Shining a Spotlight on Physician Burnout ft. Monica from Mexico

This month I’ve changed things up a bit and am interviewing a physician from Mexico!  It’s fun to get a different aspect of the dynamics of burnout across the medical field and Monica has quite an interesting story.  She also fills us in on what medical care is like in Mexico and I think it’s fascinating to learn the way different health systems operate around the world.  Read more to find out how Monica is preventing burnout, her story from student to a physician, and what healthcare is like in Mexico.  The way she honestly states what “burnout” means to her is eye-opening, raw, honest, and mostly – real.  I appreciate her for being so bold to tell her story.

 

Tell me about your background.  Where do you call home?  If you’re currently traveling, where in the world are you?

I was born in Mexico City and have lived in the same municipality my entire life.  I went to medical school here and did my residency here as well.  My father is a physicist, my mother is a real estate agent, and my sister is a biologist.  I’m the first person in my family to go into medicine!  I’m also married to a pediatric cardiologist and we don’t have any kids yet.

 

What kind of medicine do you practice and how long have you been a doctor?

I’ve been a practicing pediatrician for 7 years and did my fellowship in developmental follow up of the high-risk newborn.  Until recently I was the chief of the pediatric ER in a very famous private hospital here in Mexico.  Now I am focusing on my private practice and doing medical development for a US hospital in Mexico.

 

Why did you choose to become a doctor?

I didn’t grow up wanting to be a doctor, in fact, I wanted to become a lawyer so the original feeling of wanting to “help others” wasn’t there.  In junior year of high school, I took an anatomy class and loved it; my teacher made it so fun!  I also had ease for learning names and diseases, which gave me a sense of importance.  Once I was a senior I was debating between studying law, medicine, psychology, literature, or theology (crazy).

Fast forward to career guidance and orientation day at school and the law and medicine talks were the exact same.  I ended up deciding to pursue medicine.  The young doctor that was leading the talk was passionate and completely sold the “being a doctor is the coolest thing on the planet – you can help a lot of people” thing so… medical school it was.  If only I would have known about the long hours, loss of social life, and the crappy salary as well.

 

How did you choose which field to enter?

In my fifth year of medical school, I had a 4-month rotation in two separate pediatric units.  That made me realize that children were a lot more fun to be around than adults and I was intrigued by being able to figure out what was wrong with a little person who couldn’t yet speak.  Children are also more transparent and tend to tell the truth most of the time.

During my pediatric residency I thought about becoming a neonatologist (I loved the preemie babies), but quickly decided against it when I realized my personality was too soft for the intensive care unit aspect.  I did think that I could be a good advocate for preemies in a different way, so I studied the changes in neurodevelopment during the first two years of life-related to the NICU stay and preterm delivery.  I loved it!

 

At what age do you go to medical school and how long does it take you to graduate?

If you want to go to medical school you have to take certain subjects in your senior year of high school.  Next, you have to apply to university; the exams for public universities are very competitive while the private ones are less competitive.  Once you’re accepted, school lasts for 6-7 years.  You have 2 years of basic subjects, 2 clinical years with hospital rotations and 1-2 years of medical internship in a hospital plus 1 year of community service in a rural setting.

Next is residency, which is extremely hard to get into.  Only about 10% of those who apply will enter into residency.  I did a pediatric residency so I’ll tell you how our residency worked.

The residency for pediatrics takes 3 years.  The shifts are A-B-C (on day A you work from 7 am-4 pm; B day 7 am-7 am [24 hours]; C day 7 am-4 pm; and the cycle repeats).  I was blessed to do my residency at a private hospital because in public institutions they sometimes work for 48-hours straight.  In the last year of residency, you have to do another 4-months of community service in a general hospital, usually in a small town, then you apply for a fellowship.

When it’s all said and done, on average, medical school begins when you’re 18 years old and you graduate between 29-34 depending on how many sub-specialties you choose to study.  For me personally, it was 18-30.

 

Tell me about healthcare in Mexico.

In Mexico healthcare is divided into two groups:  those who can afford medical insurance (less than 10% of the population) and the poor who are forced into public healthcare.  Public institutions are almost always exceeding capacity, poorly staffed, badly equipped, and in terrible conditions.  Private hospitals are usually better in quality and technology with care and pricing varying from practices similar to those in the US to much more practical and economic practices.

One good thing about healthcare in my country is that it is UNIVERSAL.  This means that even if you don’t have money, insurance, or a job… there’s always a medical center that can and will provide care and medicine.  It may not be the best care or treatment but something is better than nothing!

 

I’m a huge advocate of preventing medical burnout.  What does burnout mean to you?  Have you experienced burnout yourself?

To me, burnout is the emotion you feel when something you loved turns into something you loath.  It’s that feeling you have every single day when you drag yourself out of bed after snoozing the alarm 5 times, you eat breakfast in a foul mood, scowl to every person you meet on your way to work, hate your boss, hate your coworkers, hate your patients.  You complain about every aspect of work to your husband or anyone who will listen and then cry at night because you hate your job, your life, and you loathe yourself for ever letting it get this bad.  And yes, I’ve experienced burnout.

 

What are you doing to try to combat or prevent burnout?

I suffered from burnout for nearly 5 years.  Even though I tried to speak to my boss and friends, I felt like they didn’t understand what I was trying to tell them.  Every time I shared my feelings my friends accused me of being “bitchy” and “repetitive” and my boss would “reward me” with even more work (which I was supposed to see as an advance in my career).  My main way of combating burnout was to plan my sacred 3-week vacation.  I would start 10-months in advance, reading endless TripAdvisor reviews, travel blogs, and listening to all of the travel advice I could get.  I became an expert on sights to see, clothes to wear, food to eat.  Every second of our trip was always perfectly choreographed.

Last year my burnout was so bad that it took me half of my vacation to recover from it.  Even when I was in a different country my mind couldn’t recover from being at work.  So when I came back… I decided to resign.  It was an extremely hard decision, but now, 5-months later I’m sure I did the right thing!

Unfortunately in Mexico burnout is not an issue to be addressed.  We are supposed to be grateful for having a job or for being able to enter a residency program.  We’re not supposed to complain and demand fair hours, an increase in salary, or a rewarding job.  I’m ashamed to say that in my years in the hospital I didn’t help others who felt burned out.  I would try to hear my students out and help them as well as I could, but I was in a really bad place myself.  I hope that now I can help someone.

 

Before we wrap up this interview, tell me one fact about yourself unrelated to medicine!

This is the hardest question yet!  I love to read!  I’m a hardcore fan of Harry Potter, Lord of the Rings, Game of Thrones and such.  But my favorite author is Margaret Atwood.

 

Where can people find you on social media?

My super neglected travel blog which I plan to revive:  Living in Technicolor

Instagram:  @livingintechnicolortravel

 

If you want to talk about your experience with burnout or know someone who does, please email me at passportsandpreemies@gmail.com.

 

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