The February Effect

It’s a weird time in teaching hospitals. I’m not sure if it’s been described before but I can’t be the first one to characterize the month of February as dreary for those in medical training, and not just because of the weather.

The excitement has worn off.

The number of months left of X year (intern, finishing residency, etc) is still daunting.

The work becomes mundane and overwhelming at the same time.

Your confidence is just barely adequate for the present year, leaving you wondering what you’ve been working so hard for.

Sad moments seem more sad, but happier moments seem less impressive.

Oh, and the weather probably does suck too.

This is what I’ve described in my own head as “The February Effect.” It’s my sixth year being in an academic hospital setting and I’m seriously surprised at my clockwork observations. An attending once described this time period vividly as he recalled countless groups of residents pass through training, and it was this month he seemed to pay careful attention to their collective mental health. I’ve felt it firsthand as an intern, feeling a disconnect and for the first time in my life, a lack of joy in showing up. There are a number of factors that go into whether trainees will feel “burned out” (more on this for a different time, as I talk about what it really means to care about resident wellness) but I’m not even referencing burnout here. Burnout implies an individual feeling, whereas this general “lull” that I describe here pulsates through every signout, every morning report, every noon lecture, every family meeting, every table rounds.

I thought maybe fellowship would be different, but my intuition and the general sense of interactions I have these days reminds me that it’s here again. Certainly I feel the general fatigue/low mood and sense it in others in fellowship — (first year call schedule, the reduced thrill of getting to do a procedure, etc) but I notice it more so in residents. 3rd year residents post-fellowship match, just waiting patiently for their ultimate career training to begin. 2nd years in awe they are just half way through. And the interns— My dear interns. It’s going to be ok, no matter what mistake you think you made, no matter what paper was rejected from a journal, regardless of your self-inflicted feelings that you aren’t good enough.. that’s February talking and you need to stop listening.

This effect drags into March, and we first start to claw out of it on Match Day. Something a little magical happens when we watch our students discover that their career aspirations have come true. And as the tired and slightly jaded interns/residents/fellows, we recall how we once dreamed and prayed to be where we are right now standing in that hospital with a long white coat doing this job. Throw in daylight savings and the mere possibility of catching the sun on our way home from work, and things start looking up. Our skills, coupled with our confidence, slowly start to improve. Little failures start to role off our shoulders more easily.

Whether we recognize it or not, by late Spring we are reborn. And as the coming academic year approaches, we start to prepare for our new role- transitioning from intern to a senior with more responsibility, or from resident to fellow, or resident to attending. The unknown is thrilling, and while we actively get stronger in our current role, we prepare for the next step.

Medical training is a life cycle, with February the most daunting. Like every day, but especially these days, take care of each other. Remember you’re not alone. And as we actively work on ensuring that trainees have humane and nurturing work environments, we can do our part by being kind to ourselves and kind to our colleagues. Each and every one of us deserves that.

Love,

Shanny DO