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EPISODE 76:

Stress in Medicine: Lessons Learned

Stress in Medicine: Lessons Learned Through My Years as a Surgeon, from Med School to Residency, and Beyond

Host:

Mohit Bhandari, MD, PhD, FRCSC
Editor-in-Chief, OrthoEvidence

Guest:

Nina Ahuja, BScHons, MD, FRCSC, CHE
Academic Division Head, Ophthalmology
Associate Clinical Professor, Department of Surgery
McMaster University, Hamilton, ON
Founder, Docs in Leadership

PERSPECTIVES

Drs. Ahuja and Bhandari discussed stress in medical professionals. Our discussion uncovered four core themes. These themes and their supporting insights are highlighted below.

1. There is a need to challenge the culture of silence in medicine

Drs. Ahuja and Bhandari discuss that surgery is a high stress occupation, and this is introduced almost immediately to medical students and residents. In addition to the high stress, there is a competitive nature to the occupation which breeds a hesitation to share challenges and experiences with others. Considering this, there is a need to foster an environment of transparency and openness where discussion of challenges and stress is encouraged.

Because the nature of our profession is very unique, we are often exposed to different experiences that other people are not and it is emotionally intense in many ways. So, the idea […] was to encourage people to be open about the challenges they face so that we can support one another as colleagues who can understand the context.

Dr. Ahuja

2. COVID-19 has presented new challenges and new opportunities

The emergence of the COVID-19 pandemic has resulted in drastic changes, both personally and professionally. With changes to how hospitals and schools operate there are high levels of stress, particularly in students and trainees, as there is uncertainty with regards to their programs. At the same time, for some people the pandemic has provided some time to reflect and reset themselves.

When we look at surgeons, at least in many communities, there was a 70% decline in usual day-to-day work activities. There were a lot of surgeons who were really uncomfortable and I might even say ‘stressed’. There was another group of surgeons that were calm and somewhat reflective. It seems there were many reactions to the challenges experienced.

Dr. Bhandari

It really resonated with me that the residents and medical students were all in a level of stress that is unlike what we faced when we were going through medical school and residency, which is stressful enough, simply because of all the uncertainty.

Dr. Ahuja

3. There are several features and manifestations of stress

Drs. Ahuja and Bhandari discuss the manifestations of stress, as well as personal traits that may impact how we cope with challenges in our professional lives.

Number one is a general feeling of being overwhelmed, where you lose clarity in what you are trying to actively work on. There are three components. There is the psychological component, there is the physical component, then there is the cognitive component.

Dr. Ahuja

I am more introverted by nature. We tend to go inward and not really discuss our feelings openly. I can’t get perspectives from other people who may have something valuable to contribute. From the extraversion standpoint, there is the benefit that you are likely to reach out. But […] where the introvert often sits quietly and reflects, the extrovert may not have that, and in order to develop that inner awareness of where those roots of reaction are, what your stress manifests like, you do need to have that period of quiet reflection.

Dr. Ahuja

4. Change is at the root of stresses, but there needs to be an openness to change

Dr. Ahuja posits that change is a common cause of stress, and has developed a framework to help manage stress caused by change:
 
Adapting to new ways
Doing the work
Measuring success
Introspection
Transformation

Questions and Answers:

Dr. Bhandari: What would it be like if we just lived in the present moment, not worried about the past, not worried about the future? How does one actually achieve that?

Dr. Ahuja: That I think is challenging for us, and for people in general. For us as physicians, simply because we have so many responsibilities, we are always being pulled in different directions. Whether it be work related, family related, or otherwise. To be able to stop and be still is challenging because there is so much that needs to be addressed in the day. My feeling for myself is that it is important to do that, […] whether I’m taking a few moments in a quiet room at home or lying in bed and just listening to the silence around me. That is how I’m able to get centered into that moment.



Dr. Bhandari: If you were to give any words of advice to a medical student, a trainee, a resident, or even a faculty member in orthopaedics or surgery who is feeling overwhelmed, what should they do at this point?

Dr. Ahuja: I think the biggest thing to keep in mind is wherever there is a problem, there is a solution. You just have to be patient and willing to find it. It sets up the mindset that allows opportunity to come to you and the hope of resolution.



SENSE-MAKING

Drs. Ahuja and Bhandari discussed stress in the medical profession, as well as how to better understand how you react to and handle stress. When dealing with stress, it is important to both share your challenges with others in order to gain support and insight, as well as to take time to personally reflect to better understand the root causes of your stress.

Link to purchase the book: "Stress in Medicine: Lessons Learned Through My Years as a Surgeon, from Med School to Residency, and Beyond"

https://www.amazon.ca/dp/B08N6TN2XX

How to Cite:

Nina Ahuja. Stress in Medicine: Lessons Learned Through My Years as a Surgeon, from Med School to Residency, and Beyond OE Perspectives. 2020; 1(7):1.