Learning to Lead in the Abnormal
Author: Megan Wolak, MD, Chief Resident, Department of Internal Medicine, University of Kentucky
Faculty Mentor: Dr. Alan Hall II, MD, Associate Professor, University of Kentucky College of Medicine
“I don’t think any of that will work. It won’t be the same as before. Can we all just admit this is an abnormal year?” As a chief resident, those were not the words I was hoping to hear from a disheartened resident. Along with my team, I spent the year trying to fix issues identified by the residents, as if this were a normal year. It took that quote, that cry for help, to startle me into the realization that these Band-Aid solutions were not going to be enough. My team and I were not going to win the battle to normalize training during a pandemic.Faculty Mentor: Dr. Alan Hall II, MD, Associate Professor, University of Kentucky College of Medicine
I prepared for months to transition to my role as a chief resident, but I never expected to hold this position during the COVID-19 pandemic. My residency team and I adapted like all programs during this pandemic with virtual recruitment, online learning, and layers and layers of back-up staffing scenarios, never previously imagined. I mistakenly thought my residency program could adapt to anything -- that we could make our training program that one unwavering constant that could balance out all of the uncertainty in everyone’s lives.
But, alas, this was not a normal year. There were countless new stressors on top of traditional ones, and the residents were feeling just like me -- frustrated by the unknowns, the uncertainty, and the constant changes; down about how they couldn’t see family; overwhelmed by the constant questions from loved ones; and angry with the media. Without their usual outlets, these feelings turned to resentment at work, amplified by feeling disconnected from patient care as they were shielded from some patients with COVID-19. Where would a resident turn when they felt burnt out? To their chief – who was doing everything to make things seem normal. Instead, all they wanted was someone to listen and commiserate with. By not acknowledging how abnormal residency training was during a pandemic, I unintentionally magnified all of our frustrations, making things harder on our residents and myself.
My team and I altered our approach. Rather than immediate problem solving, I focused on listening and validating that things truly were not normal. Instead of shielding and protecting, I opened up about my own challenges. I shared how my previously well-defined and predictable role was unrecognizable, much the same way their wards service I was trying to fix was. I listened to their stories of personal, family, and social strife and I shared my own. We were all scared, frustrated, and tired. What a relief it was to no longer maintain an unyielding level of positivity. I embraced the vulnerability of sharing my experiences and challenges and truly connected with the residents. Jointly, we shared strategies to promote our own wellness during a pandemic, including finding time for sleep, exercise, hobbies, and family, even if only through frequent FaceTime calls. We talked about things to avoid, including endless scrolling of the news. Talking about these things did not always make things better, but they gave me hope.
There is hope on the horizon as doses of vaccines continue to be delivered, but what the ‘new normal’ looks like on the other side of COVID-19 is a mystery to us all. At the heart of residency training during this difficult time has to be an acknowledgement of how abnormal this training is. After this pandemic abates, can we continue to normalize these frank discussions about wellness? Can we see a reduction in the virus without a reduction in our shared experiences about the challenges of learning to be a doctor, pandemic or not? Perhaps we can take this opportunity to flip the narrative on burnout and wellness from what has plagued us for almost a year now. Perhaps openly discussing our feelings, struggles, and journey won’t be abnormal anymore. I know it will no longer be abnormal for me.
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