basis. My envisaged phone call to his boss’s boss changed from a complaint against this resident to a direct complain against one thing: the medical education system.
Frederick Douglass wisely said, “it is easier to build strong children than to repair broken men.” This resident, along with 70% of residents in the U.S., is a broken man. I’d bet during that during his undergraduate career he was caring and patient, and his journey through a toxic system tore his cardinal traits from his expressed identity. The system is at fault, not the resident. He was probably yelled at and ridiculed 30 times that day, had no time to eat a normal meal, has no social life, and was on 3 hours of sleep. How could anyone, our family included, expect this resident – a human being, not a programmed robot – to perform any better? I am not justifying his behavior, but to cure a disease the diagnosis must precisely detect the cause.
We’ve come to a place where the best and brightest of our students are committing suicide at an alarming rate. We talk about it, we write about, but a doctor still kills himself daily in America. Daily.
The entire residency community needs to be open minded and vulnerable to scrutiny, for it is specifically in that domain where true evolution may occur. In reality, hundreds of people write about this, sit on committees and even implement new work-protective rules for residents. Nevertheless, if we are all honest, this communal culture hasn’t changed. Granted, a few residency directors have drastically shifted their focus onto resident well-being, and I guarantee those residents will become outstanding physicians. Hospitals covering up suicides, the continuous stereotype threat around clinicians obtaining the psychological support they need, and the encouragement of lying about the 80-hour work limit are all partially liable for the quality of residents the system is churning into attending physicians. Residents prepare themselves for their training career as if they were going to war in Iraq. Is that what we want? Can that person relate to the pain and suffering of just another dying man? Absolutely not.
That night, the resident was not to blame. He can’t flourish in a toxic environment. It is time to heed Frederick Douglass’s advice and begin building mentally strong physicians from day 1 of medical school. With that integral piece in place, patients will witness a shift in healthcare administration. Certainly, this is not the 1 factor holding back the medical field. Medical school education, insurance reimbursements, the interoperability of medical records, and physician responsibilities within the hospital setting need grand restructuring as well. Yet, working on our providers’ well-being, happiness, and work environment is a great place to start. Society owes this to the resident community, and to the patients they nobly serve.
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