Being a successful resident physician and graduate student is challenged by many competing life forces. In this paper I comment on these challenges and offer some thoughts on finding a work-life balance that is suitable for me. Keys to this balance include time management, flexibility, self-care, and frequent reflection of goals and priorities. Whereas they are demanding, the challenges of this balance also keep life vibrant and rewarding

Atwell, Karina A

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UNF Digital Commons

Masthead Logo Florida Public Health ReviewVolume 12 Article 122015The Challenging Balance of Being a Physician inTraining, a Public Health Graduate Student, andHaving a Life – A CommentaryKarina A. AtwellFollow this and additional works at: https://digitalcommons.unf.edu/fphrPart of the Public Health Commons, and the Social and Behavioral Sciences CommonsThis Article is brought to you for free and open access by the BrooksCollege of Health at UNF Digital Commons. It has been accepted forinclusion in Florida Public Health Review by an authorized administratorof UNF Digital Commons. For more information, please contact DigitalProjects.© All Rights ReservedFooter LogoRecommended CitationAtwell, Karina A. (2015) "The Challenging Balance of Being a Physician in Training, a Public Health Graduate Student, and Having aLife – A Commentary," Florida Public Health Review: Vol. 12 , Article 12.Available at: https://digitalcommons.unf.edu/fphr/vol12/iss1/12Florida Public Health Review, 12, 67-68.    http://www.ut.edu/floridapublichealthreview/   67  The Challenging Balance of Being a Physician in Training, a Public Health Graduate Student, and Having a Life – A Commentary   Karina A. Atwell, MD  ABSTRACT Being a successful resident physician and graduate student is challenged by many competing life forces. In this paper I comment on these challenges and offer some thoughts on finding a work-life balance that is suitable for me. Keys to this balance include time management, flexibility, self-care, and frequent reflection of goals and priorities. Whereas they are demanding, the challenges of this balance also keep life vibrant and rewarding. Florida Public Health Review, 2015; 12, 67-68. BACKGROUNDI am currently in the midst of my second residency and master’s education. The desire to stay within the ranks of student and underpaid physician far beyond that of my colleagues perplexes many people. To complicate things further, my current training in Preventive Medicine and Public Health is neither a well-defined nor a familiar path for someone with my background as a recent graduate of a Family Medicine residency program. This makes explaining the “what and why” of my current day-to-day and future trajectory at social gatherings, and even with close family and friends, almost not worth the effort. The elevator pitch is usually followed by the cautious inquiry: “So, what are you planning to do with that?” It is a fabulous question I ask myself most days, with an answer that does not fit snuggly into a predictable package. The breadth of competencies and demands that come with my present training in these fields equates to schedules and work-life boundaries that can be as ambiguous as my elevator pitch. I am no longer at the mercy of my Family Medicine residency training where I was at the beckon call of the inpatient wards' schedule and a pager that always knew just when I was heading out for dinner with my husband. I am thankful for this change; however, the predictability of a rigid calendar telling me where I needed to be for how long and with what duties also had its comforts. The anticipated overwhelm of my first residency was an easy justification for putting work-life balance low on the priority list given the unavoidable number and oddity of hours, late nights catching up on charts, weekend shifts, and an assumption by loved ones to expect that I would typically be unavailable. I willingly bought in to these excuses and pushed my autopilot fight-or-flight button, marveling at my colleagues who were able to juggle parenting roles and nurture their hobbies, while also remaining perceivably happy and successful clinicians. I sold the idea of another residency in Preventive Medicine, with a Master in Public Health included, to my husband as a way to step off the clinical hamster wheel that had left me exhausted and palpably cynical about my purpose and future as a primary care doctor. The predictable launch of my graduating colleagues into full-time clinical jobs that promised long-overdue shiny new salaries, looked to me like a sure and fast route to burnout. The alternative, to keep training and learning, would allow me to explore a facet of my interests that was sorely neglected in the previous three years, and more importantly, offer some space to start rediscovering what self-care, balance, and career fulfillment could be.  Realities of the Detour Now a year into my detour of sorts I would summarize the change in how I spend my time and energy as more of an equal trade in chaos rather than a newly found balance. In hindsight, this should have come as no surprise given the task of completing my MPH on an accelerated track while maintaining my clinical skills, immersing myself in a state health department, and helping blaze the trail of a new residency program. Late nights chasing due dates on papers and projects have replaced lingering clinic notes. I now have an unhealthy attachment to my calendar, trying to keep track of where I am supposed to be each day, what meeting I need to prepare for, or 1Atwell: The Challenging Balance of Being a Physician in Training, a PubliPublished by UNF Digital Commons, 2015Florida Public Health Review, 12, 67-68.    http://www.ut.edu/floridapublichealthreview/   68 which supervisor I am overdue to check in with. The workload is equally demanding, but with an exponential increase in autonomy for how I divide and conquer it. Lingering tasks easily creep into my weekends the same way my hospital duties used to. With a husband whose work demands are comparably variable and self-directed, and whose fierce independence easily competes with my own, we often find ourselves coming up on Friday and realizing we have yet to eat a meal together or go to bed at the same time that week. And so, the balancing act continues. I have come to accept that I will always be spinning many plates in the air due to the nature of my interests and personality. The juggling and variety keeps me energized and passionate, stimulating more questions and interests, which lead to more ideas for projects and experiences. The cycle is pretty clear. My hectic life does not automatically mean I am unhappy, and I find myself, overall, more content today than I was a year ago. I have a sense of choice and control over my time that was not afforded me during my previous medical training. My lack of skills to use this independence wisely surfaced early on in my shift back to school and out of clinical care. It took me a while to recognize that I was the only one getting in the way of re-prioritizing my “To Do” list, drawing work-life boundaries, and considering self-care as a worthwhile part of my day. The fight-or-flight switch that was flipped seven years prior had short-circuited to the “On” position without regard to necessity.  It was clear that, as with any skill, I was not practicing habits of balance for so long that I simply lost them.  Another Detour In somewhat serendipitous fashion, my husband and I will soon be embarking on another major life shift – parenthood. Being the vessel for our growing daughter and having a new microscope on our readiness to take on this serious shock to our current self-focused lives has put the topic of balance front and center. What felt like a busy life before will be upended completely once we add newborn care and a severe lack of sleep into the other demands of our job and life roles. I am thankful for the maternity leave I have available; however, it is also a near impossible blip of time to get my head above water before I re-enter my former world. Pregnancy has already provided many gifts and lessons in balance, and my approaching role as mother and parenting teammate promise many more. Historically, it was easy to rationalize that I just did not have time for self-care, but now this neglect physiologically impacts the current and future well-being of my child. I am stubborn and not one to ask for help, even when it is clearly warranted. I have a new appreciation for the importance of delegation and seeking a helping hand as my pregnant body increasingly slows me down and gets in the way of previously thoughtless tasks. I used to fight off an urge to nap, seeing it only as an obstacle in my way of getting more done. It has now become a welcome staple to my afternoon when I can sneak it in, helping me stay purposeful and productive. Exercise and healthy eating have similarly catapulted higher on my priority list as I try to optimize my body for all of the changes it is experiencing. Pregnancy brings out a chorus of people constantly asking me how I am feeling and reminding me to take care of myself; something I am finally appreciating and trying my best to follow. The excitement and planning for our family addition has brought my husband and I closer as we dream up baby names, work on the nursery, and excitedly predict whose personality our daughter will have, what adventures we will take her on, and how we can best help her realize her full potential in the world. This reconnecting has extended to our family and friends, whom we usually lose track of for months on end in the flurry of life. I am newly appreciating the importance of fostering these relationships, both for the overwhelming support we have at our fingertips and as a way to make the practice of reciprocating this to others a natural part of our lives. The upcoming years will unquestionably bring a whole new dimension of work-life balance hurdles; yet, I have never been so open to the challenge. A fundamental shift is occurring in the way I frame how I need to juggle and prioritize demands, driven by the unique context of what will be my most major life change to date. Learning how to be a mother will, undoubtedly, also teach me how to be a better student and physician.             Karina A. Atwell (corresponding author) (KAtwell@uwhealth.org) is a Family Medicine physician, a resident physician in the University of Wisconsin Preventive Medicine Residency Program, and a Master of Public Health student at the University of Wisconsin School of Medicine and Public Health,  Madison, WI. Copyright 2015 by the Florida Public Health Review. 2Florida Public Health Review, Vol. 12 [2015], Art. 12https://digitalcommons.unf.edu/fphr/vol12/iss1/12

The Challenging Balance of Being a Physician in Training, a Public Health Graduate Student, and Having a Life – A Commentary

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The Challenging Balance of Being a Physician in Training, a Public Health Graduate Student, and Having a Life – A Commentary

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