I have divided this into 3 key areas:
- Mental health, burnout & work-life balance
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Career guidance, alternative career options & inspiration
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Hope and Humanising healthcare: exploring compassion, resilience & more
1) Mental health, burnout & work-life balance
Assessment & diagnosis
Burnout: Are you at risk of burn out BMA questionnaire and useful resources
Depression: PHQ-9 (used commonly in primary care) and Beck inventory
Anxiety: GAD-7
Web resources & apps
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e-physician health – resources on burnout
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Helpguide – preventing burn out an award winning guide to mental illness, set up by a couple following their daughter’s tragic death
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Helpguide – emotional awareness toolkit
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Dike Drummond @ the Happy MD on physician burnout. He has an app to help combat burnout and many free resources
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Patient.co.uk – Occupational burnout
Facebook groups offering support
- Tea & empathy
- Resilient GP
- Other options for doctors
- National association of Sessional GPs
Mindfulness apps recommended by peers
In May 2016, the guardian did an article recommending the 5 best meditation apps:
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Headspace – this seems the most popular amongst people that I know. I currently use it as it is more achievable as it takes just 10 minutes out of your day. The founder Andy Puddicombe, has done a TED talk “All it takes is 10 mindful minutes“. Dr David Cox, a UK trained doctor, has been part of the management team. His interview with Dr Paddy Barrett of the Dr paradox is really worth listening to.
Articles on mental health & burnout
- “The Root of Physician Burnout” am article by an American physician which suggests that “if we are genuinely concerned about physician burnout, we need to focus less on reducing stress and more on promoting what is best in physicians: compassion, courage, and above all, wisdom.”
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“Mental health – barriers to doctors own care” – an article highlighting the problem that we have seeking help.
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“How I faced burnout working as a GP in the NHS” An article by a UK female GP juggling work & family life.
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“Self-preservation: Why I abandoned clinical practice” An article by an American physician who felt overwhelmed in clinical practice and has been much happier since leaving and has found a fulfilling alternative path
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“The darker side of being a doctor” This describes the flip side of the traits that help us become doctors
- “For doctors to survive today, they need emotional intelligence” An article by an american oncologist describing how we “use emotions as a positive tool“
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Why doctors kill themselves – a guest blog by Dr Pamela Wibble. Makes for really interesting reading.
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The widespread problem of doctor burnout – an article in the NY times
- “Burnout & depression; the doctors struggling with their mental health”. Some stories printed in an article in the Guardian.
- “GP’s demoralisation is due to our loss of human connection” by Dr David Zigmond, a GP and pyschotherapist in London. This article moved me to tears. It encapsulates for me what we have lost in general practice.
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How to beat burnout: 7 signs physicians should know an article in the JAMA network
- “How mindfulness training helps both doctors & their patients” – an article in the Guardian describing the benefits of mindfulness in clinical practice
- “Medical school has killed my soul what can I do?” – a letter and response form a British medical student to Dr Pamela Wibble.
- “Insights on residency training – what is resilience.” A thought provoking article by a US doctor following the suicide of a fellow resident. She notes that”our strength was being measured by our ability to silently struggle through whatever we were experiencing and get the job done.”
- The sirens were for you – an article in the BMJ following the suicide of a fellow anaesthetic trainee.
Articles on work-life balance
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Work-Life Balance: Women Physicians Balancing Career and Family – a humorous article on mommd.com, an american site for working mums.
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10 Top Tips for balancing work and family life another article from mommd.com
Videos / podcasts and TED talks on Mental health and burnout
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“I have a black dog – his name is depression” – this beautiful & powerful video really brought tears to my eyes
- The Dr Paradox – Deep dive into physician burnout
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Brene Brown – podcast on the Dr paradox on shame & vulnerabililty
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Brene Browns TED talks on listening to shame & the power of vulnerability
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Pamela Wibbles TED talk on “Why physicians kill themselves.
- “Depression, the secret that we share” TED talk by Andrew Solomon
Books looking at mental health in doctors
- Bad Doctor by Dr Ian Williams. This book is also truly amazing. It is a cartoon comic about a GP in rural Wales who struggles with his inner demons of OCD. Well-observed and laugh-out loud funny. I really recommend reading this.
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Physician Suicide, Letters answered by Dr Pamela Wibble. She has also done a TED talk about this physician suicide
- The Other Side of Silence: A Psychiatrist’s Memoir of Depression by Linda Gask. Her personal story of depression, what psychotherapy is about, and the role of medication.
Recommended mindfulness books
There are many books about mindfulness. Two that I have found useful are:
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Finding peace in a frantic world by Mark Williams & Danny Penman. This has an 8 week course that you can do using a CD and the book. I have completed it and cannot recommend it highly enough.
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Sitting still like a frog by Eline Snel (mindfulness for kids). I have tried this when teaching in schools and on my own children. They really love it, finding it very calming and relaxing .It starts to give children an awareness of their bodies and the changes that can happen depending how they feel. They learn to use the breath as a means of grounding themselves.
2) Career guidance, alternative career options & inspiration
Organisations looking at other options
- Other options for doctors – a really useful website with heaps of information and blogs / linked-in articles. This was a fantastic starting point for me rich with inspiring resources, great blogs with sensible and free advice. Dr Evgenia Galinsky who founded it also offers career guidance. I particularly liked her articles on re-discovering your passions and why not to use lists (mentioned & links above). When first reconsidering my options, I started looking at reams of overwhelming lists of alternative careers, none of which appealed to me, but I felt that I should try not to be negative and at least explore them all. Perhaps as medics we are all too familiar with lists!
- Medical Forum – based in Basingstoke and highly recommended to me by a few colleagues. They have been established for many years and so have heaps of experience in dealing with doctors at a crossroads. They offer career counselling and workshops.
- Medical Success organise conferences and offer advice on alternative medical careers for doctors who are looking beyond the hospital or the GP’s surgery.They host an annual event every April called Diversify. I went to Diversify 2016 this April. A great event with talks and workshops from a wide range of doctors who have pursued alternative paths, such as management consultants, entrepreneur, career coach etc. My favourite talk was by Dr Giles P Croft who talked about 10 pointer for career change. The organisers remarked how many more senior doctors attended this year compared to previous years. A further sign of the challenges that doctors are all currently facing.
- Medicfootprints – focus on Alternative Careers and Wellbeing for Doctors. They hold educational workshops and seminars frequently, generally in London.
- Non-clinical doctors – a US resource for medics considering branching out. This has a suggested tool-kit for making the transition out of medicine.
- Eurekadoc– is the only UK publisher dedicated to publishing niche career guides for Doctors. The guides span a variety of diverse medical careers, offering invaluable advice on how to get into extraordinary fields such as: Space Medicine
Articles on alternative options
- 10 pointers to finding your true passionby Evagelina Galinskaya. I found this really helpful as I had lost what my “passions” were.
- Guide to alternative careers – the Royal Benevolent fund. Advice also on getting back to work after an accident or illness
- What’s the alternative?BMJ article
- Moving on from clinical practice BMJ article
- Alternative careers for doctors – a list of other options produced by NHS medical careers
- Careers advice – alternative careers. An article in Support4doctors by Dr Houghton who is the author of ‘Know Yourself – The Individual’s Guide to Career Development in Healthcare’.
- Medically related jobs outside the NHS – Support 4 doctors
- Alternative medical careers (includes transferrable skills) by Health Careers
Blogs looking at other options
- Medical footprints – alternative options
- Other options for doctors – some useful tips
- Doc2doc – BMJ blog forum
Inspirational videos & podcasts
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The doctor paradox – a series of podcasts hosted by Dr Paddy Barrett
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Steve Jobs address to Stanford – the 3 important things in life: connectivity (seen retrospectively), love and living each day as your last. Watching this was transformational to me. The concept that people could possibly be wanting to do their job if it was their last day bewildered me completely. I knew absolutely that I would not be doing my job if it was my last day, last month, last year or last few years. Clearly, I needed to make a change!
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Brene Brown on shame and on vulnerability. This woman is absolutely amazing and so inspiring. A MUST for all doctors who are questioning themselves or unhappy.
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Opray Winfrey on “Career, life & leadership“
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Brendon Burchard – blog an podcasts on “How to lead a charged life”
Books for self-development and / or considering alternative careers
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“7 habits of highly effective people” by Stephen Covey. This bestseller is not light reading but is truly inspirational and forms the basis for so many self-development books. The “habits” are all common sense but the way he illustrates them is incredibly powerful. He emphasises the importance of discovering your authentic self and living your life as closely to this as possible. The 7 habits are:
- Be proactive
- Begin with the end in mind
- Put first things first
- Think win-win
- Seek first to understand and then to be understood
- Synergise
- Sharpen the saw
They all all so relevant to us in managing our lives & time. And for me have helped me re-connect with my values and consider ways that I would set boundaries going forwards.
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“Feel the fear and do it anyway” by Susan Jeffers – comes highly recommended – still on my extensive reading list
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“The Slight Edge” by Jeff Olson. Not a book for when you are feeling low – it looks at how every decision you take however small matters and the importance of discipline and healthy habits. I listened to the audio CD very quickly. It is fairly repetitive but illustrates the core message above effectively.
3) Hope and Humanising healthcare: exploring compassion, resilience & more
Articles on resilience, empathy & compassion
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Doctors need resilience not mental toughness – article by Alys Cole-King, a Consultant Liaison Psychiatrist and Clinical Director of the not for profit social enterprise ‘Connecting with People’ who care about suicide prevention.
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The Secret formula to resilience – ” research shows that resilience is, ultimately, a set of skills that can be taught. In recent years, we’ve taken to using the term sloppily—but our sloppy usage doesn’t mean that it hasn’t been usefully and precisely defined. It’s time we invest the time and energy to understand what “resilience” really means. “
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For doctors to survive today, they need emotional intelligence and interesting blog briefly exploring why emotional intelligence is important to survive in modern day medicine, by deliberately using “emotions as a positive tool.”
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When empathy moves us to action by Daniel Goleman. A really interesting article on the different types of empathy; how emotional empathy can lead to burnout – “Emotional empathy has a downside, too, especially for first responders. In a state of emotional empathy, people sometimes lack the ability to manage their own distressing emotions, which can lead to paralysis and psychological exhaustion. Medical professionals often inoculate themselves against this kind of burnout by developing a sense of detachment from their patients.”
- “The Cracked water pot” – a wisdom story valuing imperfection
- The Kings fund reading list for staff engagement & wellbeing
Books / resources on being human and / or humanising healthcare
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Humanising healthcare by Margaret Hannah. An inspiring quick read that accurately identifies all the problems in the current system and why we are on the brink of collapse. It offers models of hope for us achieving a sustainable model of healthcare in the future. This for me was another resource that helped me recover. It put into words everything that I was dissatisfied with in my job and explained why much of what is happening in the call for efficiency is just not sustainable. It also offers hope, describing the Alaskan Nuka model of care, and how they are starting to implement some small changes consistent with that in Fife, Scotland.
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“Being Mortal” by Dr Atul Gawande – an amazing book exploring how we look after older people and the terminal ill, and novel ways to improve and make that care more compassionate and holistic.
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Brene Brown ” Daring Greatly” – a great book exploring shame and vulnerability. She describes a “breakdown” positively as being an “awakening”
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