How can medical residents strike the best work-life balance?
Key Takeaways
Medical residents are prone to stress and burnout as a result of hefty work demands, concerns related to patient care, and poor work-life balance.
Getting enough sleep—which may necessitate naps during long shifts—is crucial to staying alert on the job, along with scheduling proper meals before the night work begins.
Residents can improve their work-life balance by prioritizing extracurricular activities outside of work, which may include exercising, cooking, and socializing.
The phrase “work-life balance” may ring an all-too-familiar bell for physicians in residency—and justifiably so, since trainee physicians are particularly high-risk candidates for burnout.
According to JAMA, stress and burnout among residents is often the result of taxing workloads and work-life imbalance. To remedy this, trainee physicians can prioritize consistent sleeping and eating habits, as well as maximize time off with rejuvenating extracurriculars.
Residents and burnout
Let’s address a hard truth right off the bat: Burnout is real, and many residents report experiencing it.
Surveys show 50% of trainee physicians in the US, Canada, and Australia report feeling burned out, and 80% say they experience symptoms of high stress.
A 2020 systematic review published by JAMA looks at the reasons why. From a total of 48 studies, researchers found that the chief cause of burnout among trainee physicians is the stress of work demands.[1]
Second in the running is concerns related to patient care, followed by substandard work environments. A defective work-life balance is next on the list.
While the rate of resident physician burnout may startle some doctors-in-training, there are actionable steps residents can take to strengthen their performance and tackle their work with greater focus. Among them is scheduling enough time for sleep.
Prioritize sleep
Sleep may make or break a trainee physician’s performance. After all, sleep deprivation in residents can lead to lower quality patient care and diminished alertness on the job.
An article published by the American Medical Association gives residents a good idea of what sleep deprivation looks like, and how to beat it.[2] For example, if you find yourself dozing or “spacing out” during conversations at work, you may be fatigued—a telltale sign of sleep deprivation.
Moodiness, clouded decision making, and weight gain are also common byproducts of a lack of sleep.
The good news is that the solution to sleep deprivation is fairly simple: Sleep more—including at work. Especially when you’re on the clock for 24 hours, finding the time to sneak away for a nap or two is essential.
"We need to find time to sleep and take care of ourselves so that we can first do no harm (to ourselves)."
— Ellen Poulose-Redger, MD
The AMA recommends taking a break when you’re tired, or taking a stroll to get a change of scenery. Be sure to snack to keep your energy up, and nap after a shift if you’re too weary to drive.
You can also ask for help. Embrace the adage “you’re not alone,” and seek guidance from program directors or other residents who know the sleep struggle well.
For Ellen Poulose-Redger, MD, Chief Resident at Stony Brook University Hospital in Stony Brook, NY, following the medical code of ethics necessitates sleep. In a blog post published by The New England Journal of Medicine, Poulose-Redger writes, “We need to find time to sleep and take care of ourselves so that we can first do no harm (to ourselves).”[3]
The role of diet and hydration
Another basic need that could significantly affect your cognitive wellness at work is food—specifically what and when you choose to eat.
According to another AMA article on resident and student health,[4] consuming about a third of your daily caloric intake two hours prior to working an overnight shift is key. Ideally, residents will ingest up to half of their daily caloric intake by the time midnight strikes. Load up on a big breakfast upon waking up, and get the rest of those calories early on in your shift.
Another tip the AMA has for residents is to skip out on meals when you’d normally be snoozing.
Regardless of chronotype, your cognitive performance suffers after eating between the hours of midnight and 6 am.
Hydration, however, is a must at all times. Residents’ energy and mood are linked to how often they sip on water, herbal or regular tea, and coffee throughout shifts. You can gauge your hydration levels by taking note of your urine color. Lemonade is a good shade to shoot for.
Finally, don’t fear carbohydrates. They are essential to learning and maintaining memory. It’s the quality of carbs that you may want to pay attention to. Instead of snacking on a donut during your next shift, try to integrate whole grain and whole fruit foods into your snacks.
Make time for play
As you work on your sleeping and eating habits to improve your well-being and performance at work, schedule time for fun outside of work.
A study published by the American Journal of Clinical Pathology mentions a few ways residents report getting their kicks off the clock. Exercising, pursuing hobbies, seeing movies, getting together with family and friends, and meditating all notably helped residents to maintain a good work-life balance.[5]
Fewer than 4% of the residents participating in the study said they never engaged in these types of stress-reducing activities. Among residents with high quality-of-life ratings, close to 70% reported weekly or daily engagement in these extracurriculars.
Regardless of the activities you choose to engage in, you may find that compartmentalization of work and play is essential to creating a balance that works best for you as your career blossoms.
What this means for you
As a physician in residency, you may be feeling the weight of your workload and significant stress related to patient care. Sleep deprivation and malnutrition only diminish your focus and overall performance on the job. In order to strike the healthiest work-life balance early on in your career, make a habit of prioritizing sleep.
Nap when you can during long shifts. Before you clock in, be sure to eat a big enough meal to keep you fueled throughout the day—and night. Finally, when you’re off work—be off work. Exercise, see a movie with friends, or try out a new recipe. Doing so will help you compartmentalize work and play, leading to a better balance in your life overall.
Our writers and editors prioritize primary sources—including peer-reviewed research and interviews with experts—to inform our articles. Fact-checkers and board-certified physicians also review each piece for accuracy. Learn more about our process and standards.
Zhou AY, Panagioti M, Esmail A, et al. Factors associated with burnout and stress in trainee physicians: a systematic review and meta-analysis. JAMA Network Open. 2020;3(8):e2013761.Z
Murphy B. Are you a sleep deprived medical resident? 4 symptoms to watch for. American Medical Association. August 6, 2019.
Poulose-Redger E. I Call BS on Work–Life Balance [blog]. New England Journal of Medicine. January 5, 2019.
Murphy B. Resident physicians: Your diet can help you make it through the night. American Medical Association. December 10, 2020.
Kelly M, Soles R, Garcia E, et al. Job stress, burnout, work-life balance, well-being, and job satisfaction among pathology residents and fellows. American Journal of Clinical Pathology. 2020;153(4):449-469.