Unbalanced but Satisfied?

During my fellowship training in critical care, my then 4-year-old daughter drew my picture in shabby scrubs with two dark circles around my eyes, and named it " mommy panda " depicting my sleep deprived and exhausted existence. At that time, I was spending about two and a half hours commuting, braving Atlanta traffic, while my husband pursued his PhD training in New York. My situation as an anchor parent of a young child with no family around and the demands of an emotionally and physically challenging fellowship training generated lots of sympathy and concerns from well-wishers and colleagues. They saw my life as unbalanced, at risk of burnout, and it is true that they had some reasons to worry since the odds were not in my favor. Physicians in general and particularly those exposed to unremitting high level of stress in specialties such as critical care are at high risk of burnout (1), a condition resulting from cumulative stress at work characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment (2, 3). Emotional exhaustion is a key component in physician burnout (2), and the reported incidence in the US ranges from 25 to 60% (4, 5). To avoid becoming yet another victim, I tried to learn what we already know about the risk and protective factors associated with physician burnout. Available evidence describes a number of work and personal factors often associated with physician burnout. Work characteristics such as heavy workload, poor work organization, conflicts with coworkers, patients and their families, and perceived lack of control of work hours and schedule, specialty choice and practice settings are reported as risk factors in both sexes (6–9). Parenting responsibilities, career and work schedule of a significant other, and the strength of social support are some of the factors identified in studies that have examined life style factors (10). As I understood, rather than individual factors, the interplay between these factors forming tension between personal and professional responsibilities, labeled as " work home interference " appears to be at the heart of burnout (11). During my training and the first few years of practice, I often found solace in the belief that " things get better with time. Evidence suggests that this may be true as younger physicians have twice the incidence of burn out as older colleagues, and onset may be as early as during training (4). Younger physicians, those …