Let's Talk: Resident mental health and wellness

"Having experiences with mental health shouldn’t be viewed as a weakness, it should be viewed as normal, and we should have supports in place to help people. If I could share a message today with medical students or residents who might be struggling, it would be to tell them that it can get better, even if it feels like it might never improve. And that there is no shame in pursuing whatever course of action you need to get yourself healthy and get yourself out of a situation that may be the cause of your feelings."

–Dr. Caroline Just, PGY5, Neurology

The PARO 24-Hour Helpline is available to residents, their partners and family members, as well as medical students. The toll-free number, 1.866.HELP.DOC (1.866.435.7362), is accessible anywhere in Ontario, 24 hours a day, seven days a week. In order to provide this service, PARO has partnered with Distress Centres of Toronto. It is not staffed by PARO physicians.

Schulich Medicine & Dentistry's Learner Equity & Wellness Office (LEW) is concerned with the physical, psychological, and professional safety of learners including residents. They offer services including personal counselling and/or referral to campus and community professionals. In London, contact 519.661.4234
equity.wellness@schulich.uwo.ca, and in Windsor contact 519.253.3000, ext. 4302

We sat down with Dr. Caroline Just to chat about the increasing incidence of mental health issues experienced by residents and medical students, the culture of medicine and how residents can support their peers.

Dr. Just is a fifth-year neurology resident and a representative for the Professional Association of Residents of Ontario (PARO) at Schulich Medicine & Dentistry. She also served as PARO Site Chair during her PGY4 year and Neurology Chief Resident from January to June 2017.

A recent Canadian Medical Association survey with more than 2,500 physicians and 400 resident doctors across the country found that residents are the most vulnerable to develop depression and burnout. A significant number are suffering burnout, depression and some are suicidal. According to the report, many aren’t accessing the help they need. As a current resident, what goes through your mind when you hear about these statistics?

It’s not as surprising to me as you might think. The process of residency is so overwhelming, and it’s quite normal to feel overworked. The normal things that help to keep a person balanced like eating and sleeping well, being active and spending time with family are really difficult to do during residency. I don’t think that having experiences with mental health make you a worse doctor, I think they help you to better understand the human experience and align your physician experiences with patient experiences.

Is there a culture in medicine that contributes to some of these issues?

Absolutely. To be self-sacrificial and to put yourself last and work really hard is inherent in medicine – and our community depends on us to be there for them. But as individuals, we need to value ourselves and take care of ourselves.

Medicine is a career for the perfectionist personality. You tend to be surrounded by high achievers, really smart people who are really good at their jobs and it can, at times, prevent you from realizing the extraordinariness of your ordinary day. And that can prevent us from enjoying our achievements.

What do you believe is important to understand in terms of mental health with your colleagues and peers?

I believe it’s most important to have empathy. People will manifest their struggles in multiple and different ways. They can be short on the phone, defensive, choose words that may not be as collegial, and so I believe it’s important to remember that we are all having similar experiences and we need to try to have empathy for each other.

What role should other residents play in supporting their peers?

As residents, we are uniquely suited to support each other, because there is only a small group of people who truly understand our day-to-day realities. We may be in different specialties, but there is much more that unites us than separates us, and we need to keep this in mind. If you have a colleague who seems troubled, ask them how they are doing.

I think, as well, we can work to not perpetuate unsupportive cultures. There’s a quote that has often been attributed to Mahatma Gandhi, and I’m not really sure if he said it or not, but it is “Be the change you want to see in the world.” As residents, I think we should try to be the senior residents that you wish you had, not the one you think you earned. So many times, cultures that are toxic to people within them are perpetuated, and this can stop when people truly realize that it doesn’t always have to be that way. The root to all of this is empathy and the desire to improve the world around you.