Let's put it ALL OUT THERE: why are people quitting medical training, my medical school debt, non-resident work hours & salary vs resident work hours & salary, etc. We have come a very long way, but we can still do better to protect the well-being of our future and current doctors. Please share this video if you feel as passionate as I do about this need for change!
Thank you for continuing to push the medical training culture toward a more compassionate direction, Rachel! Your work is saving lives and I’m honored to know you!
Hi Dr. Goodman: I watched both of your TEDx talks on resident burnout, and they’re very impactful. Thank you for putting a lot of thoughts on this topic and advocating for changes. Also congratulations on you being on the board of Dr. Lorna Breen Hero Foundation. One more resident or physician suicide is one more too many. Do you think there will be some organization with specific aim of preventing resident suicide ? How to have a focused community effort to address resident suicide and resident suicidal ideation?
th-cam.com/video/LHL2QifgbZc/w-d-xo.html This is a video that Dr. Kevin Jubbal posted. He had a personal experience with resident suicides, and he has been advocating for SaveOurDoctors. It’d be great to see there is a joint presence of all residents, fellows and attending physicians who are concerned about resident suicides and residents wellbeing on social media, to push national level organizations such as ACGME, AAMC, AMA, National Academy of Medicine, maybe even the White House and Congress take actions on this issue: “One more resident suicide is one more too many.”
th-cam.com/video/LHL2QifgbZc/w-d-xo.html This is a video that Dr. Kevin Jubbal posted. He had personal experiences with resident suicides at Loma Linda, and he has been advocating for SaveOurDoctors. It’d be great to have a joint presence of all residents, fellow and attending physicians on social media who are concerned about resident suicides and resident wellbeing, to push national organizations such as ACGME, AAMC, ANA, NAM (National Academy of Medicine), etc. on this issue, as they’re powerful enough to make changes happen for residents.
I think it is important to understand how the resident work hour restrictions came to fruition, because it may lay the path forward for future changes. The work hour restrictions arose from New York's 405 Laws, which are also known as the "Libby Zion" Laws. Back in 1984 an 18yr girl died in a New York hospital due to a preventable medical error. The circumstances of her death put the spot light on the atrocious working conditions of residents. The public and lawmakers were OUTRAGED and work hour restriction laws were passed in New York in 1989. The public and lawmakers began asking more and more questions about why medical errors occur. In 1999, the Institute of Medicine came out with their report, To Err is Human, which explained that most medical error is not due to cavalier or reckless physicians, instead it was/is due to poor working conditions, system errors, tired/exhausted doctors, etc..Finally the ACGME, in 2003, decided to implement the common duty hour requirements which mirrored NY's 405 laws. In summary, I think change will come for residents when the public once again viscerally feels that outrage again and demands further change. Talking about this issue among ourselves and other medical professional definitely has benefit (I love venting as much as anyone else), but the people who need to hear about the struggles of physicians in training are the folks outside of medicine.
As a high schooler who wants to go to college and medical school. Thank you for sparking the conversations about the field now, because it may have major effects on what it is like for me.
thank you rachel! as a future medical student, it’s reassuring that there is a movement and people are talking to better the environment i’ll one day contribute too. i’ve told myself that when the day finally comes when i’m a full attending, i’ll do my best to uphold a positive work environment and fight for change. we got this everyone, be cognizant and stay vigilant
This is such an important video! Thank you for your bravery and persistence to stop this cycle. Systemic change needs to happen. Proud of you Dr Southard and feeling proud to be part of this herd with you 🐜🦸♀️💕
Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
It's absolutely fascinating to me that we know the importance of sleep, family life, and taking time for ourselves and how important it is and yet medical residency fails in pretty much all of this. Eg. In my training right now to become a pharmacy technician in Canada, if we don't get enough sleep, it is actually a risk to patients because errors increase drastically with lack of sleep. Just because something has been done like this forever doesn't mean it should continue. Medicine and science changes as we learn more and so should medical training. It shouldn't be an attitude of well, I went through this so this next generation should too. Getting through medical training proves resiliency. It shouldn't take 80 hours of work a week to be able to prove you can do the job. That's just my take. I love so much that you are talking about this!
Unionize. Unionize. Unionize. Every program needs to unionize. Its the only way to create some organization to demand changes from your employer and acgme. No amount of self help practices can change the system. What you are describing is a level of exploitation that most people would NEVER put up with even if the salaries at the end of your program are high.
The only thing about unionizing is that if admin finds out about your intent to unionize, that could potentially be met with consequences and retaliation..
Yes there is always a risk of retliation, however it is illegal for them to do so and can be met with real consequences for them as well. The more people are involved the better, and the more people are united, vocal, out loud and proud about it when you all decide to go public the harder it is to retaliate. Its easy to target one person but 100s of residents? Way harder. The question you have to ask yourselves is what other way is there to change this? Residents who have unionized have been able to fight for higher wages, wellness funds to address wellness issues, fatigue mitigation support, educational stipends, and so much more. Its not a magical change over night- it takes work to get people on the same page. There are union organizers who will help guide you through the process and support you on any campaign to organize at you program Its just an essential tool to create the kind of systemic change youre seeking. Look at nurses!! Its not perfect but they have standards for patient care and working conditions that came about because they were organized and had a union. Without it, its like trying to fight with one hand tied behind your back.
I should also note it is your right to organize a union! Why would your employer and program stand in the way for you to exercise your rights? Why would they retaliate against forming an organization that ulimately supports you having better working conditions? Its because its incredibly effective at changing power dynamics- it gives you all a voice when you currently have none.
One last thing- you all have the power. They can not see and care for the patients without you. Your work is essential. Imagine if residents decided to not work in such horrid conditions and collectively said “Enough!”! They would have to listen- especially because your attendings would have to do MORE work without you! You all are critical to making the hospitals function, to providing your communities with the care they need and deserve. A union is the fullest expression of that power and a reminder to them- they better recognize it! Appreciate all youve done here Rachel. Ive watched you since I had considered going to medical school. Witnessing the exploitation you all endure however has made me re-think it wntirely especially with the debt situation. Its sad because 8 would love to care for people in the way you all do. I love hospice care and family medicine and would love to have that training and knowledge to support my community. But theres no way I could endure the things you all go through and come out with my mental health in check (with the amount of debt too..). Helping ya’ll fight back is the next best thing for me. 🫡
Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
Yes yes yes!! If we as a society want more doctors who are both incredibly knowledgeable and empathetic then we must support their access to sleep, balance, and holistic wellness. It will only enrich their training so that when met with challenges you have the brain power and the properly pruned neural networks to navigate the the situation at hand leading to a better outcome and enhanced sense of meaning. THIS is content and conversation we need to be having. You are incredible Dr. Southard and admire your commitment to change while in the midst of the storm.
I decided not to go to medical school because of these reasons. I graduated from college as a pre med and during my gap years I decided it wasn’t worth it. I could make a difference in people’s lives without having to endure all of that so I got a Masters in Public Health instead and I loved it. I still think medicine is so interesting and would love to do it but in context, it’s just not the lifestyle I want to live. I wish they didn’t put so many unnecessary burdens.
Literally me! Aside from the public health path. I did consider an MPH but ultimately decided to pursue a career in medical research. Thank you for sharing
Rachel, I submitted a secondary application yesterday. I honestly gave zero f**ks writing one of its essay prompts, which asked me to describe how I handled a difficult situation, the coping skills I used, and whom I sought support from. I wrote about discussing the matter with my therapist and immediately terminating a professional relationship with a client who unjustly projected his anger onto me. Yep.
Thank you so much for speaking out about this Dr. Southard! Is it possible to advocate for this change legally and safely? I understand wanting to make change, but I also understand the fear of losing one's job as a physician or their reputation as a medical student. Once again, I really appreciate hearing your take on the labor conditions for physicians in the U.S.
I am so happy I am going in reverse like Benjamin Button. I have not reached the level Dr. Southard and many others have reached yet but what I have read, studied, researched and experienced, the only thing I really need to worry about is not dying before I reach the level they are already at. No trauma, MI, CVA, murder by patient, or etc. I never thought I would make it off the battlefield and come home but now that I clean and can see clearly with the help of God, my family, docs, community and of course you Dr. Southard what I am stepping into wont be is just another battlefield and that landscape along with its traps and pitfalls I am well aware of. Having a mentor is very important and as of now she is it. Don't quit on us. I only have 2 of you that I have been watching for years upon years. Your still my hero Dr. Southard. Don't let us down and we wont let you or our patients down. Now its time to go to your other page and study study study.
When I see older doctors on social media say they had to do it and turned out fine so this generation should stop being so soft, it baffles me. I suspect they are a small minority, but this happens in areas besides medical training. It’s such a bizarre sentiment to want to inflict suffering on the younger generations because you had to endure it. Really nice to see professionals like Dr. Southerd being committed to change. That is how we succeed.
And it’s insane because it’s a profession that our society NEEDS. It’s not expendable. Like there are so many careers that we’d be completely fine without but DOCTORS? Why would we have a system that beats the sh*t out of the people that are trying to get into a very necessary job for our society? That was terrible grammar but you know what I mean
Rach, thank you for being so brave and spreading the truth. It’s so much easier to gain popularity nowadays by pretending that everything is perfect. I really appreciate the realistic perspective you bring-it’s so important. Honestly, the stats you shared are mind-blowing, and something has to change 🥺. You, however, shouldn’t-you’re beautiful inside and out 🥰. The only thing is the sad eyes, but that’s completely understandable given the topic & circumstances. Let’s hope things only get better.
Hey, if we Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
As a premed passionate about going into medicine I hope you can create that change needed for people like me. Creating change will help make this difficult training process a bit more enjoyable and maybe not so debilitating. This change can also address the physician shortage that the states say they “need to address”. Love you Dr. Southard. Thank you for being such a wonderful human being. Ps. Love your videos.
Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
Wow! It's a slap in the face that unskilled employees in California earn only a dollar less then very skilled residents 😢 Hope those responsible take the stick out of their butts and make your training more feasible and less stressful
Right!! So crazy. If we Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
Probably also worth mentioning the physicians that struggle with substance abuse (nicotine, alcohol, other drugs) as a way of coping with these conditions.
Hey ! I was a medstudent last year still and had a feeling of seeing past the glam of medschool and was really upset to hear from student till last years of medical school here in Switzerland that they were experiencing physical and mentally damage from their student experience. We asked questions to all year of medschool and started listing the things that needed to change. We are building a team that are reading to meet the direction of the faculty and the university to ask for progress. If you don't know Switzerland has a strong entrance triage for medschool and is lacking so many doctors that they have to import 40% of their exercing doctors outside of Switzerland. From my point of vue, medical students are starting to have enough all over the world. We should not tolerate pain to a point of wanting to end our lifes during our studies. IT IS NOT NORMAL. I think things will change in the next 10 years in a lot of countries. Thanks for your message of hope about all of that !
Thank you for shedding light on this. I'm a new grad nurse and I love contacting residents regarding patients because I feel like there is a certain level of approachability and ease- kind of like we are both trying to figure things out together. Thank you for bringing this to light, and the brutality of working in healthcare.
Right! Hey if we Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
I would love to look into research to evaluate if working a ton of hours = more knowledge for residents. At a certain point, residents are so burnt out that they are not learning and digesting new information at optimal levels…. I would be interested to see if working more reasonable hours (I.e. lowering the number of hours residents need to work to graduate residency) yields the same or similar learning/level of expertise as heavily over-working residents.
I want to know this too. Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
Great question, I should look into actual data on this. Like Dr, Southerd said, laws restrict the number of hours compared to decades ago, but I really doubt the board exams after residency have gotten easier (quite the opposite), and fail rate isn’t worse than decades ago. So commonsense tells us fewer hours now vs. then have not had any negative effect on competency, experience, and knowledge. I imagine there are data to back this up. I really suspect fewer hours would have real benefits, not harm.
thank you so much for this brave and informative video. Seeing other medinfluencer videos is difficult sometimes because they make it seem so sunshine and roses, and if it weren't for your videos, i wouldn't know that isn't how it is. I hope change comes--change you're fighting to see.
Do you think if residents worked let’s say an average of 50hrs/weekly vs 80 that residency duration should last longer to compensate for the cut in weekly hours? If learning in residency is hands on practice/working then cutting hours worked weekly would have to be tacked on somewhere, right? So, instead of residency being 4 years, it would need to be extended to make up those hours. Am I making sense?
I think it helps seeing it as a cultural problem too, I'm British and Swedish and have friends in medicine in both and there's such a massive difference between the two. I've been working towards being accepted to study medicine in Sweden, and when I asked some friends in their final years about the struggles of deciding when to have children, they just said that there were quite a few people who had children during their degree and that it's 100% doable/didn't seem bothered at all, like this was normal. Whereas medical influencers in the UK that I've seen on TikTok who talk about having kids during training really openly speak of the struggles and that they're far from the norm. But it's different in Scandinavia, because there's free nursery, extra childcare during early mornings/evenings if you work a lot etc, student housing options also have multiple rooms so you can have a family there with cheap rent. And the culture in Sweden is so heavily in the direction of work life balance being accepted, it's okay to complain about having to shorten your day and pick up your kid in case something came up. Doing part time or less than FT hours isn't considered strange or unusual either. When I think of my Swedish friends, they seemed far more relaxed and happier within themselves, even though there are problems with the system here. Whereas in the UK, my medical school friends seemed very anxious about the NHS and the future, and struggled a lot with burn out and having to sacrifice so much of their own life. I mean, just exams at Swedish universities are much longer in duration per test (3-6 hours) for all courses and you can retake 3 times without it counting against you or turning up like a black mark on your transcript. There's also a study out there indicating that US schools may be failing students on purpose/having high reqs to make money off retakes, whereas in Scandinavia med students fail less. Can't remember where I read it. Anyway, I think a massive culture shift and attitude change is will what will really bring the change, and I hope that all the younger residents and dr's in the us are able to make a difference :)
After watching the video I think it would be a good idea to research the systems of other countries that currently have what we are going for and look for small ways to implement their practices. I’m not familiar with the system enough to know what that would be but maybe starting there for ideas? It’s such a huge systemic issue but I’m sure a lot of people want to change it and if we all engage with it enough we will eventually find ideas
Also, that is INSANE about the med school failing people here to make more money. I read that somewhere As well when I was comparing nursing school to med school
Dr Southard, I follow you bc I'm a pelvic health PT. However, I have left pt care as well about 17 months ago, all for these same reasons. I've been in patient care for 14 yrs and it still hasn't changed. I'm not sure it ever will. These same issues are across all types of medicine, all disciplines, all settings, etc, and it's beyond sad and frustrating. We all got into healthcare bc we love our pts, but at the sacrifice of myself, it's just no longer with it. How do we as a medical community change it? No one knows, thus the cycle continues...
I follow a few med influencers and it also baffles me how in one breath they mention the hefty debt they carry and then they vlog about European vacations and other splurges! Typically, if you’re that far in debt you don’t go on vacation. You pay it back instead. 🤷♀️
Life’s very short. And putting a few bucks away here and there on a small salary is a drop in the bucket vs just going on a beautiful trip that could be once in a lifetime. I wouldn’t judge others for their decisions in that way.
In Central Europe, Hungary, the starting salary for medical residents is about 1100-1500$ a month, thus around 15k$ a year. Unfortunately, we have Western European prices without their salary. The average working hours a week are also around 60h. The problem is present all around the world.
This video was so informative and well done. A stat I'm curious about is average cost of medical school (lets say from the 60s,80s,00s) vs the salary. I feel like most young doctors are not living a super luxurious life from the start like a lot of the doctors generations before.
Hi Dr. Southard: thank you for your videos on this topic, to raise the awareness of resident burnout, dropout, or worse. Do you know personally any resident or med student who committed suicide? If so, would you be able to share the situations leading to i? (Of course not get into details for confidential purposes.). TIA.
th-cam.com/video/LHL2QifgbZc/w-d-xo.html This is a video that Dr. Kevin Jubbal posted. He had a personal experience with resident suicides, and he has been advocating for SaveOurDoctors.
Where does this info leave patients? As a patient in general I find it deeply upsetting that residents are underpaid and overworked. I think it's perfectly acceptable for residents to complain about it. But as a patient seeing these kind of videos, I feel scared to see doctors now and I don't really know how to process the fact that the person operating on me (I've had 3 surgeries)probably hasn't slept and is unhappy to be there because they aren't getting paid adequately. Of course it's not the doctors fault, but what are patients who need to use the services supposed to do to feel safe
I think it’s about everyone’s safety, both the healthcare provider AND the patient. At the end of the day, providers are just as human as everyone else and can also be a patient. But I don’t think that us residents at work think about how much our salary is. This video was more as a conversation starter and to show the faults in this system as it’s not really designed to protect the well beings of our providers. And it’s honestly not limited to just residents-nursing, physical therapy, techs, etc. Hiding these blatant facts from the general public to “protect” them is a huge disservice to the individuals that are impacted by the system.
My program recently was talking about how if the leadership hears people talking about unionizing they are suppose to report us to leadership of the hospital lol
Amazing video. We need more like this!!! When we share and comment and like videos it helps them go viral and spread important messages!! If you see this, leave her a comment!!!!
I am not a physician and I am not in school to be a physician. Who do i need to stand up for those who are? I cannot be fired or whatever would happen if someone in that field would
If you comment and like it will help the video get more engagement and help her message get out there. Everybody like it up!!!!! Comment!!!! Great video rachel
Very personal question, if you're not comfortable answering totally understandable. But, does the large amount of medical debt play any role in your decision on whether or not you want to have children?
I always say if the program was forced to pay time and a half for over 40 hours of work with a minimum wage of 35 an hour then half the problems in medicine would self resolve themselves
What I never get is why does it have to be this way? The rest of the world doesn't do it like us (8 years vs 6 post high school) (80hours vs 44hours in Europe) and I don't think anyone think European doctors are subpar to us (though my surgeon attending does think he's superior to everyone lol). On the other hand, by all health metrics, American health care in overall are more expensive, less access and lower life expectancy. The math ain't mathing here.
To your point of people staying in residency specifically because of the amount of debt doctors accrue, dare I say it sounds a lot like forced labor. Granted, they are not doing this against their will, but like you said… it’s criminal!
Rafiki, you know I’m going to voice my opinion as I feel as if you are my internet daughter. ❤ I’ve not read through the comments yet so I may not be the only person who says this but, I truly believe so many non-medical people do not care about these stats because their opinion is that, “Doctors make a lot of money later, so boo hoo if they are making less than minimum wage in the beginning or working a lot”. Why do people think this way? These humans (I think people forget medical students and residents are humans) are being mentally and physically worn down. Is this what we want for the future of healthcare? No! I also feel the medical profession has turned into a hazing ritual. Is the intent to weed out the weaker doctors? Well that’s crap. They are planting discouragement and sowing depression and anxiety. Our healthcare system will reap what it sows. I hope they wake up before the whole healthcare system ends up in the toilet. I ❤U, Rachel. Thanks for speaking up and standing up. 👏👏
The medical communicated is quitting because the health care system is broken. After covi19 pandemic, hospital lose a lot of money. Now they're trying to regain back that amount of money lose with overloaded doctor and nurse with a lot of work. Plus, additional doctor are burnout for how much patient they need to round. CEO of Hospital don't care about nurses or doctor, they want you to make profit for them and replace. Every day I saw many doctor quitting on the hospital and be replaced. I start taking with a doctor, they explain to me the situation they are passing. So now life depends on a good doctor or nurse to help you during your hospitalization. Malpractice increase over the years after covi19, because the amount of patients doctor have, poor pay check , high work. I'm thinking of going to medical school, but my friend doctor they recommend it not worth it.
I would be open to a system where we are residents for longer (maybe needing to add a year?) but with not as crazy hours so that we still have plenty of time for experience before becoming attendings- and with that there would also be improved pay or increased debt forgiveness ? That’s just something I’ve thought about before
So if they cut your hours in half (40 hours a week instead of the 80 hours you are working now, do you think they should add years to the medical school program to make up for the hours lost? Part of becoming a good doctor does involve being exposed to as many cases as possible while you are in school. You can listen to lectures, watch video, etc., but real world experience is crucial to your development as a doctor. You would have improvement in your hours to have a life outside of school, but added years to your program will increase the amount of debt you already have for sure.
Being honest, not all of those hours are exposure to cases. Lot of it is "scut work". After a certain point the benefits of learning does not outweigh the risk. I think there should be more residents allowed per program to lessen load for one
The data says what it says.🤷♀️If it said that the average American worked that much, I would’ve included that. Hope you got the point of the entire video though!
I think it's important to touch on the fundamentals and understanding how nutrition is one of the social determinants interwoven in patient health but we have registered dietitians and nutritionists who specialize in nutrition for this purpose. Many of them work closely with the clinical team. I think it's great to offer extra training as an elective but the curriculum is already dense and stressful enough.
@@RachelSouthardExactly. Totally agreed. the only reason I responded was because I felt it derailed the conversation and you shouldn't have had to respond. We're addressing VITAL topics related to our self care and wellbeing in medicine and I frankly felt it was a bit disrespectful to bring up.🥴 Thank you for responding so respectfully, Dr. Southard! Always a class act!🤎
I hardly have time to exist as a human being outside of my job as a resident doctor. I'm doing the best that i can with uploading WEEKLY content on TH-cam. Thanks for understanding.
Let's put it ALL OUT THERE: why are people quitting medical training, my medical school debt, non-resident work hours & salary vs resident work hours & salary, etc. We have come a very long way, but we can still do better to protect the well-being of our future and current doctors. Please share this video if you feel as passionate as I do about this need for change!
Yes!!!
Thank you for continuing to push the medical training culture toward a more compassionate direction, Rachel! Your work is saving lives and I’m honored to know you!
❤❤❤❤
Hi Dr. Goodman: I watched both of your TEDx talks on resident burnout, and they’re very impactful. Thank you for putting a lot of thoughts on this topic and advocating for changes. Also congratulations on you being on the board of Dr. Lorna Breen Hero Foundation. One more resident or physician suicide is one more too many. Do you think there will be some organization with specific aim of preventing resident suicide ? How to have a focused community effort to address resident suicide and resident suicidal ideation?
@@mytube785 they are both amazing!
th-cam.com/video/LHL2QifgbZc/w-d-xo.html
This is a video that Dr. Kevin Jubbal posted. He had a personal experience with resident suicides, and he has been advocating for SaveOurDoctors. It’d be great to see there is a joint presence of all residents, fellows and attending physicians who are concerned about resident suicides and residents wellbeing on social media, to push national level organizations such as ACGME, AAMC, AMA, National Academy of Medicine, maybe even the White House and Congress take actions on this issue:
“One more resident suicide is one more too many.”
th-cam.com/video/LHL2QifgbZc/w-d-xo.html
This is a video that Dr. Kevin Jubbal posted. He had personal experiences with resident suicides at Loma Linda, and he has been advocating for SaveOurDoctors.
It’d be great to have a joint presence of all residents, fellow and attending physicians on social media who are concerned about resident suicides and resident wellbeing, to push national organizations such as ACGME, AAMC, ANA, NAM (National Academy of Medicine), etc. on this issue, as they’re powerful enough to make changes happen for residents.
I think it is important to understand how the resident work hour restrictions came to fruition, because it may lay the path forward for future changes. The work hour restrictions arose from New York's 405 Laws, which are also known as the "Libby Zion" Laws. Back in 1984 an 18yr girl died in a New York hospital due to a preventable medical error. The circumstances of her death put the spot light on the atrocious working conditions of residents. The public and lawmakers were OUTRAGED and work hour restriction laws were passed in New York in 1989. The public and lawmakers began asking more and more questions about why medical errors occur. In 1999, the Institute of Medicine came out with their report, To Err is Human, which explained that most medical error is not due to cavalier or reckless physicians, instead it was/is due to poor working conditions, system errors, tired/exhausted doctors, etc..Finally the ACGME, in 2003, decided to implement the common duty hour requirements which mirrored NY's 405 laws.
In summary, I think change will come for residents when the public once again viscerally feels that outrage again and demands further change. Talking about this issue among ourselves and other medical professional definitely has benefit (I love venting as much as anyone else), but the people who need to hear about the struggles of physicians in training are the folks outside of medicine.
Exactly why I’m making this video! It’s on TH-cam for the general public to see, and sharing this video can help TH-cam push the video to others.
Well said!
As a high schooler who wants to go to college and medical school. Thank you for sparking the conversations about the field now, because it may have major effects on what it is like for me.
thank you rachel! as a future medical student, it’s reassuring that there is a movement and people are talking to better the environment i’ll one day contribute too. i’ve told myself that when the day finally comes when i’m a full attending, i’ll do my best to uphold a positive work environment and fight for change. we got this everyone, be cognizant and stay vigilant
The perfect video to come back to after a 15 hour shift 🥹🫶🏻
🤍
Also, to add in the 1960s, 1980s, 1990s etc doc were not coming out of medical school with debts this large
YES! This. I forgot to add it to the video. But YES
Your passion on this subject is contagious
This is such an important video! Thank you for your bravery and persistence to stop this cycle. Systemic change needs to happen. Proud of you Dr Southard and feeling proud to be part of this herd with you 🐜🦸♀️💕
So true!
Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
It's absolutely fascinating to me that we know the importance of sleep, family life, and taking time for ourselves and how important it is and yet medical residency fails in pretty much all of this. Eg. In my training right now to become a pharmacy technician in Canada, if we don't get enough sleep, it is actually a risk to patients because errors increase drastically with lack of sleep. Just because something has been done like this forever doesn't mean it should continue. Medicine and science changes as we learn more and so should medical training. It shouldn't be an attitude of well, I went through this so this next generation should too. Getting through medical training proves resiliency. It shouldn't take 80 hours of work a week to be able to prove you can do the job. That's just my take. I love so much that you are talking about this!
THIS NEEDS TO BE HEARD
Unionize. Unionize. Unionize. Every program needs to unionize. Its the only way to create some organization to demand changes from your employer and acgme. No amount of self help practices can change the system. What you are describing is a level of exploitation that most people would NEVER put up with even if the salaries at the end of your program are high.
The only thing about unionizing is that if admin finds out about your intent to unionize, that could potentially be met with consequences and retaliation..
Yes there is always a risk of retliation, however it is illegal for them to do so and can be met with real consequences for them as well.
The more people are involved the better, and the more people are united, vocal, out loud and proud about it when you all decide to go public the harder it is to retaliate. Its easy to target one person but 100s of residents? Way harder.
The question you have to ask yourselves is what other way is there to change this?
Residents who have unionized have been able to fight for higher wages, wellness funds to address wellness issues, fatigue mitigation support, educational stipends, and so much more. Its not a magical change over night- it takes work to get people on the same page. There are union organizers who will help guide you through the process and support you on any campaign to organize at you program
Its just an essential tool to create the kind of systemic change youre seeking. Look at nurses!! Its not perfect but they have standards for patient care and working conditions that came about because they were organized and had a union.
Without it, its like trying to fight with one hand tied behind your back.
I should also note it is your right to organize a union! Why would your employer and program stand in the way for you to exercise your rights? Why would they retaliate against forming an organization that ulimately supports you having better working conditions? Its because its incredibly effective at changing power dynamics- it gives you all a voice when you currently have none.
One last thing- you all have the power. They can not see and care for the patients without you. Your work is essential. Imagine if residents decided to not work in such horrid conditions and collectively said “Enough!”! They would have to listen- especially because your attendings would have to do MORE work without you!
You all are critical to making the hospitals function, to providing your communities with the care they need and deserve. A union is the fullest expression of that power and a reminder to them- they better recognize it!
Appreciate all youve done here Rachel. Ive watched you since I had considered going to medical school. Witnessing the exploitation you all endure however has made me re-think it wntirely especially with the debt situation. Its sad because 8 would love to care for people in the way you all do. I love hospice care and family medicine and would love to have that training and knowledge to support my community. But theres no way I could endure the things you all go through and come out with my mental health in check (with the amount of debt too..). Helping ya’ll fight back is the next best thing for me. 🫡
Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
You are the future of medicine! THIS is what we need, thank you Dr. Southard 👏🏻
Yes yes yes!! If we as a society want more doctors who are both incredibly knowledgeable and empathetic then we must support their access to sleep, balance, and holistic wellness. It will only enrich their training so that when met with challenges you have the brain power and the properly pruned neural networks to navigate the the situation at hand leading to a better outcome and enhanced sense of meaning. THIS is content and conversation we need to be having. You are incredible Dr. Southard and admire your commitment to change while in the midst of the storm.
@@AlexandraLacy-kk8fb absolutely!!!
I decided not to go to medical school because of these reasons. I graduated from college as a pre med and during my gap years I decided it wasn’t worth it. I could make a difference in people’s lives without having to endure all of that so I got a Masters in Public Health instead and I loved it. I still think medicine is so interesting and would love to do it but in context, it’s just not the lifestyle I want to live. I wish they didn’t put so many unnecessary burdens.
Literally me! Aside from the public health path. I did consider an MPH but ultimately decided to pursue a career in medical research. Thank you for sharing
Rachel, I submitted a secondary application yesterday. I honestly gave zero f**ks writing one of its essay prompts, which asked me to describe how I handled a difficult situation, the coping skills I used, and whom I sought support from. I wrote about discussing the matter with my therapist and immediately terminating a professional relationship with a client who unjustly projected his anger onto me. Yep.
Thank you so much for speaking out about this Dr. Southard! Is it possible to advocate for this change legally and safely? I understand wanting to make change, but I also understand the fear of losing one's job as a physician or their reputation as a medical student. Once again, I really appreciate hearing your take on the labor conditions for physicians in the U.S.
I am so happy I am going in reverse like Benjamin Button. I have not reached the level Dr. Southard and many others have reached yet but what I have read, studied, researched and experienced, the only thing I really need to worry about is not dying before I reach the level they are already at. No trauma, MI, CVA, murder by patient, or etc. I never thought I would make it off the battlefield and come home but now that I clean and can see clearly with the help of God, my family, docs, community and of course you Dr. Southard what I am stepping into wont be is just another battlefield and that landscape along with its traps and pitfalls I am well aware of. Having a mentor is very important and as of now she is it. Don't quit on us. I only have 2 of you that I have been watching for years upon years. Your still my hero Dr. Southard. Don't let us down and we wont let you or our patients down. Now its time to go to your other page and study study study.
The way my jaw dropped when you broke down the salaries, my goodness. Thank you so much for making this video Rachel, you're saving lives❤
When I see older doctors on social media say they had to do it and turned out fine so this generation should stop being so soft, it baffles me. I suspect they are a small minority, but this happens in areas besides medical training. It’s such a bizarre sentiment to want to inflict suffering on the younger generations because you had to endure it. Really nice to see professionals like Dr. Southerd being committed to change. That is how we succeed.
@@katvtay so true
I wholeheartedly agree
And it’s insane because it’s a profession that our society NEEDS. It’s not expendable. Like there are so many careers that we’d be completely fine without but DOCTORS? Why would we have a system that beats the sh*t out of the people that are trying to get into a very necessary job for our society? That was terrible grammar but you know what I mean
Really, really appreciate you taking about these issues. Much love to you! ❤🙏🏽
Go Rachel, your passion is definitely showing, thank you for your terrific video.
❤
Trying to make the world a better place 🌍
Dr. Southard is one of my OB/GYN heroes 🥰
Rach, thank you for being so brave and spreading the truth. It’s so much easier to gain popularity nowadays by pretending that everything is perfect. I really appreciate the realistic perspective you bring-it’s so important. Honestly, the stats you shared are mind-blowing, and something has to change 🥺. You, however, shouldn’t-you’re beautiful inside and out 🥰. The only thing is the sad eyes, but that’s completely understandable given the topic & circumstances. Let’s hope things only get better.
So true. ❤
Hey, if we Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
As a premed passionate about going into medicine I hope you can create that change needed for people like me. Creating change will help make this difficult training process a bit more enjoyable and maybe not so debilitating. This change can also address the physician shortage that the states say they “need to address”.
Love you Dr. Southard. Thank you for being such a wonderful human being. Ps. Love your videos.
@@roseestupinan good luck on your journey!
Thank you so much for this video! Very helpful and transparent I will definitely take this into consideration before applying for med school ❤
❤
Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
Wow! It's a slap in the face that unskilled employees in California earn only a dollar less then very skilled residents 😢 Hope those responsible take the stick out of their butts and make your training more feasible and less stressful
Right!! So crazy. If we Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
Probably also worth mentioning the physicians that struggle with substance abuse (nicotine, alcohol, other drugs) as a way of coping with these conditions.
Hey ! I was a medstudent last year still and had a feeling of seeing past the glam of medschool and was really upset to hear from student till last years of medical school here in Switzerland that they were experiencing physical and mentally damage from their student experience.
We asked questions to all year of medschool and started listing the things that needed to change. We are building a team that are reading to meet the direction of the faculty and the university to ask for progress.
If you don't know Switzerland has a strong entrance triage for medschool and is lacking so many doctors that they have to import 40% of their exercing doctors outside of Switzerland.
From my point of vue, medical students are starting to have enough all over the world. We should not tolerate pain to a point of wanting to end our lifes during our studies. IT IS NOT NORMAL. I think things will change in the next 10 years in a lot of countries.
Thanks for your message of hope about all of that !
@@celialusa9519 good luck on your journey!
Thank you for shedding light on this. I'm a new grad nurse and I love contacting residents regarding patients because I feel like there is a certain level of approachability and ease- kind of like we are both trying to figure things out together. Thank you for bringing this to light, and the brutality of working in healthcare.
@@andriadefilippi4512 same here. Good luck on your journey
Thank you Rachel for the inspiration and encouragement! ❤
Your speech about not quitting your job helped me a little but not quitting my ( floral job) Thanks for the advice
@@kelliebutler24th good luck on your joirney
Thank you so much for talking about this, adore u❤️
Please share it with others 🩷
🤍
What a great, informative, thought provoking video. Sending lots of hugs from 🇨🇦
Right! Hey if we Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
I worked at Barnes Hospital in 1991 … the Interns and Residents worked day and night… got tired just watching them..
I would love to look into research to evaluate if working a ton of hours = more knowledge for residents. At a certain point, residents are so burnt out that they are not learning and digesting new information at optimal levels…. I would be interested to see if working more reasonable hours (I.e. lowering the number of hours residents need to work to graduate residency) yields the same or similar learning/level of expertise as heavily over-working residents.
Definitely
I want to know this too. Comment on other people’s comments and like them all to help the engagement go up and help this video get more people watching and help share her message!
Great question, I should look into actual data on this. Like Dr, Southerd said, laws restrict the number of hours compared to decades ago, but I really doubt the board exams after residency have gotten easier (quite the opposite), and fail rate isn’t worse than decades ago. So commonsense tells us fewer hours now vs. then have not had any negative effect on competency, experience, and knowledge. I imagine there are data to back this up. I really suspect fewer hours would have real benefits, not harm.
Thank you for being brave and speaking up! & also I can’t get over your ring!!! Every time I see it in a video I smile 🥹🥰
thank you so much for this brave and informative video. Seeing other medinfluencer videos is difficult sometimes because they make it seem so sunshine and roses, and if it weren't for your videos, i wouldn't know that isn't how it is. I hope change comes--change you're fighting to see.
I hope doctor Mike brings you into his podcast to talk about this further
@@NR-lc8we DR MIKE IS AWESOME!!!! Would love to see a podcast from the two of thrm
Do you think if residents worked let’s say an average of 50hrs/weekly vs 80 that residency duration should last longer to compensate for the cut in weekly hours? If learning in residency is hands on practice/working then cutting hours worked weekly would have to be tacked on somewhere, right? So, instead of residency being 4 years, it would need to be extended to make up those hours. Am I making sense?
@@lauraheadrick4517 yes!
I think it helps seeing it as a cultural problem too, I'm British and Swedish and have friends in medicine in both and there's such a massive difference between the two. I've been working towards being accepted to study medicine in Sweden, and when I asked some friends in their final years about the struggles of deciding when to have children, they just said that there were quite a few people who had children during their degree and that it's 100% doable/didn't seem bothered at all, like this was normal. Whereas medical influencers in the UK that I've seen on TikTok who talk about having kids during training really openly speak of the struggles and that they're far from the norm. But it's different in Scandinavia, because there's free nursery, extra childcare during early mornings/evenings if you work a lot etc, student housing options also have multiple rooms so you can have a family there with cheap rent. And the culture in Sweden is so heavily in the direction of work life balance being accepted, it's okay to complain about having to shorten your day and pick up your kid in case something came up. Doing part time or less than FT hours isn't considered strange or unusual either. When I think of my Swedish friends, they seemed far more relaxed and happier within themselves, even though there are problems with the system here. Whereas in the UK, my medical school friends seemed very anxious about the NHS and the future, and struggled a lot with burn out and having to sacrifice so much of their own life. I mean, just exams at Swedish universities are much longer in duration per test (3-6 hours) for all courses and you can retake 3 times without it counting against you or turning up like a black mark on your transcript. There's also a study out there indicating that US schools may be failing students on purpose/having high reqs to make money off retakes, whereas in Scandinavia med students fail less. Can't remember where I read it. Anyway, I think a massive culture shift and attitude change is will what will really bring the change, and I hope that all the younger residents and dr's in the us are able to make a difference :)
❤
Lovely comment
After watching the video I think it would be a good idea to research the systems of other countries that currently have what we are going for and look for small ways to implement their practices. I’m not familiar with the system enough to know what that would be but maybe starting there for ideas? It’s such a huge systemic issue but I’m sure a lot of people want to change it and if we all engage with it enough we will eventually find ideas
Also, that is INSANE about the med school failing people here to make more money. I read that somewhere As well when I was comparing nursing school to med school
Thank you for this! ❤
LOVE YOUR VIDEOS SO MUCH. !!!
🤍🤍🤍
Dr Southard, I follow you bc I'm a pelvic health PT. However, I have left pt care as well about 17 months ago, all for these same reasons. I've been in patient care for 14 yrs and it still hasn't changed. I'm not sure it ever will. These same issues are across all types of medicine, all disciplines, all settings, etc, and it's beyond sad and frustrating. We all got into healthcare bc we love our pts, but at the sacrifice of myself, it's just no longer with it. How do we as a medical community change it? No one knows, thus the cycle continues...
I follow a few med influencers and it also baffles me how in one breath they mention the hefty debt they carry and then they vlog about European vacations and other splurges! Typically, if you’re that far in debt you don’t go on vacation. You pay it back instead. 🤷♀️
Life’s very short. And putting a few bucks away here and there on a small salary is a drop in the bucket vs just going on a beautiful trip that could be once in a lifetime. I wouldn’t judge others for their decisions in that way.
you're so well spoken Rachel!!
In Central Europe, Hungary, the starting salary for medical residents is about 1100-1500$ a month, thus around 15k$ a year. Unfortunately, we have Western European prices without their salary. The average working hours a week are also around 60h. The problem is present all around the world.
This video was excellent! Thank you, Rachel!
Yes!🎉
Glad it was helpful!
In the Building watching from Baltimore MD 😎😎😎
This video was so informative and well done. A stat I'm curious about is average cost of medical school (lets say from the 60s,80s,00s) vs the salary. I feel like most young doctors are not living a super luxurious life from the start like a lot of the doctors generations before.
This is very true!
Hi Dr. Southard: thank you for your videos on this topic, to raise the awareness of resident burnout, dropout, or worse.
Do you know personally any resident or med student who committed suicide? If so, would you be able to share the situations leading to i? (Of course not get into details for confidential purposes.). TIA.
th-cam.com/video/LHL2QifgbZc/w-d-xo.html
This is a video that Dr. Kevin Jubbal posted. He had a personal experience with resident suicides, and he has been advocating for SaveOurDoctors.
I’m so excited I’m finally catching a premiere! 😁
Same!
I didn't even think about it growing every year with interest
Where does this info leave patients? As a patient in general I find it deeply upsetting that residents are underpaid and overworked. I think it's perfectly acceptable for residents to complain about it. But as a patient seeing these kind of videos, I feel scared to see doctors now and I don't really know how to process the fact that the person operating on me (I've had 3 surgeries)probably hasn't slept and is unhappy to be there because they aren't getting paid adequately. Of course it's not the doctors fault, but what are patients who need to use the services supposed to do to feel safe
I think it’s about everyone’s safety, both the healthcare provider AND the patient. At the end of the day, providers are just as human as everyone else and can also be a patient.
But I don’t think that us residents at work think about how much our salary is. This video was more as a conversation starter and to show the faults in this system as it’s not really designed to protect the well beings of our providers. And it’s honestly not limited to just residents-nursing, physical therapy, techs, etc.
Hiding these blatant facts from the general public to “protect” them is a huge disservice to the individuals that are impacted by the system.
My program recently was talking about how if the leadership hears people talking about unionizing they are suppose to report us to leadership of the hospital lol
Amazing video. We need more like this!!! When we share and comment and like videos it helps them go viral and spread important messages!! If you see this, leave her a comment!!!!
💪👏👏👏 gotta comment for that algorithm
YOU KNOW THE DRILL🚨
Yes!!!! Help it go viral!!!!!!
Thanks doctor! 🥰
I am not a physician and I am not in school to be a physician. Who do i need to stand up for those who are? I cannot be fired or whatever would happen if someone in that field would
If you comment and like it will help the video get more engagement and help her message get out there. Everybody like it up!!!!! Comment!!!! Great video rachel
Very personal question, if you're not comfortable answering totally understandable. But, does the large amount of medical debt play any role in your decision on whether or not you want to have children?
Not at all. The debt is there, and oh well. I will not stop living my life because of it.
I always say if the program was forced to pay time and a half for over 40 hours of work with a minimum wage of 35 an hour then half the problems in medicine would self resolve themselves
What I never get is why does it have to be this way? The rest of the world doesn't do it like us (8 years vs 6 post high school) (80hours vs 44hours in Europe) and I don't think anyone think European doctors are subpar to us (though my surgeon attending does think he's superior to everyone lol). On the other hand, by all health metrics, American health care in overall are more expensive, less access and lower life expectancy. The math ain't mathing here.
To your point of people staying in residency specifically because of the amount of debt doctors accrue, dare I say it sounds a lot like forced labor. Granted, they are not doing this against their will, but like you said… it’s criminal!
Rafiki, you know I’m going to voice my opinion as I feel as if you are my internet daughter. ❤ I’ve not read through the comments yet so I may not be the only person who says this but, I truly believe so many non-medical people do not care about these stats because their opinion is that, “Doctors make a lot of money later, so boo hoo if they are making less than minimum wage in the beginning or working a lot”. Why do people think this way? These humans (I think people forget medical students and residents are humans) are being mentally and physically worn down. Is this what we want for the future of healthcare? No! I also feel the medical profession has turned into a hazing ritual. Is the intent to weed out the weaker doctors? Well that’s crap. They are planting discouragement and sowing depression and anxiety. Our healthcare system will reap what it sows. I hope they wake up before the whole healthcare system ends up in the toilet. I ❤U, Rachel. Thanks for speaking up and standing up. 👏👏
Not to mention that the debt to salary ratio for young doctors are incredibly high. Doctors do NOT make as much as people think
it is not worth it on long term, let's be honest. but we are all stuck
The medical communicated is quitting because the health care system is broken. After covi19 pandemic, hospital lose a lot of money. Now they're trying to regain back that amount of money lose with overloaded doctor and nurse with a lot of work. Plus, additional doctor are burnout for how much patient they need to round. CEO of Hospital don't care about nurses or doctor, they want you to make profit for them and replace. Every day I saw many doctor quitting on the hospital and be replaced. I start taking with a doctor, they explain to me the situation they are passing. So now life depends on a good doctor or nurse to help you during your hospitalization. Malpractice increase over the years after covi19, because the amount of patients doctor have, poor pay check , high work. I'm thinking of going to medical school, but my friend doctor they recommend it not worth it.
I would be open to a system where we are residents for longer (maybe needing to add a year?) but with not as crazy hours so that we still have plenty of time for experience before becoming attendings- and with that there would also be improved pay or increased debt forgiveness ? That’s just something I’ve thought about before
All this for 3-5 yrs residency training ? What about once you become full time physician ? You will earn a way more right? Please talk on that as well
YOU DESREVE SO MUCH MORE MONEY THAN THAT! 💰
Enrollment for medical school and nursing school is going lower and lower.
TRUTH BE TOLD
This is not surprising if so
So if they cut your hours in half (40 hours a week instead of the 80 hours you are working now, do you think they should add years to the medical school program to make up for the hours lost? Part of becoming a good doctor does involve being exposed to as many cases as possible while you are in school. You can listen to lectures, watch video, etc., but real world experience is crucial to your development as a doctor. You would have improvement in your hours to have a life outside of school, but added years to your program will increase the amount of debt you already have for sure.
Im not disagreeing with you. I don’t have the solutions yet, but this is good thought-provoking discussion. 😊
@@ahoward3819 good idea!
Being honest, not all of those hours are exposure to cases. Lot of it is "scut work". After a certain point the benefits of learning does not outweigh the risk. I think there should be more residents allowed per program to lessen load for one
@@jessicalownes7479 what do you consider scut work?
not the old, nasty, rotten milk ie the boomer energy 🙃
Wow, you look completely drained in that thumbnail 🥴😅
I don’t even know how you have the energy to edit a video
Honestly same
Great video love your channel, but this so is terrible and makes me not want to pursue medicine. This is unethical on so many levels.
❤
I do not know what adults are only working 36 hours a week. Most work 60-80+ hours a week, and they are raising children.
The data says what it says.🤷♀️If it said that the average American worked that much, I would’ve included that. Hope you got the point of the entire video though!
🙌🏽
How about how medical school teaches nothing about nutrition?
My medical school had a few lectures about nutrition, but not hardly enough. But yeah! A little off the point of the video 🥴
I think it's important to touch on the fundamentals and understanding how nutrition is one of the social determinants interwoven in patient health but we have registered dietitians and nutritionists who specialize in nutrition for this purpose. Many of them work closely with the clinical team. I think it's great to offer extra training as an elective but the curriculum is already dense and stressful enough.
Trust me, I very much understand! But again, it’s not really aligned with the topic of the video so it’s not something that was discussed.
@@RachelSouthardExactly. Totally agreed. the only reason I responded was because I felt it derailed the conversation and you shouldn't have had to respond. We're addressing VITAL topics related to our self care and wellbeing in medicine and I frankly felt it was a bit disrespectful to bring up.🥴 Thank you for responding so respectfully, Dr. Southard! Always a class act!🤎
Appreciate you🩷☺️
We want longer more uncut content! Plz n thx!
She’s busy. Her job is more important than adding to her heavy workload to make a longer video for you.
I hardly have time to exist as a human being outside of my job as a resident doctor. I'm doing the best that i can with uploading WEEKLY content on TH-cam. Thanks for understanding.
@@RachelSouthardYou owe us nothing! Always love when you are able to! You first! Hope you were able to enjoy some kind of nice Thanksgiving!
@@RachelSouthard❤❤❤❤❤❤❤❤❤
@@shorty7764❤❤❤❤❤❤
Thank you for speaking up about this 🩷 Suffering should not be a rite of passage to become a doctor.