Staying Human during Residency Training: Q&A with Allan D. Peterkin and Derek Puddester

The ultimate survival guide for medical students, interns, residents, and fellows, Staying Human during Residency Training provides time-tested advice and the latest information on every aspect of a resident’s life – from choosing a residency program to coping with stress, enhancing self-care, and protecting personal and professional relationships. Read a behind-the-scenes look about the book by the authors Allan D. Peterkin and Derek Puddester:

How did you decide that you wanted to write the seventh edition of Staying Human during Residency Training? Is there a story behind it?  

Allan: We were all trying to cope with the Covid pandemic, personally and professionally. I was seeing the impact on our med students and residents in the hospital where I teach. Mounting feelings of loss of control and disconnection, which are the two major risk factors for resident burnout. 

I realized it was time to take another look at resident wellbeing, resilience, and happiness. Including the larger picture: new technologies including the impacts of AI, the EMR and virtual assessments, emerging regional wars, a polarized political climate, housing crises, and climate change. It has been a troubling time, and we are all citizens of the world. 

I reached out to Derek because he had so much expertise in physician health and education, leadership, and governance. I was delighted when he agreed to co-write this edition. He brought new eyes and enthusiasm to the project. It has been a terrific collaboration, and the Press has been wonderful.

Derek: Allan called me to let me know he was exploring options to develop the 7th edition and…well…it was a bit of a mind-blowing call. When I was a resident, way back in the last century (before social media and iPhones!), the first edition inspired me to practice in the area of physician health. Allan is a pioneer, much like Drs. Michael Myers and Mamta Gautam, in the physician health world, so to get a warm and friendly invitation to join him on this project was incredible! 

And besides the honour of working with Allan, I knew the time was right for an update. So much social change within medical culture had taken place in the preceding years, and the pandemic shone new light on the value of staying human. During that first call we had so many good ideas that we wanted to include in the update, particularly amplifying the good work being done by so many across the medical education and training system. 

Are there any examples, anecdotes, or lessons that stood out to you during the research process of this book?

Derek: We did a deep dive in the published and grey literature relevant to every chapter in this edition. And I mean deep!  I had wrapped up a master’s thesis the year prior to this project and was so grateful to have had a refresher on research and synthesis. We collected hundreds, probably thousands, of references along the way, as well as personal stories and elements from the humanities (e.g. poems, short stories, and films).  What really stood out to me was how much incredibly good work has been done in the area of physician health.  And to put the icing on the cake, the bulk of the work reflected a deep commitment to action-oriented research that was increasingly influenced by principles of inclusion and social justice.   

When I started my career in physician health, the bulk of the literature was focused on just a few important themes.  Primarily, “physician health” was code for “physician substance use” and, a bit later, “physician suicide.” Our research demonstrated a positive shift to a wholistic model of resident health and well-being, with excellent research and policy work on prevention, workplace/learning environment culture, social justice, positive psychology, and specific elements of assessment/treatment/recovery. It was wonderful to see how the mental models the profession applies to “health” have broadened so much over the years. While there is much good work to do, we are definitely heading in the right direction. 

What was the most challenging aspect of putting together this project? 

Derek: A little thing called COVID! I had just moved to Vancouver and Allan, of course, was in Toronto, and all sorts of challenges to in-person work were in flux as we started the writing process. We were also incredibly busy with doing our part in supporting patients and health systems during the pandemic, leading to lots of competing demands on our limited time for collaboration and writing. Many times, I wished we could just drop out for a week, share a cottage in the country, and enjoy the gift of compressed collaborative writing time! 

But Allan is such a pro, and an incredibly supportive colleague. He helped us design a timeline to keep tasks on track, ensured we had an easy way of exchanging ideas and feedback along the way, and was gifted at removing potential barriers in our path to completion. I learned so much from him during the process, particularly how he ensured potential challenges were thoughtfully and readily managed. I’m so grateful for the experience. 

How was your experience working with the University of Toronto Press editors of this book?  

Derek: Oh. My. Goodness. This was such a good experience. And kudos to UTP for their excellent collaboration! 

Allan and I would send along chapters that we had written, exchanged, edited, exchanged, edited again, shared with others, edited again, re-read again obsessively, and fact-checked repeatedly. We were so determined to submit our best possible work to the editors for their review. We knew they were a sacred resource and we wanted to respect their time and skill. And, I suppose, at least for me, I still have a bit of anxiety submitting written work to an expert holding a red pen! 

The editors were incredible. Every sentence was carefully weighed and measured, structure and flow assessed to ensure a positive reader experience, and absolutely every reference reviewed for factual accuracy and relevance. Such a collaborative, and humbling, experience. When “red-pen” comments flowed back to us for review, we treated them like gold dust. The input of the editors made the overall project that much stronger. Again, I am so grateful to have learned so much from them. 

What do you hope medical students, interns, residents, and fellows will take away from reading Staying Human during Residency Training? 

Derek: First, I am so glad they are part of the profession. Medicine is such a joyful career and on such a good path of evolution and humanization. Their leadership will make our profession, and our ability to serve people and communities, even stronger. 

Second, they got this. Learners are coming to the profession increasingly aware of the challenges that lie before them, and increasingly aware of their skills in managing threats to their integrity and well-being. And when they need help, they reach out more often than those generations who came before them. I hope the book illustrates how many resources, both internal and in-system, are available to help promote and enhance their success. 

Finally, they are surrounded by people who want to support them. As we spoke to learners over the course of this project, we heard over and over again how learners have focused on building and contributing to their learning and practice communities. There were some touching stories of intervention, advocacy, celebration, and grief shared with us that illustrated the many things that are going well in our profession. Medicine has its challenges, no doubt, but there are many things that are going very well.   

Learn more about Staying Human during Residency Training: How to Survive and Thrive after Medical School, Seventh Edition, here.

Listen to the CFP Podcast featuring Allan D. Peterkin, here.

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