The importance of identifying our values in residency

As a senior psychiatry resident physician who has additional interests in meditation and mindfulness practice, the idea of “values” comes up quite often in my work. But what exactly are values and why should we as resident physicians care about them?

Well for starters, working as a resident physician places us all at risk of burnout which heightens emotional exhaustion, depersonalization and a reduced sense of personal accomplishment. As resident physicians we often have both personal and systemic factors that add to our risk of burnout. Time demands, long work hours, lack of control over work planning and work organization, inherently difficult job situations and interpersonal relationships are just a few of the contributing factors that lend to burnout and a lowered sense of career satisfaction. Perhaps you’ve already experienced your inner dialogue asking, “Is this worth it?” For many, the perceived lack of control in residency and in life as a physician can leave us feeling depressed or struggling with other mental and physical illnesses.

The question then becomes, “What do you want your life to stand for and how do you want to live your life?” There is a reason we were driven to health care, to helping others and to devoting ourselves to being life-long learners. But what exactly is it that makes us continue to work tirelessly towards a life dedicated to such a demanding service as medicine? Perhaps it’s because you value power, knowledge, money or connection.

Our values are things we place importance on and that we head towards or stand for in life. They are not to be confused with goals or specific achievements we accomplish in the service of a particular value. When you think about values, try to shift away from morality or what you think you ‘should’ care about (such as the environment and perhaps recycling for example). Also try to avoid choosing values that look good or appeal to your desired self-image. We want to get clear on what matters most to us from a deeper sense of ‘knowing’ and what drives us to keep going despite the hardships and set backs of life. Values guide our behavior, actions and decisions in life. They are not oppressive, meaning that having values does not mean you will no longer experience pain or discomfort. Generally, we choose our values based off of what causes us pain or what we have found difficult in the past.

For example, if you’re afraid of being hurt or let down in a relationship (either by a romantic partner, friend or family member), you might avoid getting into a relationship altogether or you might avoid having difficult conversations because of the discomfort, awkwardness or pain it might cause. This may indicate that you desire, or value, connections with others. Medicine may further contribute to you living out of line with your values given the high work demands. You might find yourself becoming irritable, moody or on edge because of a 70+ hour work week. Apart from lack of sleep, it likely means you’ve had little time to connect with friends, family or lovers as a result. You may be feeling disconnected from these relationships, which means medicine may be pulling you further away from your core value of connection despite it being a career goal. When we know our values, we can take action to live in accordance with them, hopefully leading to greater fulfillment in our lives. Internal tension arises, often triggering destructive habits and negative self-talk, when we violate our values.

Ok, so I’ve convinced you that values, and getting real with what your own values are, is important. Now what? Problems with identifying them are likely to arise. People often say, “I don’t have any.” My advice is to look to your pain for clues. Perhaps you’ve spent your whole life avoiding the things that cause you the most pain. In addition, looking back and reflecting on periods of vitality and aliveness might indicate times when you were fully living in line with your values.

Ask:

-What do I want to be about?
-What do I want my life to be about?
-What really matters to me?
-It may be useful to complete the sentence, “ If _____ wasn’t such a problem for me, then I would ______”.

This is meant to be an experiential exercise. It will take time. Values are not static, they are meant to be lived, and they may change as you transition throughout your life.

Below is a list of common values that people identify with. It is not exhaustive--feel free to add to the list as you see fit. You may even wish to compile them individually on separate pieces of paper and randomly place two values next to one another in a card sorting exercise. Choose the value that most fits or resonates with you out of the two and discard the value that doesn’t. Once you have spilt the values by half, continue sorting the values against others from the pile that resonated with you. Once you have narrowed your list down to 6-9 you can take an honest look and review which of the values you are actively living now and which of the values you are struggling to live out. Try to select 4-6 key values.

From here the real work begins. Getting clear on your values allows you to actually make time for them in your life. As physicians we spend time scheduling our lives (things won’t get done unless we schedule them!) In residency, as mentioned before, it’s often that we feel as if we have no control over our lives. The importance in identifying our values means we have the opportunity to get intentional about how we choose to spend our time. I ask of you, what would it look like if you scheduled time in your day, week or month, for your values? What would it look like if you were living your values 100% of the time? How would things improve in your life and what specific things would you notice changing if you started living your values?

Believe it or not, we actually have a choice in how we want to live our lives. Getting clear on what matters to us is the first step towards exercising our choice.