I am three months into my medical residency, and I am getting fat.  Not the noticeable change-in-pant-size fat, not yet.  But I am most certain that what was once muscle is now just “padding,” and I can no longer solely attribute the words “muffin top” to the anatomy of the snacks that I scrounge to stay alive during the long hours in the hospital.


I am three months into my medical residency, and I am stressed.  Not the bug-eyed, frazzled-haired stress, not yet.  But I am most certain that what once were exciting thoughts surrounding my life as a physician have now been acutely replaced with persistent fears of making mistakes on the job that I cannot afford to make.

In short, I cannot say that I am in a state of good health.  And if you or anyone you know is in the midst of medical training, I am confident that you will agree with me that I am not alone.

So whose fault is this?

It’s hard to say.  I’d like to attribute my declining sense of well-being to the intrinsic stress of caring for the sick, the lack of time for more than just sporadic trips to the gym, and the plethora of unhealthy food options served daily to the hospital’s house staff during meetings and lectures.  However, I know that the job of a resident physician itself is only partially to blame.  Add the work-hard, play-hard culture surrounding medical residency and my personal lack of motivation for self-care beyond basic survival needs and we may be on to something.

Regardless of the source of our health issues and the obvious problems that we residents have with this almost expected physical and mental deconditioning, we should be aware that by not actively addressing our own well-being, we are perpetuating a crude “do as I say, not as I do” dialogue with our patients that we know that deep down in our fatty livers may not be the best approach to patient care.

Which brings up the Resident’s Hypocrisy. In an environment where it is so easy to slip away from acting personally accountable for our own well-being, it is our duty as physicians to educate, motivate, and ensure that our patients become personally accountable for their own well-being.

This is bad.  I wouldn’t go as far to say that we are infringing on medical ethics and morals by choosing to spend our limited free afternoons watching Breaking Bad on the couch instead of hitting the gym (guilty as charged), but I do think that care is optimized in settings where physicians practice what they preach.  After all, no one wants to see his or her doctor plow through a pile of fried onion rings in the hospital cafeteria before an office visit focused on weight management (very guilty as charged).

Despite the difficulties of staying hale and hearty during the busiest few years of a physician’s career, medical residents not only have a personal responsibility for their well-being but also an obligation to their patients to engage in the healthy behaviors that they recommend.

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Brian Secemsky, M.D.

Medical writing for patients, students
and practitioners.

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