We interviewed Dr. Marlise Sovka this month, who is a PGY-2 in Family Medicine. We chatted with Dr. Sovka about her experiences with burnout and recommendations for fellow residents, wellness resources, motherhood during residency and during two outbreaks: first measles, and then COVID-19.
At the start of your residency, you experienced burn out and took a four month leave before returning to the program. Since then, you have helped with the Resident Wellness Office’s peer mentoring group to assist other residents. What was burn out like for you and what are some signs that residents should watch out for to indicate that they may be experiencing burn out?
Yes, it was a new experience for me to go through burn out as I had never struggled with that before. I think I had been mentally pushing myself so hard as I went through medical school, and then through the increasing demands of residency, that I hadn’t realized how important it was to slow down. It is easy to get wrapped up trying to study all the time and experiencing the imposter syndrome and pressure that you somehow need to know everything.
It was unfortunate that I had an extremely challenging and unsupportive rotation at the peak of my burn out that really pushed me over the edge. Some signs that should have warned me I was burning out were:
- I had stopped eating very much since I constantly felt nauseous from anxiety
- I couldn’t get a good sleep as my mind was always racing
- I stopped doing any activities/exercise outside of work
- I was not getting any enjoyment from work or my life outside of work
- I was constantly anxious and stressed
I had even mentioned some of these feelings to preceptors who told me that it was normal to feel this way at the beginning of residency, that I didn’t appear stressed or like I was drowning (even though that’s how I felt), and that I was doing a good job. I am sure these comments were meant to be supportive, but it mostly made me feel like I had to just keep pushing through. I am glad that I felt comfortable enough to talk to other residents and family who encouraged me to reach out to the Resident Wellness Office (RWO) that ultimately determined I was burning out and had to take a break.
There are so many resources available, and it can sometimes be overwhelming. I’d recommend choosing one or two to see what works best for you:
- RWO: check in every now and again with one of their counsellors. It is helpful to gain their perspective as they deal with all residents in every type of situation and can normalize what you are experiencing or point you in the right direction
- RWO Support Group for Residents on Leave: this is a 4-week group session facilitated by one of the counsellors and runs 4x/academic year
- RWO Peer Support Program: this is a new program being offered where residents can reach out to the RWO who will then set them up with a trained peer supporter
- Podcasts: The Anxiety Podcast by Tim JP Collins was on Spotify and helped me process new feelings I was having while burning out. It may not be for everyone but was something I stumbled across and was helpful for me.
- Apps: “Simple Habit: Meditation, Sleep” was one I like as they have a variety of free guided meditations and ones that calmed my mind and helped me get to sleep. Other apps like Headspace or Mindshift didn’t really work for me, but I’ve heard they have been helpful to others. I enjoyed the guided meditations to provide me something else to focus on instead of ruminating over work or stress.
- Books: I browsed through “Mind over Mood” with my RWO counsellor but never really got into it. Other ones I heard a preceptor recommend was “Feeling Good: The New Mood Therapy” and “Breaking the Patterns of Depression.”
- Friends/Family/Colleagues: I found it is best to talk about things instead of ruminating and bottling up feelings/worries/self doubt/etc. I would recommend being honest, open, and sharing your true experiences with others; you may be surprised that a lot of other people are feeling the exact same way.
I have loved becoming a parent over these past three years. I wasn’t sure how it would work with residency, but the program has been very supportive and flexible with scheduling. Life is busy for sure, but we make it work and I wouldn’t have wanted it any other way. It is such a joy to come home to my kids and they make me learn how to balance my life. It was great timing for me since many of my co-residents were also pregnant and taking maternity leave at the same time, so I had a nice support network. I hope other residents who are considering it, see that is it possible, as many people do start a family in residency. It can sometimes feel odd to take a break from the program, but just like other types of leave (ex. stress leave, medical leave), many residents do end up off-cycle for various reasons and can hop right back in where they left off. It can seem like you need to graduate “on time” with everyone else, but you really don’t. I have ended up being a part of 3 different cohorts (thanks to 2 maternity leaves in 4 years) and have gotten to meet so many lovely residents. I just had to be intentional about meeting them and connecting during resident socials or chatting on Signal/WhatsApp.
For your resident scholar project, you worked with a team of resident mothers to create a comprehensive parenting website for UBC residents. What are some things you found that residents may not know about, or that surprised you when researching?
Similar to when we were discussing resources for burn out above, there are so many resources out there for pregnancy, maternity
leave, and transitioning back to the program. Our team wanted to try and consolidate all the information we could find from various websites like RDocBC, UBC PGME, government websites, RWO, etc., so that it was easy to find and easy to understand. I personally found it tricky figuring out the logistics of taking leave and how to get paid while on leave, so I hoped after siftingthrough everything, I could help make it more clear for future resident parents. Our website (https://ubcresidentparentguide.com/) is currently live however we are in the process of merging that with either the UBC FP page or with RDocBC. Something that surprised me while working on this project was that there were so many organizations or people that you should notify before or after you take leave. For example, reaching out to the Divisions of Family Practice, touching base with CMPA, and contacting CPSBC to name a few. We have created a handy summary page that outlines this. Another thing that surprised me, was how you can take “medical leave” prior to your due date if you are unable to work late in pregnancy, and it doesn’t become formal “maternity leave” until your baby is due.
You were pregnant with your first child during the measles outbreak in Vancouver and were transitioning back into residency (while pregnant with your second) when COVID hit. What were some of the challenges you faced during these times?
It definitely was a challenge having a baby at home and being pregnant during the measles outbreak and now the pandemic. Not only was I trying to keep myself healthy and safe, but I now had other factors to consider. I always made sure to let preceptors know I was pregnant, and I would try my best to not be exposed to patients who were overtly contagious or could put my pregnancy at risk. Even though I would take all the proper precautions and make sure I was wearing the correct PPE, there were some situations where I felt working was too risky. For example, I had to cancel one of my electives in an urgent care clinic since I was late into my pregnancy, and it was a COVID testing site where I was likely to be exposed to COVID positive patients. The elective coordinator and my program coordinator fully supported my decision, and it was relatively easy to try and find another place for me to work. The program and the RDocBC collective agreement are very helpful in outlining your rights as a pregnant resident or resident parent and allowing you to go to things such as prenatal visits and taking time off if you have a sick child. Of course, there was the personal pressure that I needed to be the best resident I could be and still do everything a non-pregnant resident could do, but at some point, I had to accept that I was tired and swollen and had to give myself some slack since I was growing another human inside of me. I was pleasantly surprised by how supportive preceptors and colleagues were, and fortunately I never experienced any type of shaming or discrimination.