Good afternoon, everyone. We are going to go ahead and get started. Thank you so much for joining us today. We have a really great program scheduled, so I'm excited for this one. Just a little bit of housekeeping rules before we get started. Each of our speakers will go one after the other, and then afterwards we will leave the rest of the time for Q&A. My name is Jasmine Tapia, and I will be your moderator for today's session, Resiliency and Managing Burnout. And so I'm going to go ahead and introduce our first speaker, Dr. Stuart Slavin. He is a senior scholar for well-being at the Accreditation Council for Graduate Medical Education, short ACME. A graduate of St. Louis University School of Medicine, Dr. Slavin completed his residency training in pediatrics at UCLA and then served as a faculty member there for 17 years before returning to St. Louis University as Associate Dean for Curriculum. While at St. Louis University, Dr. Slavin led efforts to improve the mental health of medical students that produced dramatic decreases in rates of depression and anxiety in pre-clerkship students. He joined the ACME in 2018 and is helping to lead efforts to improve the mental health of residents and faculty across the U.S. So please join me in welcoming Dr. Slavin. Thank you so much, Jasmine. Just a pleasure to be here with all of you. Yeah, I think it was a little dangerous to actually title this Resilience, you know, Managing Burnout and Resiliency because one of the things I think that's going on right now in medicine is there's a pushback against resilience. So kudos for you to be here. And I understand, like, why people are saying it. I mean, what we need to recognize is this is the mental health crisis, burnout crisis in medicine today is primarily an environmental problem. But what I worry about when people push back and say, oh, don't look at me, you know, I don't need to be more resilience. No, I think there are ways that we can help teach skills and orient people so that the environment, this toxic environment, causes less distress, causes less pain for people. So as we work on the environment, I think we can develop these skills that will really help people try to kind of flourish despite the challenges that exist in medicine today. And I think all three of us are going to have different angles on how to do that. And one of the messages is each person has to find their own path. I mean, that's one thing I think is that we can't be prescriptive in this work. We need to help people find their own path. So in terms of introduction, a handful of framing thoughts as I look at this issue of well-being that kind of has informed the work I've been doing. And one is, there's this big focus on well-being. And as I was traveling the country before the pandemic, and now, you know, as the pandemic hopefully winds down, a lot of pushback from residents and faculty around, like, don't even talk to me about well-being. I like, given the work environment I'm in, well-being isn't even a possibility. And I can kind of understand that. And I've started saying, yeah, well-being can be a target, but it shouldn't be the only target. And what I landed on was, can we help people find more satisfaction? Really in two areas. First satisfaction with work, so that we should be working in the work environment rather than just giving people well-being techniques to take. So that's kind of a piece. But the second, which I'm going to talk about, a major focus of what I'm going to talk about today, is satisfaction with self, which reality, a lot of people in medicine struggle with, where we're really hard on ourselves. And trying to change that narrative in the stories we create, I think, is really important. Second is that we tend to think about mental health and well-being and burnout, depression, anxiety, all of these things as if they're binary. You're depressed or you're not, you're well or you're not. And they're not. None of them are binary. They all exist along a continuum. And so if you think of it as a continuum, I think the implications are significant. Which is, if you're pretty well, if you're pretty satisfied with your work yourself, maybe you can move to very satisfied. But if you're extremely dissatisfied with your work yourself and you're not well, maybe we can get you to moderately dissatisfied. And that's progress, right? You don't have to make this magical leap to what seems like an impossible goal. I think wherever you are in that continuum is moved to a better place. Well-being is not just about engaging in positive practices. Positive practices, which you're going to hear about from Sean, I think, to a great degree, and Melanie for that matter as well. Those are vitally important. But we should not ignore the negative forces that exist and that can affect us all and see if we can mitigate the damage caused by those negative forces that can complement those positive forces or positive actions we're taking as well. And then last of the framing thoughts that I think is really most important is this. This is a classic coal miner with the canary, right? So late 1800s, early 1900s, before technology advanced, they would take these little birds down into the mines, right? And if the bird got sick or died, they knew they had a problem, right? But they didn't give the canaries little yoga mats or tell them to meditate or exercise or eat well, right? They said the problem is with the mines. So while I'm talking about resilience, I have to say again, we are not going to resilience our way out of this problem. And we need to continue to push hard so that the environment is not so toxic, not so toxic. Again, what we have to recognize is our experience as human beings, not just physicians, is it's not shaped only by the environment. And what's interested me in recent years is these other drivers of poor mental health, which actually have been very well studied. And there's a good amount of evidence to support what I'm going to be talking about in terms of these other drivers. And what I term them, the terms I have for them is problematic mindsets and then automatic thoughts. And I'll start with the problematic mindsets and kind of talk about the ones that I think really come to play for physicians. And actually, it happens well before practice in residency, medical school, and even earlier. I'm doing work with high school students right now that finds these mindsets are extraordinarily prevalent. So these don't just pop up suddenly when you're a physician. These can be long standing and exist for quite some time. So the first cluster is the one that I'm going to focus on the most. And it's one that I would say is characterized by a self-critical voice. That voice that says you're not smart enough, you're not capable enough, everybody else is performing better than you. And there are a number of specific mindsets that kind of fit into that. The first one is viewing performance as identity. You know, in academic terms, it's getting an exam score, step one or step two score that's lower than you expected. And feeling not that I got that score, it's I am that score. It's a measure of my value or worth as a human being. As a physician, it's, you know, forgetting to check a lab or making a mistake. And rather than thinking, oh, I made that mistake or I forgot to check the lab, it's I'm a bad doctor, I'm a bad person. Very different impact on our well-being, I think, if we view performance as who we are rather than what we've done. Second, if things don't go well, it's tendency to move to kind of personalization and self-blame. That it's all my fault. You know, how could I do that, et cetera, et cetera, right? And you know, so again, let's say you forgot to check a lab, just beating up on yourself rather than going, honestly, like the demands on me are completely inappropriate. It's understandable that things can, you know, fall through the cracks. It's this tendency to beat up on yourself completely. These next two I'm going to put up together because I think they travel together sometimes. And the second one has actually gotten more attention, which is imposter phenomenon. And it should be getting a lot of attention. It's the feeling that you're an imposter, you're a fraud, you don't know what you're doing and it's only a matter of time before you're kind of outed in some kind of way. It's that other one that I think isn't getting enough attention, frankly, that I think is widespread, absolutely endemic in medicine, which is maladaptive perfectionism. That tendency, which is exactly what it sounds like, to set the bar so high for yourself that you're repeatedly disappointed in yourself. Not disappointed in your performance, disappointed in yourself. So those are kind of these mental models and mental filters, the thought processes in which we can view ourselves in our own performance. What also is interesting to me, though, is the feelings that can be associated, the feelings that sometimes are produced by those kind of thought processes. And back at St. Louis University, we looked at this in our first year medical students. Feelings of inadequacy, feelings of embarrassment, or the one that's most toxic, feelings of absolute shame about yourself. And what we found, we did a really interesting study with first year medical students where we screened them for maladaptive perfectionism and imposter. And what we found is if you screened positive for either one of those conditions, you are much more likely to report feelings of inadequacy, embarrassment, or shame. And if you had feelings of inadequacy, embarrassment, or shame, you are much more likely to screen positive for depression or anxiety. Now there's no way you could prove causation with that. It was cross-sectional. All we could prove was correlation. But it really fits with a psychological kind of cognitive behavioral model that thoughts can drive feelings. Feelings can actually contribute to adverse mental health outcomes. And those adverse mental health outcomes can then produce even more distorted thinking. When we get depressed, our thinking about ourselves becomes more distorted. So two more. Stanford Duck. This one is less known by people. And it's not unique to Stanford. Stanford undergrads came up with it. But the University of Pennsylvania has it as well. They call it Pen Face. But I really like Stanford Duck. I think it's really evocative of the condition, which is you imagine this duck floating along the water in a pond or a lake, so peaceful, so calm. But if you look under the surface, their little feet are paddling like crazy, right? So there is a strong culture in medicine. Hide your distressed. Hide your struggle. And the problem with that, really twofold. One is if you're struggling, and you look at all your colleagues, and they look great. They look like they're on top of it. It tends to be isolating. It makes you feel like, oh, no, I'm the only one struggling. No, you're swimming with a lot of ducks, OK? And there are other people who are struggling as well, right? So that's one. And then the second is, especially with medical students, residents, when they're engaging in Stanford Duck, it makes it much more difficult for us to identify those who are in serious problem may have suicidal thoughts because of the stigma they're hiding, their vulnerability. So a major problem that we need to continue to work on in terms of the culture of medicine. And then this last one, you're probably familiar with this, is this fixed versus growth mindset. It's mostly been applied to cognitive ability, like your ability in math. But I think we need to have this growth mentality when it comes to things like resilience. How well your capacity to deal with adversity and manage to flourish despite challenges in your life. So those are it for cluster one. And I always have to pause at this point in my presentation to say a couple of things. One is, if you're like, check, check, check, I got a bunch of them still, right? Don't feel bad. These aren't evidence of psychopathology. They aren't character flaws or character weakness. You didn't choose them. They actually were fostered and nurtured along this pathway before med school, before residency. And frankly, what we're doing to our teens right now, this is a major source. Everybody's pointing to social media. Studies I'm doing right now, ACGME gave me 15% time to work on adolescent mental health. What I'm finding is it's academic pressures and achievement pressures that is a primary driver. But it's not the only thing that's causing distress in our lives, in our kids' lives. Yeah. So check, check, check, don't feel bad about it at all. That's the last thing I want you to feel. And then the second thing that's really most important is, if I ended the talk right now and you suffer from these, you'd be, oh, thanks for pointing all of these out. But I think the really important thing to transition to is, no, there's hope. Every single one of those mindsets can be changed. Every one of them can be changed. And what the primary focus of this talk is how to do it. Two key skills, and then just in the last few weeks, I didn't add this to the slide, but there's a third skill that I think is really important as well. So the first two, metacognition, which is the primary one, but it needs to be supported by mindful awareness. And then the third one I have added recently is self-compassion. Self-compassion. I think it's absolutely critically important to help manage, you know, the challenges of these mindsets that I talked about before. So metacognition is just a fancy way of saying be able to examine your thinking and change it in ways that are more accurate and serve you better and cause less pain. Of the metacognitive skills, there are a number of them. To me, the one that is most useful is cognitive restructuring. And cognitive restructuring basically, people probably know, forms the basis of cognitive behavioral therapy, which is still gold standard treatment for anxiety disorder, helpful for depression, primary treatment for depression. And actually, if you saw a therapist for maladaptive perfectionism or imposter, they would almost certainly use some form of cognitive behavioral therapy to help you out. And the question I ask, and I don't really have a good answer for this, maybe we can talk about this at the end, is why do we withhold these techniques until you've developed a mental health disorder and need to see a therapist? And I actually have research protocols right now with high school students and with college students saying, can we teach these cognitive restructuring skills to actually prevent depression and anxiety so that you don't need to see a therapist? So cognitive restructuring, how does it work? It's really simple, which is what I love about it. Very easy to teach, very easy to understand. Harder to put into practice, though, because you've been thinking a certain way for a really long time. And it's training your brain to look at yourself and your situation in different ways, right? And that takes practice. We tend to go through life thinking adverse event equals outcome. Something bad happens, that's our personal outcome. And we don't like to say the absolutes in medicine, but this is an absolute. It is never true. It is never true that adverse event equals outcome. It's adverse event plus your cognitive emotional reaction. The meaning you create about that adverse event that produces the outcome. And by definition, the adverse event has occurred. You almost never can change the adverse event. It's happened. So the only way you're going to impact your personal outcome is by managing your cognitive emotional reaction in ways so that it doesn't add to the distress. And a story I heard recently that kind of I think frames this in a really interesting way is an ancient story. This comes from Buddhism. And I always have to say, if you're a practicing Buddhist, I hope I honor this story. I'm not Buddhist. But this story, I think, really resonated with me. And what the Buddha says is basically, when something bad happens in our life, two arrows fly at us. Two arrows fly at us. One is the event itself. And oftentimes, we have no ability to change the trajectory of that. It's going to hit and it's going to hurt and you will suffer from that first arrow. But every time a bad event happens, a second arrow flies at us as well. A second arrow. And that we shoot ourselves. That's the meaning we attach. And what cognitive restructuring is about, managing your thoughts, is managing the trajectory of that arrow. So maybe it misses you completely. Or maybe it hits a glancing blow. Or it doesn't strike deep and it doesn't add to or multiply the pain of the event itself. So really, to be clear, with cognitive restructuring, the goal is not to be happy when something bad happens. The goal is to not make the pain worse with your cognitive emotional reaction. And the problem is, we are all susceptible, as part of the human condition, to distorted cognitive and emotional reactions. One set that I've already described to you that produces this is these mindsets. These kind of broad mental filters. But in addition to those, there are a whole range of more micro thoughts, micro reactions that we can respond to or responses to events. And that's these automatic thoughts and cognitive distortions. And just in the interest of time, I'm not going to go through these, but I'm just going to kind of name them and define them quickly. Magnifying taking a small event and blowing it up into something really big. All or nothing thinking, getting the result you want, this goes with perfectionism, or thinking of yourself as a failure. Overgeneralization, taking one negative event and seeing it as part of a pattern of bad things you always do. Tunnel vision is kind of the converse of that. Focusing in on this negative event and discounting all the positive things you do and all the positive things that exist in your life. Fortune telling, predicting the future with certainty. Catastrophizing, taking this little event and imagining some terrible catastrophic event in the future that's going to result just from this tiny little event. Mind reading, having the belief that we can be, you know, know with certainty what someone is thinking or why they're behaving a certain way. You can have an idea of that, but there's no way you can know for sure. And then finally, disbelief if someone tries to counter your distortions. And again, what I would say, check, check, check, don't feel bad if you have these. There's a widespread and endemic, and I think they're particularly common in physicians. You know, we're hard on ourselves. We drive ourselves. We're very self-critical. And what I should say is that's not just, it's not all a bad thing, right? I mean, that conscientiousness, this desire to perform at the highest level is wonderful. But if it's carried too far, it can add to profound distress, profound distress to ourselves. And it isn't functional. It isn't adaptive at that point. So cognitive restructuring, quickly, how does it work? Three simple steps. The first step is to simply notice, to be able to kind of recognize, you know, the thoughts and feelings you are experiencing. And maybe it seems obvious. Of course, I would do that. Now, with all the incoming, you know, stimuli coming at us, especially in clinical practice, it's easy not to notice. And this is where the mindful awareness comes in. Second is to label it, give it names, right? So to identify, oh, I'm using that maladaptive perfectionism. Don't stop with one. Oh, I'm doing all or none thinking, add magnification. And the key here, this is where that third skill comes in, which is that self-compassion. You do not want to beat up on yourself as you're labeling, right? At a minimum, you want neutrality. The last thing you want to have is like, oh, there I go again. I'm such a loser. No, neutrality is at minimum what you want. And if you can look at yourself with some self-compassion, that's even better. It used to be thought that you had to go on to the third step, which is to dispute. But there's a whole range of what's called third wave cognitive behavioral therapy, dialectical behavioral therapy, DBT, acceptance commitment therapy that says, no, don't dispute. If you can notice, label, and distance yourself, and then there are other strategies you can use to kind of manage these. But you don't have to get in a fight with your thoughts. But I have to say, to me, at least I need to teach you the disputing strategies and decide if it works for you. But even the notice and labeling can have therapeutic value. The disputing, there are a bunch of disputing strategies. Two, I'll mention briefly, is one, what's the evidence this thought is true? And what's the evidence it's not true? My daughters, when they were high school, used to be stunned that I would tell them that there were medical students who I would meet with in kind of supportive meetings who would say they felt stupid. And my daughters were shocked. How could a medical student feel stupid? They're in medical school. And my daughters were right. We tend not to admit low intelligence people to medical school. So it's an example of what's the evidence this thought is not true? But then the second one, which I really like, and can be done in combination, is called the double standard, which is, let's say your best friend in practice, in fellowship, whatever, comes up to you and says, oh, my gosh, I forgot to check that lab. I didn't know that answer on rounds. And it's so embarrassing. Would you say to your best friend, well, you're completely incompetent. You're stupid. You're never going to be a decent doctor. You might as well quit now. No. I hope to God you wouldn't. So the question is, why do we use a voice with ourselves that we would literally use with no one else? And second, if somebody used that voice with you, you'd be outraged. You'd be like, how can you speak to me that way? So it's finding a little of the compassion that we show to so many people around us and directed at ourselves. The difficulty for some is I think that sometimes people feel that beating up on yourself is essential for your performance. And I cannot disagree more. And what you should be after, I think, is a healthy pursuit of excellence rather than an unhealthy pursuit of perfection. We are all going to make mistakes. We are all going to have knowledge gaps. And we can't continue to beat up on ourselves. Because if that produces depression or anxiety, that will have a negative impact on our performance. So keeping ourselves in that healthy place, I think, is absolutely important. Mindful awareness, I'm just going to say a quick word, which is how to cultivate the most notable way of doing it. And I support completely is meditation. But the reality is most people as physicians are not going to meditate. I wouldn't discourage anybody from meditating. But it's not the only path to mindful awareness. And if it's hard to fit that into your lives, you can use informal practice that takes no extra time in your day. I love those techniques that take no extra time. And an informal technique is, you know, when I was at St. Louis University, my office was a minute from my parking spot. And I would use whenever I could remember that as an opportunity for a little mindful awareness exercise, which was just to focus on one of the senses. One day it might be sight. Another day it might be sound. And just as thoughts come in, notice them and then return your attention to the sense. And that's it. And over a course of six months or a year, I became more mindfully aware. Could I have been more mindfully aware if I meditated? Probably. But I didn't need to be. I got to a level of mindful awareness that served me well. So that's it in terms, that's the bulk of the talk. And I just want to just mention this problematic mindset cluster two, which is much more related to mood and affect. And just want to mention it briefly and tell you some resources to deal with this. You know, I'm back traveling the country a lot. And one of the things that I think is going on is the mood in physicians in academic medicine feels really profoundly negative. And it's understandable. And what I'm seeing is a lot of negativity, cynicism, pessimism, frustration. That was going on before the pandemic. And what I see more now, though, is like anger and resentment. And again, I think it's understandable. But what I think each of us is challenged to do is to say, do we want to live in that emotional space? Fine to feel it. Completely appropriate to feel it. But I think there's a challenge for each and every one of us to say, can we pull ourselves out of that so that we can still find joy and meaning and purpose and try to flourish even in an environment which isn't supporting us in the way it should? Wellbeing toolbox. My stuff before was, I think, pretty prescriptive. I really do think having some ability to manage your thinking is really essential. These tools really are not ones that I think you can't do all of them. And I'll say right here, I don't have time to go through these at all. I only have a minute left in this presentation. I actually have, there are a series of podcasts that if you're interested in looking, if you just search ACGME Aware, A-W-A-R-E, there's a series of four on cognitive skill building. And the last of those podcasts, 20 or 30 minutes, deals with these. So if you're interested in finding some tools to deal with these challenges to our mood and affect, I think is really important. But the last I'll just mention is finding joy and finding meaning that I'll end with is this quote from Viktor Frankl, who Holocaust survivor, neurologist, psychiatrist and author of the book Man's Search for Meaning said the following, there's nothing in the world I venture to say that would so effectively help one to survive even the worst conditions as the knowledge that there's a meaning in one's life. There's much wisdom in the words of Nietzsche, he who has a why to live for can bear almost any how. So as physicians in this broken healthcare system, I think we are all challenged to find that why, to feel that why and be sustained by this why. So good luck to you. I can't wait to hear the next two presenters that will shed more light on this issue of how to thrive in this just challenging time. Thank you so much. That was wonderful, Stuart. Thank you so much. I really enjoy his talk, and I really like the fact that he talked about self-compassion, because I think often in our spaces, we don't give ourselves enough grace. So thank you for that. Our next speaker is going to be Dr. Shana Newton-Levaille. She received her PhD at UC San Diego, where she studied the reproductive neuroendocrine axis in the lab of Dr. Pamela Mellon. In 2018, she completed the Rady School of Management micro-MBA program and was accepted into the Endocrine Society's Future Leaders Advancing Research in Endocrinology FLIR program. She was an active member of the Endocrine Society's Trainee and Career Development Core Committee from 2018 to 2020, and served as chair of the Society's Summer Research Fellowship Program in 2019. She is currently a postdoctoral fellow in Dr. Graham McVicker's lab at Salk Institute, where she is studying the role of genetic risk variance in type 1 diabetes. So please join me in welcoming Dr. Levaille. Thank you so much for that introduction. I'm going to be taking more of a personal approach to my presentation, but it's really nice following Dr. Slavin because I think you'll see some of these mindsets that he was talking about as I talk a little bit about my story. So let me go ahead and get started. So I first just want to start off by sharing a little bit about my background. I used to always skip over this part because I didn't think it was relevant to where I am now. But as I've learned over the years, my background is very central to who I am as a person and how I operate. So I'm originally from San Bernardino County. I went to low-income school districts from elementary school through high school. And in these schools, it was not the norm to go to college once you graduated. Most people just stuck around in the area. I was very fortunate that my parents always valued education, and they encouraged my sisters and I to pursue college. And even though they didn't have any experience with it themselves, they instilled in us from a very young age that we could do anything we wanted in life as long as we worked hard and were dedicated. So with that mindset, I went to Cal State Long Beach for my undergraduate degree. I eventually settled in as a biology major. I joined a lab where I studied mating behavior in fruit flies. And I worked hard between classes and studying, working in a lab, working outside of a lab. I always felt like my biggest challenge was time, not having enough of it to do everything that you needed to do and to be able to do it well. But I was dedicated. I was willing to work hard. So I made sacrifices. I sacrificed my sleep, number one. I sacrificed my social life. I never went out, like maybe two, three times a year at most for a single day. And I basically sacrificed anything that wasn't directly leading me towards my goal, which was to get into grad school. And the reason I did this is because I felt if I wasn't spending every single moment of my time working towards my goal, then I wasn't doing enough. And if I failed, it's because I wasn't dedicated enough. So that's the sort of mindset that I had. And for undergrad, it worked. I did well in school. I published a paper in my undergrad. And I got into grad school, yay. I just have to do it all over again now, right? But I was ready. I did it before. I was motivated. I was planning to study hard, put in the extra work if I needed to, network, join committees, make novel discoveries, and get my degree, right? All it takes is hard work and dedication. Well, it turns out that's just one part of the puzzle. Because the road is long, and it doesn't end after your degree. You know, then you have your next stage of training, and then the next. And it's continuous. So if you are not working hard in a way that's sustainable, at some point or another, something's going to come and knock you off your feet. And the reality is, no matter how well you plan, life is going to throw you obstacles. You know, and this might be something simple, like your assays don't work. Maybe there's a major life event. You got sick. A family member got sick. You know, maybe you just have negative data after negative data after negative data, because that's how science works. Or maybe there's a global pandemic, you know? And for me, the global pandemic is what ultimately knocked me on my feet. I was in my final stretch of grad school. You know, I was up to my ears in experiments. I was mentoring three students. I was chair of the Endocrine Society's Summer Research Fellowship Program, and I was taking an online class to help me be better prepared for my next career transition. And you know, I was going full force, doing the same thing I was always doing. And I felt like I was running full speed on a treadmill, but I was doing it, you know? And when the pandemic came, it's like it just unplugged the treadmill, and I fell flat on my face. And I struggled. And a lot of the mindsets that Dr. Slavin talked about really resonate with me, because I found it very difficult just to switch over to working from home. You know, I had things to do. I had manuscripts to write, but I couldn't do it. And the more that I wasn't doing it, the angrier I was getting at myself. It was a shame for not being able to do something so simple as write. When I'm working from home, there's nothing else for me to do, so why couldn't I do it? And the angrier I'd get at myself, the harder it was to do anything, and I could see myself going into this downward spiral. And so ultimately, I finally had to take a step back from focusing on work and trying to do this thing that I couldn't do and focus on my mental health. So I ended up taking this course called The Science of Well-Being by Yale professor Dr. Laurie Santos. It's on Coursera if anyone's interested in checking it out. And so today, I just want to share some of the things that I took from that course and that have really impacted my life over the last couple years. So to start off with, I just want to talk about what resilience is. So resilience is the process of adapting well in the face of adversity, trauma, tragedy, or significant sources of stress. Resilience is not being unaffected by the difficulties or stress, and it is not being able to just grin and bear it. I think one of the reasons the pandemic hit me so hard is because I was already operating on empty. I was walking this fine line, and I didn't even know it. But the good news is you don't have to wait till you're burnt out to start developing it. You can start working on it now. And if you're not burnt out and you just want to implement it, it can transform the way you operate. So we can do this by developing work-life stability. So I first want to say that I don't like the term work-life balance because it inherently implies that if you are taking time for yourself, then your work is going to suffer. And if you want to do well in your career, then you're going to have to sacrifice your personal life. But as I went through this course and started focusing on my life, what I found was that I felt better emotionally, I felt better physically, and I was just happier overall. But the surprising thing is once I started building up these personal wellness techniques, my work started coming back. I had more bandwidth. My productivity shot through the roof. And the quality of my work was better. So to me, it was mind-boggling. I was so confused almost. Super counterintuitive to the way I had been operating my entire life. Could I have been doing this this whole time, enjoying my life and producing quality work at a higher rate than I was by sacrificing all of my time? So the answer is yes. And I have really taken this to heart and continue to practice this. So I just want to share some of the practices that I learned through this course. The first one is obvious. Everybody knows we should be doing this. And that's sleep. You know, seven to eight hours of night on a regular basis. You know, research shows that it improves mood, it consolidates memories, it facilitates insight, and improves motor skill performance. You know, we're in very high-demanding jobs, and we need the energy and the bandwidth to produce quality work. Of course, we're going to have deadlines, we're going to have things thrown at us that were unexpected, because that's life. And so you have to be, you know, sometimes you do have to give a few hours. But if you're on a normal basis, rested, you have the energy to kind of like give and take, and then come back to your normal state once that has passed. Another really big one is exercising, 20 minutes about three times a week. And this doesn't have to be, you know, going to a gym, going for a run. It could be light to moderate, you know, going for a walk, playing outside with your dog. You can make it whatever you want. But research again shows that it improves mood, and it's actually more effective at long-term recovery of depression than medications. It improves cognitive tasks. And again, you don't need to do anything intense. Light to moderate exercise is sufficient. But here are, through this course, there was a whole bunch of different practices. I actually tried implementing all of them one at a time. But the one that really stuck out to me and really changed my life was meditation. I used to also be very resistant to meditating, because who has time to sit there and think about nothing? You know? I didn't think I did. But, you know, I was like, okay, I'm willing to give it a try. And I did. And I find now that it's a very powerful tool, because it trains your brain to work for you rather than against you. You can train your brain to focus its attention where you want it to go. And then you can learn to redirect it once it's wandered, because that's what brains do. They naturally wander. And for me, I think one of the big reasons it was really helpful is because it helped me recognize some of the problematic mindsets that I was having. So I started meditating during the pandemic. I never stopped. I'm at 1,100 consecutive days. So I just wanted to share that, because I'm proud of it. Some other ones that you can do are acts of kindness to others. That increases your well-being. Social connection. Even if you're an introvert, just smiling at somebody or waving at somebody that you pass on your morning walk can bring more feelings of well-being and happiness. There's gratitude. Yes. You do have to work, and I will get into, yeah, so I'm talking about all these different things that Yeah, and that's that's an excellent point because I'm talking about all these things that everybody knows one You can't do all of them. You have to choose what works for you and what works in your life and After this light, I'm actually going to get into how you can start integrating it into your life without You know adding additional bandwidth to your day if you're out of bandwidth, how are you going to do these things? You know, how are you actually going to implement them? And I am gonna talk about that, but that's an excellent point. You can't do everything You have to choose So again gratitude giving and I just want to touch upon one of my favorites is savoring And this is one that anybody can do because it doesn't take any extra time out of your day All it is is stopping to recognize the moment that you are already experiencing, you know And this is something I never did. I think life was just passing me by because I was you know on track to do all these things But it can be something as simple as enjoying the sunshine when you walk out of a cold building, you know or a conversation that you're enjoying with, you know a stranger or a relative, you know, just Enjoying the moment while you're in it so that has been a big one for me because it's brought joy in times of you know when I'm slammed when there's been family deaths like It's really helped me But let's talk about how we actually do this and The best way I think is the power of habits And this is because every time we do something new no matter how simple it is We have to one decide to do it decide when to do it and then decide not to do something that we're normally used to doing and that requires brainpower and In our high demanding jobs, we have limited brainpower and if you're not sleeping you have even less of it so first Focus on one or two new habits out of time. No more. Just choose to focus on one Second you can find both personal and professional habits to help both your personal life and to make your career easier And the key is to start small and make it easy and When I say easy, I make mean make it so easy that you can't give your in itself an excuse not to do it So during the pandemic one of the problems that I was having was, you know Being productive getting back on track and I knew I had a manuscript to write But I just couldn't do it so I started a writing habit and I started with two sentences a day That's all I did two sentences if I felt like doing more I would but I couldn't give myself an excuse To not do two sentences, even if it's the end of the night I'm tired. I can sit down and write two sentences and more often than not those two sentences led to more And those two sentences turned into 15 minutes and then I would do 15 minutes a day and If I did wanted to do more I would if not, I'm still making progress towards my goals So I always joke that my first paper from grad school. I wrote two sentences at a time But it worked and I still use that method today when I have to start writing a new grant or a new paper Sometimes it's hard getting started. I just start with two sentences So you can think about what's going to help you in your career to make it easier And so I talked a little bit about different strategies to help build resilience I also want to talk a little bit about some practical strategies to manage burnout First be selective about where you invest your time. You can't do everything everywhere all at once I know that we feel like we're expected to but we can't So the way I kind of decide Where I want to spend my time is one asking if it's beneficial to you if it's beneficial to your career Secondly, is it rewarding, you know, maybe it's not gonna help you move forward in your career But if you enjoy doing it, you know, it's gonna be restorative if it's not it's gonna be draining and take away more bandwidth Second create boundaries and stick to them This I think is the hardest part in all of our jobs because we do have these expectations. They're coming from others But some strategies to kind of stick with them. You don't have to give an answer right away You can tell them let me check my schedule and get back to you if you're put on the spot Or if you know, you absolutely don't want to do it you can tell them I would love to but I currently don't have the bandwidth and If it's coming from a boss or superior that does have the authority to tell you what to do You can ask them what they would like you to deprioritize that way you're establishing that you can only do so much at once and Lastly I want to talk about Stop being so hard on yourself It's not helpful. And Again we have to untie our Failures from our self-worth, you know Also own your accomplishments. I think we are so used to diminishing the things that we do We need to start celebrating them, you know, be proud of yourself and be proud of your efforts I start celebrating things when I submit something now because it's the effort You know that you should be proud of you can't determine the outcome you can't control the outcome of a grant You could put all the work do all the right things and not get the outcome you want But if you're proud of your effort, you know, you can continue and go on to the next one Celebrate both the big things and the small things and also celebrate others I think it's very important to try and foster the environment that you want You know foster the environment where you're lifting others up because they're gonna turn around and try to lift you up It's again about changing that environment That we're used to struggling in And with that that is all I have to share with you guys Thank you so much Shana for that that was wonderful I really liked the part where she talked about redefining work-life balance right stability I think the whole concept of doing something small and eventually it will lead to something big a bigger outcome I think that was great. So we're gonna round this out and finish it up with dr. Melanie McReynolds She is an assistant professor of biochemistry and molecular biology and a Dorothy for Huck and J Lloyd Huck early career chair in biochemistry and molecular biology at Pennsylvania State University Dr. McReynolds holds a BS degree in chemistry and physics and an MS degree in molecular biology from Alcorn State University She completed her PhD in biochemistry microbiology and molecular biology at Pennsylvania State University and Melanie was recognized as a rising star on the cell press list of top 100 inspiring black scientists in America during her postdoctoral tenure at Princeton University And so with that, let's welcome. Dr. McReynolds All right, good morning afternoon, I'm not sure what time it is now But I am excited to be here today to talk about ways we can manage burnout and promote resiliency especially at a time when I am very Right, and I'm happy to go after the first two speakers because I'm going to summarize basically what we discussed and Introduce a tool that I use which is faith in science to really Navigate the problematic mindsets and to promote well-being in science and medicine All right so first I just want to you know for us to get to know each other to have some cute a moment of questions and Answers and we're all here today Managing burnout and promoting wealth well-being and resiliency. So what do you all hope to gain? AJ Well, yeah, how do we manage stress anyone else? All right What in your opinion what is resilience or resiliency and can we ever really develop it over time? I See a lot of nods so is something that we can develop. Okay, and Your opinion what is burnout? Can we ever really manage burnout? Can we avoid burnout or do we have tools to just kind of navigate burnout? I think burnout is when you feel like you just can't do it anymore. You're overwhelmed just too much going on Can we really manage it? I haven't learned how to do it yet. So I'm hoping to learn some tips on that Megan yes That's true. The key point, I think, giving ourselves grace, yes. It is, yes, it's tough. Yeah, so, yeah, I'm excited to dive into this and talk about a couple of practices. For my own research, right, I'm a scientist, I study metabolic resiliency and stress as we age. So it's interesting to talk about this as far as ourselves, right, but it's all interconnected. And so first let's understand burnout. So at the general point, burnout is a state of chronic physical and emotional exhaustion, cynicism, and reduced professional efficiency as a result of prolonged exposure to work-related stressors. And so in medicine, in science, again, burnout is defined as a loss of enthusiasm for work. We're in medicine, we're in science because we were once passionate about science. We're in medicine, healing people, identifying discoveries. But with burnout, we're over it, right? We have those feelings of cynicism where we know, we think everybody is out for themselves, it's like a personal, the lady who left brought up a really great point of like that personal self-interest and drive that can trigger us into burnout. And then we get that low sense of personal accomplishment because we're always setting the bar so high. So Stuart really talked about that with his problematic mindsets. And then when we're making accomplishments, it's still never good enough. And then we get a negative attitude towards others at work, right? And so you begin to hate the people you're working with. So if you're a medical doctor, if your nurses are annoying you, what are we really doing? Like a lot of us in the lab here are starting new labs or are new PIs. And so we really don't need to be annoyed with our research technicians, our grad students, our postdocs in order to be a team, right? Because we're better together. And finally, when we know we're burnt out is when we have days off and we are unable to recover. We are unable to get any rest because we're always thinking about what we're not doing as we are working or we're thinking about work and we're just over it and then just exhausted. So this, so burnout can have multiple impacts, right? First on individuals, it triggers physical and mental health issues as we've been discussing, job dissatisfaction. So you're just over everything you're doing and that creates an impairment in performance. So you're not able to do what we're supposed to do in those spaces. And then we're hard on ourselves because we're not meeting our goals. And then those interpersonal relationships, right? So when you're burnt out, it's hard to have relationships with the people you're around and it really creates more animosity and negativity in those spaces. And within the organizations at the hospitals or within our own laboratories at universities, we get decreased productivity, right? So we're not collaborating within the lab, we're not working together, increased turnover or even just being absent. So we're just not showing up. And even if we are showing up, mentally we're not there or we may see staff turnover, right? So you really are unable to get a really good vibe and cohesion with your, let's say, with your medical group if people are always in and out. For a lot of us new PIs, the reputation of our lab means everything. So if I'm walking around my lab stressed out every day, how will I recruit grad students into that space? And when I think about medical, the people in the medical profession, patient outcomes, right? When you are burnt out in a hospital, what happens to your patient, right? If you don't even care to be there. And so as it was mentioned earlier, there has been research that really shown that there is increased prevalence of burnt out among healthcare professionals and scientists. Again, it can lead to detrimental effects on patient care, mental health issues. We see now in science and medicine that there's so much depression and so much anxiety. And again, the high turnover rates and reduced job satisfaction where we're just not happy to be there. And when we think about scientists and industry and academia, again, burnout can negatively impact productivity, creativity, and innovation. We are meant to be innovative. And again, when we think about in academia, the career advancement and progression, that's really how we get the leaks in a pipeline where you have people falling out of the grad stage and the postdoc stage as they're transitioning into other areas. And I think about us who are postdocs or just new faculty members, the pressure to secure funding, publish our research, meet tenure requirements, all combined with just exhaustion and a lack of motivation. And it can affect everything we're doing or we've worked so hard to do to finally be in this position, impacting research productivity, collaboration, and just our overall career satisfaction, which will lead into our trainings later. So again, what are these factors? We have high workloads in medicine and science, long hours, all of the emotional demands. I can only imagine what it's like working with humans and dealing with patients, right? That can really weigh administrative burden. I think in medicine and science, administrative issues, it's a lot, especially now with high turnover at that place too, right? A lot of times, lack of control or anonymy can really impact us. Those interpersonal challenges, either at home or at work, the professional expectations that other people put on or even what we put on ourselves. And finally, the ethical dilemmas, right? So how do we navigate those issues that is not really clear? And I think it's really essential for both scientific organizations and healthcare organizations to prioritize well-being for their staff to create systems that support resilience and prevent burnout. But how do we get there? So again, today, there are several tools that individuals can use or organizations can use to help mitigate burnout, but I'm going to focus on sole care. So I'm presenting faith as just one potential aspect of resilience. There are so many more tools, and I'm respecting and acknowledging that there are various perspectives and various beliefs, but just in general, how can we use faith to begin promoting resiliency? First, I want to just quickly talk about some of the best practices for promoting well-being and resiliency or what I'm currently thinking about and what I share with others. Shana talked about this in great detail, right, but we know exercise, eating healthy, and adequate sleep, right? Just light, moderate, any exercise is very beneficial. We know as scientists, exercise releases endorphins, which are natural mood elevators, and it reduces a lot of those stress hormones. Eating healthy, right? When we are busy, when we're burnt out, when we're on a go, go, go, go, go, it's impossible to eat healthy, and we know that the food in our body gives us all of the energy we need. So having a good nutrition, it can support our energy levels. It can enhance the cognitive performance, and it can really strengthen our immune system, which contributes to overall well-being, and finally, adequate sleep, right? And it's hard because we have so many things to do, and when we get home, we still got to answer emails, right? Like, how do we answer emails during the day when we have so many other things to do? Or when do we finally write? When do we finally go through our clinical data, et cetera? But we got to give ourselves time to recover. And so again, adequate and restful sleep, it allows the brain to, like, consolidate memories, all of those thoughts, all of those questions you had, like, oh, my God, this would be a great R01. But if you're going, you're going to forget those ideas, right? Your emotions, and also, it just allows you to recharge for the next day. I like what you said, work-life stability and not really work-life balance, right? But here are some of the, you know, it's a really a continuous loop. I don't have a pointer, I keep trying to point, but self-care and well-being, and then you can seek support and communicate, right? Communicate with others what you're going through. I really love the Stanford duck, because when people ask me, how am I doing? I'm like, I'm a duck. I'm floating peacefully, but you don't see how crazy I'm kicking. But somebody else can be going through what you're going through, too. Prioritize and set realistic expectations for yourself and others. Establish boundaries. That's one of the most important things that I'm learning now as a new PI. Everyone can have access to you, and it's okay to have boundaries. Delegate and collaborate. It's okay. You don't have to do everything yourself. And if you can delegate tasks and allow, and sometimes I realize like some of my grad students, they actually want to do, and I don't have to be a postdoc forever. I need to let go and trust, and actually we get more done when I can just delegate those tasks or even collaborate with others. Time management, I call it, or I'll even say, you know, we all are procrastinators, but how can we procrastinate productive? So having productive procrastination, and sometimes we just need to disconnect and unplug and just, you know, from the news, from social media, from everything, and again, that leads back into the self-care, well-being, and seeking support. And so secondly, building a supportive environment. If you're working in a hospital or you have your own lab, fostering a supportive workplace that encourages open communication and empathy, it can play a crucial or critical role in promoting well-being and building resiliency among individuals in your organization. So doing this can promote psychological safety. It can reduce stigma, promote social support, collaboration and teamwork, empathy and understanding amongst others. You can begin to resolve conflicts and problem-solve, and then it helps your trainees or the people under you to kind of go into leadership roles, et cetera. And so again, all of this work together to enhance or foster a positive workplace culture. And hopefully this, again, can reduce burnout, promote well-being, and build resiliency amongst your employees. Thirdly, what about various stress management techniques? And again, being able to manage stress is essential for promoting well-being and building resiliency, right? And so there are a couple of techniques, deep breathing, mindfulness movement, positivity and self-care. We all know that. But I wanted to highlight that resilience and stress is linked scientifically and is linked interpersonally. We know that people low on resiliency or resilience are four times more likely to be burnt out. But how can we begin to connect the two? I think we talked about this earlier too, but the professional development and growth mindset, we have that mindset. We know that continuous learning, skill development, and setting achievable goals is essential for promoting well-being and building resilience. A lot of times we have too harsh of expectations, right? But what are those manageable expectations that, you know, it's like celebrating those small victories that can keep us encouraged as we're going through. And again, by embracing a continuous learning and skill development, we can cultivate a positive growth mindset and equip ourselves with the tools necessary to thrive personally and professionally. And so where I'm going with this today, how do we take all of this and integrate faith into these resiliency practices? So sometimes if we can just set a... I think the question earlier was how do we have time, right? How do we make time? But how can we make time each day for prayer, meditation, or reflection, right? And this can be a moment of just really connecting with your spiritual beliefs or seeking guidance, expressing gratitude, or just finding that inner personal peace. And finding that inner peace can really help you reduce stress, promote mindfulness, and provide a sense of calm and clarity, right? And so we talked about positive thinking earlier. Here we have like... We can see how the physical, the emotional, the spiritual, and the mental all connect to create coherence. And basically at the center of this, if you can connect your work to a greater purpose and align it with your faith values, this really can have a positive impact on what you're doing and how others view it in a way to promote well-being as individuals and also as a society as a whole. And again, incorporating faith into daily practices is a personal and an individualized journey, right? But you have to find the practices that resonate with you and really align with your beliefs. All right. So in the final part of this talk, how can we use faith as a tool in managing burnout? And so faith to me, it refers to a deep trust, belief, or conviction in something that is greater than oneself. And this can provide us with a sense of purpose, meaning, and support. And so let's first explore how faith can provide a sense of purpose, hope, and meaning, acting as a protective factor against burnout. So when we think about a sense of purpose, again, faith encompasses a belief in a higher purpose or calling. So this sense of purpose can serve as a guiding light, reminding us of the meaningfulness of their work and the impact that we have on others. Provides hope and optimism. And so faith instills hope by providing a belief in the outcomes and the possibility of growth and resilience. And so again, this encourages individuals to maintain hope in the face of adversity, allowing us to see our challenges as temporary or surmountable. And then we also get meaning and fulfillment. Faith provides a framework for finding meaning and fulfillment in life. And again, this allows individuals to find purpose beyond our professional roles or our achievements, and emphasizing the importance of that personal growth, the relationships, and just a service to others. And again, summarizing what I've already just talked about, but faith as a powerful tool for managing burnout and resiliency, again, that sense of purpose and meaning. When we have purpose and meaning, we can navigate the hardships of life. We get a source of support. During those challenging times, it also can provide a mechanism to cope. How do we really begin to navigate stress, adversity, and burnout, and leading to resiliency and hope? And finally, that self-care and those boundaries, and yes. And so summarizing this, the emotional support and comfort during challenging times. We're going to have challenging times day and day, but just having that, knowing that it's only temporary, everything happens for a reason. And that also ties into the coping with stress, right? It's just like, ah, I know that I'm learning something in this moment, and I believe that I'm going to get through this. And that belief is just really that sense of purpose, like, okay, I'm a scientist for a reason. My life would have not led me into these doors if I was not meant to be here, or if I didn't have what was needed to do the job at hand. So it's really, you know, kind of reversing the problematic mindsets and just really believing in your own purpose. And again, faith is a thing to hope for, right? So it fosters that hope and that optimism, because you know that on the other side of that storm, there is going to be some sort of positive outcome, and a potential of growth and resilience. And again, a lot of faith traditions and practices emphasize this community and social connection, and we know that we are better together. And finally, just that moral compass and that set of guiding principle, it can just give you more values and help you with those ethical dilemmas. So finally, I have a couple of personal faith antidotes before we go into like a short discussion. So Dr. Johnson, a dedicated scientist, faced numerous setbacks and failures in her research. The constant pressure and disappointments were taking a toll on her well-being and motivation. Through her faith, she found solace and resilience. She sought comfort in prayer and meditation, allowing her to reflect on the bigger picture and find renewed purpose in her work. Her faith provided her with the strength to persevere, maintain hope, and eventually make breakthroughs in her science. The second antidote, Dr. Patel, an accomplished researcher, found himself overwhelmed by the demands of academia and the constant pursuit of grants and publications. The high-pressure environment led to burnout and a loss of passion for his work. Seeking guidance from his faith community, he realized the importance of balance and self-care. He started incorporating regular moments of prayer, meditation, and Sabbath rest into his routine. By setting boundaries, prioritizing his well-being, and trusting in a higher power, Dr. Patel regained his enthusiasm for research and experienced overall well-being. And finally, Sarah, a young scientist, struggled with imposter syndrome and self-doubt. Despite her achievements, she felt inadequate and constantly compared herself to her peers. Through her faith, she discovered a sense of worth and purpose beyond external validation. She leaned on her own spiritual beliefs, finding comfort in the knowledge that her value as a person and as a scientist was not solely determined by her accomplishments. This shift in perspective allowed her to embrace her strengths, overcome self-doubt, and approach her worth with a renewed confidence. So how do you all manage burnout, and are there any mechanisms that you believe you can incorporate into your daily practices? Sing it in a choir, that's a good release, I like that, yeah. Do you think it's healthy to be resilient all the time or is it really possible? Yeah, they do, yeah, yeah. I like, yes, yes, I could have not said that better myself. Can we really truly overcome burnout or will it always be a common occurrence that we need to navigate? So we're just going to always have to be able to navigate and know how to maneuver when we feel burnout coming. All right, so to summarize this in the last two minutes, I'm hoping to leave you with faith as a resource for managing burnout, promoting resiliency, and enhancing well-being. And just some of my personal antidotes, throughout this journey, through the scientific pipeline, I've learned that faith is not developed by being certain, but walking through doubts, fears, and just overwhelming uncertainty, right? And so with that, I learned to keep walking in faith. It's not a journey. It's a journey. It's not a destination. So you're not going to ever just get there, but you're just going to be continuing maneuvering all your life. It is faith that will dispel the gripping fear that keep us from having peace. And for me, it's particularly right. So fear, why am I here? I'm afraid. You know, I have these grad students, will I ever get funding for them to actually finish? But I have to believe that I'm there for a reason. I have to have my faith to get rid of that fear. Everything that we're going through is preparing us for our next moment. That's where my faith is. It's like, oh, wow, okay. This year was tough. These rejections were tough. But rejection is protection and redirection. So I know that it's going to propel me into where I'm meant to be. I've learned that doubt and faith cannot coexist. So if I'm being doubtful, I don't have my faith. If I have my faith and I believe, then I should not be doubting the circumstances that I'm going through. I learned early on in grad school, faith without work is dead. I just can't sit there and believe that I'm going to do something without putting in the work, right? But doing the work, I believe that one day it's going to pay off and it's going to work out for me. And I think that leads into the faith really provides hope or really something to look forward to. And if we can just keep that little positive, you know, in the midst of all of the negative and the darkness, then we know that, okay, I'm going to ultimately get led to somewhere. So hopefully keep this in mind, hindsight, insight, and foresight, right? Everything that you've gone through, that's your hindsight. Allow it to really influence what you see right now and what you're going through now. Your hindsight, allow that to trigger your foresight so that you can be able to navigate the challenging times and the various burnout to come. So when you come across one of those issues, you're able to navigate it and then your trainees can see that as well. And finally, I believe a lot of people talked about grit all the time, but faith is really that internal motivation to just keep going and persevering. And I really believe it's a foundation of grit. But like Megan said, pulling it too much, it can really break. So it's not really a superpower, but it's just what allows us to keep going. And at that time, we can have the overall discussion. Thank you. Well, thank you to all of our speakers. That was wonderful. And I think the overarching theme, especially as it cleared up here, find our inner peace. And so with that, we're going to open up Q&A. Please come to the mic and also introduce yourself. Thank you. Hi, I'm Sudeita Imtiaz. Thank you so much for this wonderful talk on this very, very important topic. My question is this, that when we're talking about mindfulness or meditation, what exactly do you mean? Is it the ability to change your thoughts to some senses or is this something more different than that? So what's your definition of it? So I think with meditation, there are so many different things. I think traditionally, I was hesitant to be hesitant to it because it's this idea where you just sit there and do nothing and that's supposed to help you. But there's different ways to do it. I also think that Dr. Slavin, when he was talking about sort of, what was the term? The other, not the meditation, but the mindful awareness, I would consider mindful awareness a form of meditation, kind of active meditation. You don't have to sit there. It's just being able to focus your attention where you want it to. And people always say, well, I can't sit there, my mind wanders. But that's what it is. Meditation isn't about being able to clear your mind. It's about training it to redirect its attention. And then there's also other types of meditation like loving compassion or meditations where you think about things you're grateful for or people that you care about. So there's different ones and I think just finding what works for you. I do a lot of guided meditations, so I don't have to think about it. I just download an app, play it, listen to it, and then that's it. So that's kind of my thoughts. So I had a question about sort of the caregiver role as physicians. I often say many of my patients need a mother, and we have children. We have children late in life, so we also are taking care of aging parents. And practically speaking, how do you manage, for those of you who are parents, manage doing that self-care when you come home at 5 p.m. and you have a second job? And ever try meditating when somebody's saying mommy every 15 seconds? So just how do you approach that? Yeah, I didn't have time to present it today, but that's a third cluster that I'm starting to talk about is this kind of caretaker rescuer that I think is a really dangerous place and is really tempting. And it's not just in our professional lives, it's our other lives. And going along with that caretaker rescuer is a tendency not to have boundaries, not to care about self, always worry about everybody else. And I think it's not only unhealthy for ourselves at a certain point when it gets carried too far, it's not healthy for the people we're trying to caretake and rescue because it creates this dynamic where they're just looking for you to solve their problems, right? And so by letting go a little bit, to let people take care of themselves a little bit, to ask for care sometimes from others, I think is not just a healthy place for ourselves, but it's a healthy place for others. And I don't think we talk about that enough in medicine. And what I, in my experience, the group that is much more susceptible to this is women and especially moms. I mean, like you're giving, giving, giving, giving, giving everywhere in your life and asking for nothing. No, we have to start asking for something ourselves and shouldn't, you shouldn't just embrace that role so fully. So I think you've really tapped on to something that's really critical, that's something we have to face. Yeah, it's a wonderful tendency to be a caretaker, but if we carry it too far, it's not a good situation for anybody, I think. Shauna, or Melanie, anything to add to that? Thank you so much for this really wonderful talk. My name is Nupur. I'm from MD Anderson Cancer Center in Houston. I'm actually the wellness lead for our department, and we have a large department. It's 23 clinical faculty in the endocrine department and about 12 research faculty. And one of the challenges that I found is getting buy-in from faculty. Our department skews 60% tenured professor, and it makes it very challenging to add something else to their plate in a very, very highly demanding environment as it stands. Also, all of our patients have cancer, which adds another level of burnout because we have patients that we're very attached to that pass away much more frequently than probably the average population. So from your standpoint, what can depart, what can we do on a departmental level or even on an institutional level to foster wellness in this kind of environment? I guess I can start. If you're going to do well-being activities, I think it's absolutely incumbent on people to also have interventions that are trying to improve the environment in whatever way you can. And so to me, you have to lead with environmental changes, and then you have more buy-in, I think, to help people develop their resilience skills. Second is if you're going to teach resilience skill, be really mindful of time. Don't overburden people. And do it on company time. Don't do it on time after work, that kind of stuff. And then I guess the last thing I would say, I think people are looking for this like one size fits all solution to this mental health crisis in medicine, and I don't think there is one. I mean, what goes on in your department might be completely different than in general internal medicine or surgery or whatever, not only in other institutions, but in your own institution. The stressors might be completely different. And one of the things I think we need to do is I think that the way I would describe it is I think we're often jumping to well-being treatments without having a diagnosis. We need to have a diagnosis of what's the problem. In some department, it might be, I don't know, a clinical load that is just overwhelming, or in another one, there may be a lack of community or connection. There may be problems with a sense of autonomy that you have any say in how the work is done. So making diagnoses, I think, is a really important approach to leading to interventions that are then specific for that diagnosis. So but there's a lot of work that needs to be done, I think, in that kind of direction. Trying to find out, I think the last thing I say, the more I understand the lived experience of the people I'm trying to help, the better I'm able to come up with interventions. And investing in that, not just measuring depression and anxiety and burnout, but looking at the health of the system itself, I think, is critically important. Do we have any other questions? Okay. If we have no more questions and our speakers have nothing that they would like to say left, let's give them a round of applause. Thank you.

video

introduction

moderator

presentations

speakers

managing burnout

promoting resilience

mental health issues

mindful awareness

self-compassion

work-life stability

self-care practices