Finally An Attending...But Still Unhappy?!

Finally An Attending...But Still Unhappy?!

This is a common belief for medical students, residents, and fellows. This often gets them through the grueling hustle of years of inadequate sleep, ridiculously long hours, never-ending tests….the belief that someday, in the dreamland that is attending-hood, they will have finally MADE IT. Sure they will still have the cognitively demanding career of being a physician, but they will finally be able to sleep and have a life and enjoy the life of being a doctor who actually makes a decent living. All the things we want to finally be able to do (be a real doctor without supervision, start a family, buy a house, travel, etc) are unfortunately dampened by the harsh reality and realization that becoming an attending isn’t all it’s cracked up to be.

Several factors contribute to the persistence of patterns, poor coping mechanisms, chronic overworking, and high standards even as individuals transition to attending physicians.

  1. Institutional Culture: The culture within healthcare institutions, often shaped during training, can perpetuate high expectations, long working hours, and a focus on individual achievement. These norms may persist into attending roles.
  2. Professional Identity: Physicians may internalize the identity cultivated during training, where overworking and high standards are perceived as essential for success. Shifting this identity can be challenging.
  3. Workload and Responsibility: As attending physicians, while gaining more autonomy, the workload and responsibility remain significant. The demands of patient care, administrative tasks, and ongoing professional development contribute to sustained stress.
  4. Financial Pressures: The burden of student loans and the need to maintain a certain standard of living may drive attending physicians to overwork. Financial pressures can exacerbate stress and contribute to a persistent activated state.
  5. Cultural Expectations: Societal expectations around the medical profession, including a culture of sacrifice and dedication, can reinforce the tendency to overwork. The perceived need to meet societal expectations can maintain these patterns.

Short-Term Impacts:

  • Physical Health: Increased risk of burnout, fatigue, and sleep disturbances.
  • Mental Health: Higher rates of anxiety, depression, and emotional exhaustion.
  • Work Performance: Decreased job satisfaction, impaired cognitive function, and potential errors in patient care.

Long-Term Impacts:

  • Chronic Health Conditions: Prolonged stress may contribute to long-term health issues such as cardiovascular diseases, autoimmune disorders, and gastrointestinal problems.
  • Burnout and Career Dissatisfaction: A persistent activated state can lead to burnout, reduced job satisfaction, and a decline in the overall quality of life.
  • Interpersonal Relationships: Strain on personal relationships due to time constraints and emotional exhaustion.

Gender Differences:

  • Work-Life Balance: Women in medicine may face additional challenges in achieving work-life balance, balancing caregiving responsibilities at home with demanding professional roles.
  • Mental Health: Studies suggest that women in medicine may experience higher rates of anxiety and depression compared to their male counterparts.
  • Professional Advancement: Gender disparities in opportunities for professional advancement and leadership roles may contribute to additional stressors for women physicians.

Addressing these challenges requires systemic changes in medical culture, prioritizing work-life balance, and fostering environments that support physicians' well-being. Advocacy for policy changes, mentorship programs, and initiatives promoting diversity and inclusion can contribute to a healthier and more sustainable medical profession for both men and women.

We can continue to use our voices and experiences to create change. I would argue that the stakes are far too high not to do so. What are your thoughts about this topic?

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Cynthia A.

Physician ? Internist ? Iconoclast ? Life Sciences ? Biology ? Botany ? Chemistry ? Ornithology ? Mycology ? Impossibly Curious ? Social Justice ? Mom ? Lifetime Learner ? Journey = Destination ? Meliophile ? Aesthete ?

9 个月

More like, I’ve been an attending for over 15 years, and things haven’t changed for the better at all. And now I’m wondering if holding onto hope for the next phase after the kids are off to university. Will it be any better?

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