Program Director’s Corner – January 2019
Physician, Heal Thyself!
David Lieb, MD
Program Director, Endocrine Fellowship Program
Eastern Virginia Medical School
I wanted to introduce myself – I am David Lieb, and I am the Program Director for the Endocrinology Program at Eastern Virginia Medical School in Norfolk, Virginia. I’ve been program director for four years, and was the associate PD before that. I am proud to be the 2019 APDEM Newsletter Committee Chair, and will be reaching out to you all in the coming months, asking for ideas for our newsletter, and for articles that we can post. I’m honored to follow Dr. Rich Auchus, who was our first Newsletter Chair, and who has really blazed the trail for me to follow. I’m also excited to work with all of our wonderful program coordinators, who we all know are the real directors!
At our monthly Graduate Medical Education Committee meeting this month, we discussed resident and fellow wellness. We are entering the 3rd quarter of the academic year – a time that is particularly difficult for our fellows. They may be back in the hospital again, on a busy consult service, while at the same time trying to get a research project off the ground that they started in July or August. They are presenting what feels like their 100th case conference, and a maybe a journal club too. And it’s likely cold and snowy, or rainy, or windy where they are. And they miss their families. You get the picture. We watched an important short video on preventing medical trainee suicide that I would highly recommend you share with your fellows. Link here:
Maryann Dundon touched upon wellness in her excellent Program Coordinator’s Corner post in April 2018 (Importance of Wellness). In it she talks about some of the awesome things they have done at the Allegheny Health Network Program in Pittsburgh, and I recommend everyone read about their experience.
While we discussed resident and fellow wellness at our GME meeting – we didn’t get into program director wellness too much. In some ways, when compared with peers in other specialties, endocrinologists seem pretty happy. The just-released 2019 Medscape Physician Lifestyle and Happiness Report shows that endocrinologists are among the happiest doctors (outside of work), and have higher self-esteem than many of our peers (https://www.medscape.com/slideshow/2019-lifestyle-happiness-6011057). And the Medscape Physician Compensation report from 2018 (https://www.medscape.com/slideshow/2018-compensation-overview-6009667) reported that 82% of us would choose endocrinology again.
But the 2019 Medscape National Physician Burnout, Depression and Suicide Report (https://www.medscape.com/slideshow/2019-lifestyle-burnout-depression-6011056) shows that endocrinologists are among the most likely of all physicians to report feeling ‘burned out’ (47%), and don’t seem likely to seek help (26%) when feeling burned out and depressed. Only 26% of us report being happy at work. It’s hard to know quite what to make of such surveys given the small number of participants, and it’s not clear how many of the endocrinologists included were in academic positions.
The Physician Compensation survey also notes that Endocrinologists are in the bottom three of all specialties with respect to salary (and dropping), and finances weigh heavy on many of us. Seeing patients and trying to make financial ends meet is stressful enough, but having the added responsibility of caring for fellows and a fellowship program, along with teaching and research responsibilities, can be overwhelming. And it’s especially hard when many in your division look up to YOU to set the tone – you have to be happy, and have it all together – because if the fellowship director doesn’t…who can?
So what to do?
Well, I’m certainly not perfect, and not happy all the time (ask Natalie our program coordinator) – but here is my simple list of things to consider working on and trying during these drab winter months.
Have a mentor – this is especially important for early program directors and associate program directors – link up with a program director that has significant experience and can help you setting up programs (like a QI program for your fellows), and responding to fellow needs with which you may not have had much (or any) experience. This person may be a PD in another medical subspecialty, or another endocrinology PD that you meet at a conference, or the previous endocrine PD at your institution.
Check on and care for your colleagues in medical education – consider organizing an outing for the associate PDs and PDs at your institution – something simple – going out for dinner, or to see a movie. A gathering at someone’s home. It doesn’t need to be much. Just something social. It’s rare that I don’t feel better after talking with colleagues going through similar things.
Do something fun with your fellows – again, it doesn’t need to be much. Have them over for pizza. Maybe do a case conference or a journal club off-site at a restaurant. It’s good for them to see you happy – and it’s easier for you to be happy and feel fulfilled when they are happy too.
Make friends through social media – I’ve been enjoying getting more involved on Twitter – #EndoTwitter – there are a handful of us right now – but it’s fun to set up polls and ask questions, post good ideas and fellowship accomplishments.
Seek help – early – Your institution most likely has a pathway for you to see a therapist, and you may need to meet with someone to discuss medications if needed. Don’t wait – if you notice that you aren’t doing as well as you feel you should be – seek help.
Don’t multitask – it doesn’t work. When you are with friends and family, be with friends and family. Don’t try to do a significant amount of your work from home if you know it only makes you feel guilty. You’d be surprised how much you can get done with two solid hours on a Saturday morning BEFORE your day really begins – and you’ll feel much better spending your non-work time later in the day.
Use your vacation time! Plan ahead – and not just for work-related meetings. Visit friends, go on trips with your family. When the kids have a teacher-work day – make it a 3 day family vacation. But use it!
Exercise, meditate, sleep, eat right, yada yada yada – we all know this. But the important thing is making time to plan meals, pack your lunch so you aren’t eating crackers, etc. And remember – if you aren’t well rested and healthy, your fellowship program won’t be either. And if you can’t make a 7am meeting because it interferes with your time to care for yourself, that’s okay. Make it clear to others that it’s a priority for you.
At our upcoming APDEM meeting at the Endocrine Society meeting in New Orleans we are hosting a presentation by Dr. Stuart Slavin – Senior Scholar for Well-Being at the ACGME. Dr. Slavin is an internationally-known expert in the area of medical student and resident well-being, and I’m looking forward to hearing his thoughts about fellows, fellowship programs and program directors.
I hope this list is helpful – just some friendly reminders. Take care of yourself, and take care of each other.