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Jan. 14, 2022

What I Wish They had Taught Me in PA School

What I Wish They had Taught Me in PA School

As I look back on over 16 years as a surgical PA, there are some things that I wish they would have taught me in PA school.  These are more intangible things, but are just as important as the anatomy, physiology, pharmacology, critical thinking skills, surgical dexterity, and the multitude of other skills needed to practice medicine.  I feel strongly that our schools gave us the tools with which to build our professional career but failed to properly prepare the foundation for us to build upon. 

After using my tools to build my career, gathering experience, knowledge, and clinical pearls, the cracks in my foundation that had been there since graduation started to affect me.   I started feeling like I was having to spend extra time and energy to hold up everything and keep it in working order.  It was futile.  I felt trapped by the career that I built.  I didn’t know what to do.  And then the day came where I succumbed to the weight of it all.  I was severely burned out.

Here is where I found myself four years ago.  My relationships were crumbling.  I didn’t have any friends.  I was having health troubles that doctors couldn’t explain.  I hated going to work and was starting to forget things at work.  I was cynical, exhausted, and wondering, ‘What the hell happened?”

Fast forward to now and I can see very clearly what happened.  Even though my intellectual brain was eager for all of the information to start a career in medicine, there was another part of me that needed to be taught.  I needed a better understanding of the interconnection between my mind and body.

I wish we had a course called “A foundation for wellness– how to have a long and healthy career in medicine”. 

This course syllabus would look like:

Brain Non-Evolution: How your brain is wired to see the negative in order to keep you alive.  You are wired to see threats, but our threats are now getting cut off in traffic, insurance companies not approving the treatment for our patient, argumentative patients, personal relationships, etc.  Medicine reinforces and actually rewards this wiring in our brain when we can predict and avoid the things are may hurt our patients.  What I never knew was that this wiring becomes our default based on usage.  So now we see the negative in our relationships, in our work, and in the community and all really without any conscious choice on our part. 

Thinking: How your thoughts alone can trigger your fight, flight, or freeze response flooding your body with stress hormones all day every day.  Thoughts centering around our worry, anger, and anxiety will release stress hormones just as if we are being chased by a lion.

What these chronic stress hormones do to your body: Research has correlated damage to the cardiovascular system and immune system along with metabolic syndrome and sleep disturbances.

Mental Health for practitioners: You will experience trauma.  It may lead to depression or PTSD.  Symptoms may include sleep disturbance, anhedonia, easily irritated, or quick to anger among others.  It is not only okay to get help, it will not get better without help.  YOU CANNOT IGNORE IT. GET HELP.

Healthy Boundaries:  Start as you want to go.  If you answer emails after work, people are going to send you emails after work and expect a response.  If you never take you vacation time and then ask for 2 weeks off, people will give you a hard time because you have trained them to depend on you being there.

The gut microbiome: This is your second brain.  The food you eat has a direct effect on your mood via the nervous system in the gut that talks directly with your brain.  Think twice about eating those sugar treats if you would like to feel happy.

Self-compassion: End the self-criticism. Research shows that people that have more self-compassion are more successful.  Flatulating yourself with sharp criticism does NOT make you a better practitioner.   

Guilt and shame:  Shame is that you are bad.  Guilt is that you did something bad.  This is very different and how you think of your mistakes will shape your actions.  Shame needs to be spoken to take it’s power away and not hidden in silence. 

Positive Psychology: There are ten positive emotions that have been studied.  These emotions can help you re-wire your brain from the negative default mode to a more positive default mode.  Just a few seconds (that is right seconds) a day of joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe, and love can make a drastic difference in the chemistry of your brain. 

Scheduling in down time and play: Take every single hour of PTO you have. EVERY. SINGLE. HOUR.  Your body needs to reset, recharge, and relax. Research shows that play is just as important to the adult brain as it is for children.  It helps us see creative solutions and is not a “waste” of time. 

Sleep: This is the everyday reset for your brain.  If it doesn’t reset, the literature proves literally every cell in your body suffers causing an increased risk of cancer, cardiovascular events, and automobile accidents.  It is recommended to get 7-8 hours a night. This may no be possible all the time especially with night shifts, but prioritize sleep when you can.

Know your Core Values and make decisions based on them.  If you value time with family, do not take a job that has you working 60-80 hours a week along with being on call.  If you are single and want to pay off student loans and retire early, working 60-80 hours at a high paying job, fits with your values.    If your values do not align with your work, you WILL get burned out. 

Mindfulness meditation: Strengthens pathways in your brain to help with attention control, emotional regulation, and self-awareness.   This practice can also help calm your body and mind. 

This class would have at least introduced some of the science of wellbeing to me and maybe I could have avoided complete burnout.  I hope just reading this helps you and I hope that you pass on any pearl you take from here to your colleagues.  I want to help break the burnout cycle in medicine and shift the culture to one where we can actually thrive and not just survive our days.

If you want to know more about these subjects, you can listen to my podcast, book me for a speaking engagement or coaching, or reach out to me with a question.  Just head over to the contact page and send me an inquiry.

With lots of love,

Meg Leddy PA-C