Working hard or hardly working?

Striking the right work-life balance can be difficult for the best of us—and is a dilemma medical students and doctors alike are also constantly trying to figure out. Gone are the days where foundation year doctors (or house officers as they used to be known) work in excess of 100 hours each week, neglecting social and family commitments and—perhaps most importantly—rest. We are no longer spending most of our waking hours physically at work. Thankfully, nowadays newer legislation protects workers from these long hours. In theory, we should now have more time—but there are now so many extra things that doctors are expected to do in order to progress through their careers (have publications, prizes, audits, and be a “well-rounded” individual with interests outside of medicine) for which there is no specific allocated time during a working day.

On the latest episode of Sharp Scratch, the team were joined by Greta McLachlan, Higher General Surgical Trainee and Leadership Fellow at Cleveland Clinic London, to talk about their social lives, maintaining a work life balance, and training less than full time.

The panel had a varied approach to how they used their free time. Lily shared that she thought she had a good work-life balance, “though perhaps too much ‘life’!”, she joked. Whereas Kayode expressed a habit he has fallen into of filling every space in his diary—and described picking up extra shifts or accepting new projects rather than taking the opportunity to rest and unwind. But do all these extras count as work, or life?

“It’s all work to me”, said Kayode, “if it’s not sleep or watching Netflix, I count it as work.”

On reflection, the panel became aware that we have been brought up within a system that has commodified extracurricular activities and things anyone else might do for “fun,” as “worthwhile” or “useful.” Medical students may often catch themselves thinking, “I’ve just done X, Y or Z, I should probably get a certificate for it. It would look good in my portfolio…”

Everyone says medicine is competitive. We now ask why some students, such as Kayode, see the only source of rest or relief as sleep or passively watching TV. “I think this might stem from my own feelings of inadequacy and wanting to remain competitive. I must get that extra publication. I must get that prize. I must show that I have an active interest in music, otherwise this could become a wasted journey.”

Greta speaks of her work at the Cleveland clinic and how much she has enjoyed and learned from setting up a branch here in the UK. She recognises the flexibility pursuing a LTFT training pathway has given her to pursue a portfolio career. LTFT is now increasingly being utilised with some specialties not requiring trainees to give specific “valid” reasons. This option is becoming more alluring for many trainees—perhaps as a result of a desire to pursue more life outside medicine.

Although many doctors desire to have a more positive work-life balance, break-taking habits at work still remains a popular topic of contention. Kayode and Lily noted that in their part time jobs as a healthcare assistant (HCA) and carer respectively, they have noticed nurses and other allied health professionals are much better at taking scheduled breaks and allowing themselves a protected opportunity to rest. Greta suggested that this may be to do with the type of self-selective personality that may be drawn to a career in medicine, and how the selection process is aimed to find “resilient” individuals who are also highly competitive, and perhaps with a slight tendency to strive for perfection. This can mean medics may find it more difficult to walk away from a seemingly never ending list of jobs, or deem it important enough for them to have a sit down and a hot drink.

Greta finishes with a James Tomlinson quote, “medicine is difficult … but it shouldn’t be hard.” There are many systemic factors we have no control over but there are things we can do to make things easier for ourselves and our colleagues. Make sure you are enjoying yourself in and outside of work. Finally, “Always have a lunch break and have some water.”

Olukayode Oki, Fourth year medical student, University of Dundee.

Nikki Nabavi, Editorial scholar, The BMJ, and fourth year medical student, University of Manchester.

Competing interest: The authors wrote this piece in their ‘free’ time.

—

Listen to the episode on Spotify or Apple pods

—

Sharp Scratch episodes to recommend:

How competitive are you?

Making ends meet

Leaving medicine

Naps & nightshifts

Surviving the night shift