Staying Motivated: Tips to Maintain Focus and Performance During Fellowship

All of us trainees embarked on the cardiology training pathway because we loved our field. However, during the busy call nights, endless daily work and long procedures, that love can certainly be tested. It often feels like the grinding slog of being a clinical fellow is a permanent state and that just getting through the physical and mental challenge is the only goal that counts. However, the completion of training is not as far off as it seems, and the time between now and then is highly valuable. What constitutes work-life balance differs among individuals, but finding as much of this balance as possible is at the heart of fellowship success. We all know reading a text book daily, reviewing recent articles and studying guideline statements is important; however, maintaining the motivation to do these things and squeeze in some academic work on the side, all while performing well in our daily clinical work, requires a plan.

For many, the first consideration is ensuring you get enough sleep. Between work and personal factors, trainees need to abide by the old adage: sleep when you can. With enough sleep you can more efficiently complete tasks, make the best clinical decisions and have the patience to navigate challenging interpersonal scenarios. Although it sounds juvenile, designating a bedtime and wake up time and having them be as stable as possible is often helpful. Manage your sleep around your program's call schedule to ensure you are getting enough.

Although a stable sleep schedule is critical, taking care of one's family can be a direct challenge to this. For many, the care of small children can be even more challenging than a rigorous call schedule and as much as possible, planning and using available resources such as family to provide support during particularly challenging clinical blocks is essential. Taking advantage of maternity/paternity benefits can be helpful, but often requires advance planning and discussions with your program leadership. For all trainees, the time investment of a cardiology training program can be stressful for families and significant others, so coming up with a plan to spend adequate time with them is very important to ensure your own happiness.

Allocating personal time for stress relief is also critical. For many, activities such as recreational reading or exercise are a healthy way to mitigate stress. Binge watching the latest streaming show can be good too but do not let it ruin your sleep. Regardless of what activities you enjoy, scheduling in advance helps to make them more likely to happen. During this time, it is crucial to take your mind off work. Use vacation time allotted in your program to recharge your batteries. If possible, take your time off to do something you enjoy.

Finding diverse approaches to engage with clinical material can also be helpful. Facing a textbook after a long day is very challenging but finding alternatives such as podcasts that review important topics can help you remain productive while you decompress. Attending conferences not only changes your interactions with material but also imparts a social element and allows comparison between your approaches and those of others. Regular group discussions, such as among you and your fellow trainees are often a good way to discuss topics and learn from each other – and often these meetings can be arranged in a casual social setting that also facilitates camaraderie.

As we all know, cardiology is a diverse, complex and ever-changing field, and training as a cardiologist is necessarily challenging to meet the demands of your career after training. You can make the most of your time as a trainee not only by learning the ropes but also by implementing good work-life practices early, including sleep, social interactions, protecting personal time and recognizing when you need time off.

This article was authored by Charles Miller, MD, electrophysiology Fellow in Training (FIT) at Tufts Medical Center in Boston, MA.