Let’s just start with some transparency. Residency is hard. Patient care and difficult patient outcomes are hard. Navigating relationships with attendings and residents (especially those with big personalities) is hard. Constantly being new at things is hard. Losing sleep and sacrificing self-care for the grind is hard. And the internal stress that we often put on ourselves as residents makes it even harder. As I round out my last 6 months as a junior surgical resident, I have found myself reflecting on a few simple wellness and mindfulness mantras that have really changed my life in residency. Googling mindfulness/wellness in residency will land you a few hits. They will take you to articles about academic medicine, a few notes from the AMA and AAMC, and some honestly vague advice that never felt practical, beneficial, or attainable to me. When a mandatory wellness lecture suggested listening to music we liked to get through challenges, I found myself wondering if this was too big of a job even for Taylor Swift to take on. I hope that the techniques below will prove to be less vague, more attainable, and more hopeful, as they have been stress-tested through every one of my recent tough patient encounters, frustrating cases, and sleepless nights.

1. Life is not 0% or 100%.

As a recovering perfectionist, I struggle when I can’t make things perfect. Completing my to-do list, doing my FULL nightly skin care routine, rocking all 25 of my nightly board vitals review questions, etc.; the list never stops growing. Then, life happens. Call happens. And when they do, 100% gets harder to attain. But, 10% is ALWAYS better than 0%. Life isn’t all or none. If you can’t do all the review questions, try ten, try one. Even brushing your teeth for the full, recommended 2 minutes seems like a challenge when call has you beat down? That’s okay. Do 1 minute, do 30 seconds. Can’t squeeze the full 50 minute recommended cardio session in? Go for a 20 minute walk. Take the stairs today. Try again tomorrow. Partial credit can be okay in the game of life.

2. Trust people to be how they are.

This one is my mantra. It has saved my soul more times than I can count, in residency and in my personal life. It takes some time to truly believe it, but fake it ’til you make it. We cannot change other people. Life isn’t a game of Sims. Some people are going to have personalities that are diametrically opposed to you. BUT, here’s the important piece – that doesn’t have to affect you OR have anything to do with you, your performance, or whether or not you are worthy of good things. Your attending is frustrated and short in a tough case? It isn’t about you. Let them be frustrated. A person is acting disrespectfully to you? That’s awful, and it’s not because you deserve that treatment. I am not at all righting the wrongs of people who are slighting you or making you feel less than human. I am simply suggesting that you deserve freedom from others’ poor actions. When you allow yourself to remember that people are responsible for their own actions and that you don’t have to expect any more from them, it can be a really nice release.

3. Prioritize scheduling your time.

Residency is like being in a circus. But the tent is on fire. And everything is on fire. And NONE of the acts seem to have things together. One way to help is with simple time management. If that means buying a cute agenda and pens, by all means DO THAT. But, if that seems like too much work in your already overly busy life, start small. For me, that simple step is my notes app on my phone. I schedule everything, even the fun things (see number 8.) Since I am pretty type A, the little hit of serotonin that I get checking the tiny yellow check bubbles on my notes app helps to remind me of all the things I’m winning (even if it’s just my mandatory work, prepping for tomorrow’s cases, and remembering to actually pick my Hello Fresh meals this week.)

4. One bad thing will not ruin your day.

Have I cried because the bagel shop in town ran out of my favorite bagels after a tough call day? Yes. Was it really about the bagel? Obviously not. It’s a damn good bagel, but not worth unraveling my day. Sometimes when things feel overwhelming, it’s easy to put your eggs in one basket, or onto one bagel, assuring yourself that things will be better if that one thing happens the way you plan. Life isn’t that black and white. This one is another fake it ’til you make it. After repeating this to myself 100 times, I’m not perfect, but I am certainly better at not letting one bad interaction, mistake, or missed bagel ruin my day.

5. You can do hard things.

If you’re on this page it’s pretty likely you’re in residency or medical school, or maybe you’re out in practice. Regardless of where you are, you’ve already done hard things. Every single day. And you’ve survived every one of them. You’re literally holding a perfect 1.000 batting average on surviving all of your toughest days. Don’t forget that.

6. Anger is a poison you drink yourself.

More fake it ’til you make it mantras here. I repeat this out loud – a lot – as a reminder to myself and as a reminder to my friends. It is so easy to be angry. Angry with a colleague, family, a patient, yourself when things get bad or don’t go as planned. The trouble is that the person or thing you are angry with doesn’t lose the sleep you do. They don’t feel the stress you do. The only person suffering from the poison of anger is yourself. Think carefully before you decide to imbibe.

7. Finish the day with gratitude.

If a pretty bullet journal is your vibe, then journal about your gratitude that way. If mantra number one, above, resonated with you, maybe journaling sounds like another task that you won’t complete if it doesn’t look Pinterest worthy. If that’s the case, you’re in fantastic company. Remember number three? It doesn’t need to be pretty, it doesn’t need to be poetic, it just has to be genuine. This one is another quick notes app addition for me a couple of times a week. Reading back through the gratitude note really helps to recenter me when things are tough. (Bonus points for pictures, they are great additions for recalling those grateful moments.)

8. Don’t forget self-care (that’s why you’re here, right?).

This one is extremely tied to number three for me. I have always been good about putting work tasks and studying on the to-do list, but I never gave myself credit or space for self-care. Putting skin care, hair-washing days, cooking dinner, and playing Nintendo Switch with my husband all take time and they are important to my overall well-being. When I schedule them in, I find that I am more respectful of the space they deserve in my day. And, back to the comment above, checking that little yellow box in my notes app is a double dose of serotonin. Not only have I completed a task, it’s a task that is all about my well-being.

9. Be patient with yourself.

When I started my self-care journey, it was hard. I didn’t immediately believe some of the mantras above. I didn’t understand how I was going to accomplish another thing on the old to-do list. Life isn’t a staircase. You won’t always feel the improvement day to day. Some days you’ll take a few steps back. Breaking those negative self-thoughts is tough. If you’ve made it this far, you’re already making progress.

10. Don’t struggle alone.

Back to the beginning here: residency is HARD. If it seems impossible, talk to someone. Hopefully this space allows you networking and conversations that help make it a little easier. I am NOT a licensed therapist, this list is not made by one, and it’s all about an active work in progress (aka: me). Please don’t discount your friendly, local therapist. They will have many more techniques and tips to help you to continue to be your best self. Many programs have resources that can help. Outside of those, apps like Sanvello (a personal fave) are a nice jumping off point. If at any point, things get too hard, remember there are resources that can be found through the Wellness tab on this site.

If you made it this far, I am proud of you. I hope some of this helps. This list isn’t one size fits all. There are things above that won’t work or resonate with everyone, but if I can even hit a few struggling fellow residents it will be worth it. Keep providing the excellent care you are giving to your patients. Keep learning and developing your skills. Keep enjoying the things that make you feel whole. Keep winning the little victories. Your favorite music won’t carry you through the tough times. You will. I’m rooting for you. You got this.