There may be times in your training when your exhaustion or burnout exceeds your ability to continue. This happened to me while on home call for a week (working day and night), and I sent an email to my attending on the sixth day of the call. Thankfully, schedules like this don’t exist anymore at my previous program.
At that time, I was so tired I didn’t know what to say or type. I’ve created a template email in case you ever need it. I sent this to my supervising attending, who was on service that week. You could also send something similar to someone you trust—a chief resident, a mentor, an assistant program director, or a program director.
(And remember that many good people are working to improve conditions for doctors in training. Be part of the solution. Keep track of what is not working well. Offer solutions. And when possible, continue to advocate for creating a more positive culture of medical education and training.)
In my mind, this is a reasonable framework:
Dr. XYZ,
Paragraph 1: Thank them for their efforts in supporting medical training.
Paragraph 2: Explain the challenge, whether an unsupported rotation, excessive workload or sleep deprivation on long call, or home call.
Paragraph 3: Although this is pretty bold to include, consider mentioning how the current climate does not fit with ACGME guidelines. I would only send this if you trust the mentor or chief resident.
Paragraph 4: A statement iterating how important the training program is to you, that you are seeking support and workable solutions and want to be part of a better path forward.
Thank you for your support,
Your name
Example Email
Dear Dr. Jones,
Thank you for your continued efforts to support fellows and to promote our learning and well-being. I am in a difficult spot right now and seeking your guidance.
As you know, our home call weeks are incredibly busy. We work all day and often all night for a week straight, and lately, the call volume has been tremendously high. Last night, I received more than 45 pages, and despite trying to sleep from 6:30 p.m. on, I received just over 1 hour of fragmented sleep. This is my sixth day of call.
The ACGME says home call “must not be so frequent as to preclude rest,” and I believe this week the volume of calls has truly precluded rest.
This fellowship is very important to me, and I want to perform at a high level. I do not think it is good for patient care or for my health to work all day and all night without rest, especially when my daytime responsibilities are supervisory in nature. I'm hoping to find any workable solution.
Thanks again for your support.