2. Maintain Work-Life Balance
Many residency programs are built on a rigid structure, but fellowship programs typically promote a more self-directed approach. Depending on the fellow, this can potentially result in slacking off. At the opposite end of the spectrum we find fellows who can’t turn off work mode, leading to a workaholic lifestyle. Because rheumatology is an outpatient-based subspecialty that provides consultative service, some days (weeks) during a fellowship will be busier than others.
The key to successful work-life balance lies in the creation of a personal schedule. Self-
assessments of motivation can help trainees determine whether they need more structure to avoid the idler or workaholic mentality. Don’t be afraid to ask your program director for help balancing the workload.
Successful work-life balance requires time dedicated to activities unrelated to and outside work. Whether single or married with children, all trainees should find activities they enjoy outside the hospital. For some, this may mean scheduling a date night with their spouse or attending a spinning or Pilates class. In our programs, for example, many fellows and faculty participate in local running races. Regardless of the activity, mental health and well-being should be a priority. A personal schedule that allows time for family, social activities and physical fitness should be established early during fellowship training.
Fellows and program directors should make it a priority to identify any mental health resources offered through their institution. As trainees discover in medical school and residency, life doesn’t slow down despite career advancement. Fellowship is no different. Having a solid work-life balance promotes positive mental health, which improves work performance and, thus, creates a happy, productive and compassionate physician.
3. Research Financial Resources
The choice to continue medical training through subspecialty fellowship bears a commitment to another two to three years of post-graduate training salary. Unfortunately, many trainees have significant educational debt. To add to the financial burden, relocation often involves moving costs, rental deposits or down payments. Trainees with children have the added expense of childcare.
The stress associated with financial hardship can interfere with fellowship performance and productivity. Fortunately, resources are available to help mitigate the financial burden. Pediatric rheumatology fellows committed to research can apply for the National Institutes of Health Loan Repayment Program, with applications due each November. Income-based loan repayment can also help trainees keep their loan repayments affordable. Likewise, early commitment to an underserved area may qualify a fellow for a stipend during training or loan forgiveness through such programs as Public Service Loan Forgiveness.
Graduate medical education offices also offer financial planning resources. Early in training, fellows should meet with a financial advisor to discuss current and future financial planning. It’s never too early to plan for retirement.
