Knowing Your Vitals: Work-life Balance and Work-life Wellbeing in Residency and Fellowship Decision-Making

by Dr. Julie Hau and Zahra Muhsin

When individuals are making decisions about which medical school to attend, they may also be considering residency and fellowship. That is, where they would like to work, live, and play. Once they are in medical school what drives their decision in the match process may be steadfast or differ vastly from the ideas they had as medical school students. Three to eight years later they may be remaking that decision, if they elect to pursue a fellowship. With residency programs ranging in length between 3 and 8 years and fellowships between 1 and 3 years, these decisions on where and how to spend that time are at the forefront of the minds of many in medicine this time of year (September/October).

According to the American Medical Association (AMA), the most important factors in match selection are as follows:

• Overall goodness of fit—cited by 78%.
• Interview day experience—75%.
• Desired geographic location—75%.
• Work/life balance—64%.
• Quality of residents in the program—64%.

A critical factor in maintaining a lifestyle focused on health and wellness is work-life balance. Work-life balance is a factor medical professionals consider when selecting a program. Terms like “wellness” and “work-life balance” are steadily rising in Google Analytics–capturing the societal shift when prioritizing work.

Google Trend of the term “Work-Life Balance” from 2019-2024

Work-life balance can be defined in many ways, but most importantly is how individuals define it for themselves. Furthermore, the Surgeon General brought to the forefront the concept of work-life wellbeing. Movement from placing the focus on the individual to the environment of organizations in which we work is a central tenant for work-life wellbeing and harmony.  To make work and life harmonious, an important consideration is the employee’s schedule and autonomy. While notoriously difficult at times in medicine, boundaries between work and non-work time are essential in combating compassion fatigue, burnout, and stress.

Ultimately, some of the decision-making is outside the purview of the medical student or resident, considering how the match system is designed. Though the selection process brings to light several vital questions about the working life the med student or resident envisions, the process can be both exciting and daunting.

Here are some ideas for taking your work-life balance or work-life well-being vitals.

1. Take your pulse: Write a list of your “non-negotiables” and what are “nice to have” in work-life balance or wellbeing.
2. Take your body temperature. Are you on a short fuse? Are you easily angered? Are you experiencing compassion fatigue?
3. Take your blood pressure. How well do you tolerate pressure/high-stakes environments? How is my workplace supporting me?
4. Count your respiration rate. How many deep breaths am I taking? Am I making time for mindfulness, deep breathing, and meditation practice?

Careers in Medicine? Go to AAMC.

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