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Staying Human During Residency Training

Staying Human During Residency Training

Allan D. Peterkin
Copyright Date: 2008
Pages: 162
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  • Book Info
    Staying Human During Residency Training
    Book Description:

    Known as an invaluable resource by thousands of doctors across North America,Staying Human during Residency Trainingis a concise manual designed for medical students, interns, residents and fellows in all areas of specialization. Covering every aspect of a resident's life from choosing a residency program, to coping with stress, enhancing self-care, and protecting personal and professional relationships, this fourth edition updates important material with new references, resources, and websites.

    Containing an expanded section on learning and teaching, this new edition also has an increased emphasis on balance, personal values and professionalism. With the same vitality of previous editions, Dr. Allan D. Peterkin provides hundreds of practical tips on coping with sleep deprivation, time pressures, and other issues of concern for hospital residents, while also discussing ethical and legal matters, issues pertinent to women, parents, as well as international, and minority students. Offering advice on how to deepen relationships with colleagues, friends, and family, and to foster more empathic connection with patients, he also offers practical antidotes to cynicism, careerism, and burnout.

    Informative, compassionate, and professional, this new edition will again show whyStaying Human during Residency Trainingis a veritable bible for medical students and new physicians pursuing postgraduate training.

    eISBN: 978-1-4426-8919-0
    Subjects: Health Sciences, Education

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-x)
  3. Foreword to the Fourth Edition
    (pp. xi-xii)
    Susan Edwards

    I accepted the newly created position of Director of Resident Wellness in the Postgraduate Medical Education Office at the University of Toronto in July 2006. My understanding of the issues of physician health were essentially experiential, albeit close to my heart, but the opportunity to develop a unique, innovative program to support residents and educators find personal and professional balance was one I couldn’t resist. The first thing I did was pick up a copy ofStaying Human during Residency Training. The second was to pick up the phone and call Dr Allan Peterkin, who has been a wise advisor...

  4. Preface to the Fourth Edition
    (pp. xiii-xiv)
    Allan D. Peterkin
  5. An Appeal to Educators
    (pp. xv-2)
  6. CHAPTER ONE Body and Soul: The Risks of Residency Training
    (pp. 3-15)

    Residency training can be stressful, but it also provides many opportunities for great personal and professional development. Interns and residents are not fragile; they are bright, compassionate, and dedicated men and women who are eager to learn. Along with medical students, they make up approximately one-fifth of the physicians workforce in the United States and Canada. It is striking, however, that some of the character traits that lead many people towards a career in medicine are also predictors of eventual impairment.1, 2, 3

    High levels of responsibility, intense contact with people, time restrictions, role uncertainty and transition (i.e., from student...

  7. CHAPTER TWO Preventive Medicine: Choosing a Humane Residency
    (pp. 16-25)

    Until 10 years ago or so, graduating medical students, when choosing a residency program, focused more on the program’s reputed standards or prestige than on the quality of life they could expect during that 4- to 6-year period of their lives. They sometimes based their choices on hearsay or information acquired by chance. In interviews they concentrated on practical questions such as the size of a program or the opportunities it offered for research. Because selection was highly competitive, students seldom introduced other, more human concerns for fear of appearing demanding or not sufficiently dedicated. Increasingly, medical students are figuring...

  8. CHAPTER THREE Physician Heal Thyself: Taking Care of Your Body
    (pp. 26-39)

    No one has studied the nutritional status of physicians in training or their particular needs, but several known factors suggest that they do not eat well. Stress and lack of sleep may suppress the appetite or lead to increased consumption of junk food or caffeine. Time pressure, and poor quality or variety of hospital cafeteria food, often make residents decide to skip meals entirely. The hypothalamic response to prolonged stress – such as occurs in residency – results in increased turnover of protein, carbohydrates, and fats and, if severe, may deplete vitamin and mineral reserves. This is itself a physiological...

  9. CHAPTER FOUR Staying Whole: Maximizing Supports and Finding Balance
    (pp. 40-57)

    Chapter 3 suggested ways of safeguarding physical health by improving your eating, sleeping, and exercise habits. This chapter discusses two important strategies for protecting your mental health: establishing adequate support systems and maximizing a sense of personal control and balance.

    Relationships with family, friends, and colleagues are discussed in chapter 5, since most residents tend to go to these individuals when experiencing difficulty. Other types of support that you might not have considered are available from the following people, groups, and organizations.

    Surprisingly, many physicians do not have their own physicians, preferring to treat themselves or somehow expecting preferential care...

  10. CHAPTER FIVE Protecting Personal and Professional Relationships
    (pp. 58-84)

    The stresses of training that tax residents will also affect their couple life. Residents’ lack of time, exhaustion, absence, and general unavailability often produce conflict at home. Because most residents’ partners also work outside the home,¹ scheduling of quality time and household duties is complex. Historically, wives of physicians score high on interpersonal sensitivity, depression, and hostility scales.² Husbands of physicians may feel threatened by their wives’ success, level of responsibility, or income and decision-making power. In his book,Doctors’ Marriages: A Look at the Problems and Their Solutions,³ Myers points out that the key stressors for the married resident...

  11. CHAPTER SIX One Size Does Not Fit All: Unique Concerns
    (pp. 85-98)

    Back in 1989, when the first edition of this book came out, 44 percent of Canadian medical school graduates were women, compared with 6 percent in 1959 and 33 percent in 1981.¹ In 1990, 30 percent of all medical residents in the United States were women; by the year 2010 it is predicted that over half of all U.S. physicians will be women, although the 1989 AMA Women Physicians Health Survey put it at 29.4 percent.¹ In 2003 the number of women enrolled in medical school surpassed 50 percent in many provinces in Canada and had reached 52 percent by...

  12. CHAPTER SEVEN Whiz Kids: Teaching and Learning with No Time
    (pp. 99-110)

    Effective study seems virtually impossible when you are tired or overworked. Decreased sleep, anxiety, physical discomfort, and high noise and distraction levels have variable effects on the desire to learn, memory, reading capacity, concentration, and task performance. The housestaff member who has a weekend or evening off is unlikely to study because of a need for sleep or social contact; he or she may then feel guilty and inadequate. Study when you are relaxed as you will learn and retain more.

    Be aware of your preferred learning styles and which one to use in different circumstances. (Most people’s learning styles...

  13. CHAPTER EIGHT Not Just a Job: Professionalism, Ethics Issues, and Legal Considerations
    (pp. 111-126)

    In 1996 the Royal College of Physicians and Surgeons of Canada introduced a framework called CanMeds for medical education, which established core competencies for all doctors. Seven key roles of the doctor were identified (¹

    Medical expert



    Health advocate




    The Royal College defined this last role as follows:

    ‘Physicians are committed to the health and well-being of individuals and society through ethical practice, profession-led regulation, and high personal standards of behavior. Physicians have a unique societal role as professionals who are dedicated to the health and caring of others. Their work requires the mastery...

  14. CHAPTER NINE Taking Care of Business: Managing Your Finances
    (pp. 127-139)

    The complete details of budgeting and investing and of planning and setting up a practice are beyond the scope of this chapter. In Canada, more information can be obtained from the Canadian Medical Association and the MD Management Limited network. This network also offers superb tax, financial set-up, and financial counseling seminars, preferred loans, and other services to Canadian medical residents in training. In the United States, the American Medical Association offers some practice-related workshops,¹ and further financial information can be obtained from unions, the Committee of Interns and Residents (CIR), the American College of Physicians (ACP), the American Association...

  15. CHAPTER TEN Iʹm Finally Done: Now What? Thoughts on the End of Residency
    (pp. 140-147)

    In Greek mythology, Procrustes was a robber who pretended to be an innkeeper on the road to Athens. Travelers seeking success in that city would stop at the inn, where Procrustes would tie them to a bed and adjust them to its length, cutting off the limbs of those who were too tall and stretching those who were too short. He was eventually killed by the hero Theseus.

    Residency is truly a modern ‘Procrustean voyage,’ where conformity, even to deforming principles, can be the price of success. Musical, creative, playful, spontaneous, even romantic aspects of our lives may be cut...

  16. CHAPTER ELEVEN Knowledge Is Power: Helpful Web Resources
    (pp. 148-160)
  17. Index
    (pp. 161-164)