key: cord-0043725-ixxn5hnl
authors: Ky, Bonnie
title: Resiliency and Our Cardio-Oncology Community
date: 2020-05-22
journal: JACC CardioOncol
DOI: 10.1016/j.jaccao.2020.05.003
sha: e38abede97c6ebdb426b11505c042301d79c97c9
doc_id: 43725
cord_uid: ixxn5hnl

nan

R esiliency. If there is Q3 one quality that I hope for in my mentees, it is resiliency. Why?

Because, as care providers in medicine, we have all experienced the sincere pain and the feelings of failure that come with loss-our patient who succumbed to a terrible metastatic disease or severe heart failure, and the inability, despite all our best efforts, to save him or her. We all know the realities of physician "burnout" and mental illness in our community (1,2), with 1 survey indicating that one-third of residents reported their lives were "quite a bit to extremely stressful" (3), and a recent meta-analysis suggesting that the prevalence of depression or depressive symptoms ranged from 20.9% to 43.2% among resident physicians (4) . The risk of suicide is high among physicians; an older meta-analysis suggests that, compared with the general population, the rate ratio was 1.41 (95% confidence interval: 1.21 to 1.65) for men and 2.27 (95% confidence interval:

1.90 to 2.73) for women (5) . And, in the era of this hor- providing resources to help individuals promote selfcare; 9) supporting organizational science" (6) .

Moreover, in academic medicine, papers and grants are more likely to be rejected or unfunded on their first or even second submission, particularly with some journal acceptance rates of 7% or less, and National Institutes of Health funding pay lines on the order of the 10th to 15th percentile. We have all experienced these rejections, and they feel quite discouraging. As noted by others, "Don't tie up too much of your selfesteem in someone else's evaluation of your work" (8) . The physician scientist path calls for persistence, requiring a "fire in the belly." Ultimately, despite the challenges and struggles we face, we need to maintain excellence and perseverance. We need to be driven by rigor in study design and execution, and in an unbiased view, evaluate the strengths and limitations, as well as the potential significance and impact of our work (9) . When confronted with my own academic disappointment, I give myself some time to critically reflect on the situation and determine what I can learn from it, but then I move on. We have to move forward to advance science and clinical care for our patients.

To my community, please believe in the greater good that you are each called to do, and please do not suffer in silence. We are in this together. Ask for help. As one great mentor once stated, "Even when you are able to do things [write your own grants, write your own papers, and direct a laboratory], you still depend on many people. Functioning as part of a team is the key to success" (10) . Twitter: @pennmedicine.

Suicide-rewriting my story

I solemnly share

The happy docs study: a Canadian Association of Internes and Residents well-being survey examining resident physician health and satisfaction within and outside of residency training in Canada

Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis

Suicide Rates among physicians: a quantitative and gender assessment (meta-analysis)

Mastering resilience in oncology: learn to thrive in the face of burnout

If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians

Career advice from an oldish not-quite geezer: you can't count on your publications and awards Q2

The Chronicle of Higher Education

Against pandemic research exceptionalism

From platelets to preschoolers, always with scientific rigor