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Study Break
Kathleen Pladson realized during her first year of medical school that she needed to take better care of herself. “I was feeling stressed out during anatomy,” she recalls, noting that she wasn’t taking time to exercise, eat right, or simply have fun. She decided she needed to do something to change that if she was going to get the most out of her medical school experience and avoid becoming burned out. So when Pladson discovered a medical student well-being group at a student activities fair, she signed up.
Now a second-year student at the University of Minnesota Medical School, Pladson is president of the group. About a half-dozen students help plan events designed to promote a sense of community and to bring balance to lives that otherwise might be consumed by academics. In recent years, they have written a cookbook and sponsored an evening with massage instructor Sister Rosalind Gefre.
Last year, the group sponsored a canoe trip on the Mississippi River and workshops on emotional shifting, a technique for substituting a negative emotional response for another more positive one, and identifying personal strengths. This month, medical students are collaborating with other students from the schools within the Academic Health Center on Mental Health and Medicine Week. During a workshop that week, they will portray people with depression to illustrate the different ways it can manifest. The group is also planning open-gym, bowling, and dance nights, and another evening of massage. More information is available at www.meded.umn.edu/ wellbeing.
Pladson says the activities are designed to be fun and to encourage students to be mindful of wellness. “It’s important for them both professionally and personally,” she says, “to avoid burnout.”—Carmen Peota
Mindfulness in the ER
When emergency medicine physician Laurie Drill-Mellum, M.D., first decided to study integrative medicine at the University of Arizona two years ago as part of a Bush Foundation fellowship, it was because she wanted to find new ways to help her patients at Ridgeview Medical Center in Waconia. Drill-Mellum had noticed that an increasing number were coming to the ER complaining of depression and anxiety or with problems related to chronic conditions. “What we’ve traditionally offered, giving them a pill or doing a procedure, wasn’t enough,” she says. She wanted some new tools to use with them.
Drill-Mellum was surprised to discover how relevant one of those tools—mindfulness—was to her professionally. She realized that the state of awareness and focus it brought was exactly what was called for in the Comprehensive Advanced Life Support (CALS) classes she taught. One of the basic tenets of CALS is to pause for a moment before responding, she says. “They’re not calling it mindfulness, but what they’re doing is … taking a calming approach instead of a frenzied approach,” she says. “In a frenzied environment, care becomes scattered and inefficient.”
Now Drill-Mellum says that when she feels the energy level in the ER mounting, she’ll stop and remind her colleagues to take a deep breath in order to settle before acting. “When you’re taking care of someone who’s critically ill, as a leader, you need to be able to focus and focus your team.”—Carmen Peota
The Importance of a Happy Home
Last May, members of the West Metro Alliance, Hennepin County’s organization for physician spouses, gathered at the Interlachen Country Club in Edina to celebrate the organization’s 100th birthday. Shortly after the event, the leaders of the group began disbanding it. With an aging membership, “the leadership just wasn’t there,” says Dianne Fenyk, a long-time member and current co-president of the statewide MMA Alliance.
Fenyk says demographic changes (many more women going into medicine) and cultural shifts (many more two-career households) made the group less viable than it once was. But, she says, the organization was a vital part of its members’ lives for many years not only because it provided an opportunity to work on public health issues but also because it functioned as a de facto support group. “We all had the same kinds of issues,” she says. “Our spouses would be involved with their patients. Sometimes the family came second. We all learned to accept it. But it was nice to talk to someone about this.”
Fenyk, who is married to John Fenyk, M.D., a dermatologist who had his own private practice for 25 years and is now a professor at the University of Minnesota, became especially interested in the issue of the medical marriage. While attending an AMA Alliance meeting in Chicago a number of years ago, she was introduced to the work of Wayne and Mary Sotile, psychologists who’d identified stresses faced by couples when one is a physician. The ideas they shared resonated so deeply with Fenyk that she eventually developed a talk on medical marriage that she has given at various Alliance gatherings.
Fenyk emphasizes that the unique challenge in a medical marriage is that patients have to be the priority for the physician. “The only other profession that’s somewhat similar is that of a minister or pastor, whose congregation members often come first,” she says. “It really is important that everybody in the family is comfortable having the same priorities and understanding why.”
She believes that physicians and their spouses need to pay attention to their marriage because it can affect the physician’s performance. “It started to dawn on me that a healthy home life makes for a happier physician and that leads to better medical care because then the physician can focus on the patient,” she says.
Fenyk says she’d tell young people simply to “accept your partner for who they are. The profession they’ve chosen,” she adds, “is part of who they are.”—Carmen Peota
Support for Young Spouses
In her talks about the medical marriage, Dianne Fenyk advises spouses of physicians to support each other. Although this can still be done in person, it’s now also possible to find support online. Here are a few websites:
Mrs. MD (//mrsmd.wordpress.com/about/), a blog for medical wives that claims to be “where women who happen to be married to doctors or docs-to-be gather to share the joys and challenges of living a medical marriage.”
The AMA Alliance Young Member Connection (physiciansintraining.blogspot.com/2009/04/medical-marriage.html), a site for medical students, residents, and their spouses.
The AMA Alliance’s “Personal Space” section of its website (www.amaalliance.org/site/epage/77832_625.htm), which is dedicated to the well-being of medical families.
Med School Tackles Hidden Problem
The University of Minnesota Medical School is in the midst of a three-year effort to raise awareness about and improve the climate for medical students and residents with invisible disabilities, in particular psychiatric conditions, attention deficit disorder, and learning disabilities. The project Taking It to the Next Level: Advancing Awareness and Equity of Medical Trainees with Invisible Disabilities was launched in September of 2009 with a $75,000 grant from the Marcus Foundation.
As a first step, staff from the medical school and the university’s Disability Services office held focus groups consisting of medical students, fellows, residents, and faculty to find out how invisible disabilities affect trainees and the medical school as a whole, and what changes might be made to improve the environment for all. The university plans to hold a faculty training session that will feature Michael Myers, M.D., vice chair of education and director of training in the department of psychiatry and behavioral sciences at State University New York–Downstate, on promoting mental health, resilience, and success in medical trainees.
Marilyn Becker, Ph.D., director of learner development for the medical school and the principal investigator for the grant, says she hopes these activities will reduce the stigma around mental illness, attention disorders, and learning disabilities and that the medical school community can come to see these conditions as differences that enrich the educational environment.—Carmen Peota
Asleep at the Wheel
Driving while intoxicated, speeding, and not wearing seat belts are among the most dangerous things one can do behind the wheel. Almost as risky, but likely even more prevalent, is driving while drowsy.
In a telephone survey conducted last spring, AAA found that 41 percent of U.S. drivers admit to having fallen asleep while driving at some point in their lives. Eleven percent said they’d done so in the past year and 3.9 percent in the past month. AAA estimates that drowsiness is a factor in 16 percent of auto accidents that result in a fatality.
Physicians, particularly residents and interns, are among the groups the National Highway Traffic Safety Administration considers most at risk for drowsy driving because they routinely are sleep-deprived. In a 2005 study published in the New England Journal of Medicine, Harvard researchers found that the likelihood that interns would have a motor vehicle accident on their drive home after working an extended shift was more than double their odds of having one after a regular shift. And a 2005 study published in the Journal of the American Medical Association found that residents who had worked a heavy call schedule were more impaired than controls with a blood alcohol level of 0.05 percent when performing simulated driving tasks.
The National Sleep Foundation’s advice: Nap before you navigate.