As it is known, health care delivery can be a source of increased morbidity and mortality for patients. Furthermore, emotional exhaustion and burnout resulting from medical attention could be associated with tragic consequences such as depression, suicidal ideation, and suicide ¹. In that sense, it is essential to improve physicians’ well-being as it can contribute to the safety and care of patients, the protection of health care professionals, and the prevention of medical errors. Lee JY, et al. ² made a conceptualization about timeouts, defined pausing as “a conscious decision to stop current performance for a physical time that allows for additional cognitive activities”, and recognized its role in clinical reasoning and decision making processes. Benefits of this kind of brief pause are described, but what about a longer pause and reboot of medical practice, including the entire timeline from undergraduate to graduate years?

At any time during the profession, health care professionals might face crises, both personal or related to the learning process, training, or practice, which demand an additional physical and emotional effort. These situations can often lead professionals to face the decision to continue or stop their medical practice. However, multiple individuals and social barriers make that challenge to happen. Let us briefly describe some of them.

The social construction of health care professionals

Historically, medical practice has received significant recognition and prestige at the social level, representing an ethical compromise ³. This construction allowed the generation of value judgments and demands to the health care professionals. Along with personal, mental, or emotional difficulties, they are forced to consider all these moral charges before deciding. Thinking about taking a pause may represent a renunciation to that social construct and demands.

The economic factor

For undergraduate students, there is an effort to be admitted in a college career, particularly in developing countries, and face a shortage of opportunities to access higher education. It implies that many students must wait several years before going to a public university or undergoing financial credits to gain career access at a private university. Nevertheless, even when they get access to a public and accessible university, families can face economic limitations to sustain their education, learning material, transport, feeding, and other needs, which could even cause dropping out of their courses ⁴. In addition to this out-of-pocket inversion, many economic demands are transversal to professional life, such as self or home maintenance, health, needs and sustenance, children’s education, and medical insurance.

Mental health stigma

Finally, we want to give special attention to mental health issues. We have mentioned the social and cultural construction of the health care professional. It was evident even with the pandemic. Doctors, nurses, and all health personnel were considered heroes. They could not give up, must resist, and had to be resilient.

Nonetheless, this is the same response that physicians give themselves when they face a mental health problem: to resist, be resilient, go forward, and never stop. This attitude makes it very difficult to accept that a mental health problem exists and that it is necessary to slow down and look at themselves for a moment. It is all part of the mental health stigma around the medical practice ⁵.

To conclude, although taking a pause is an option rarely considered by health care professionals, it could be a decision that slows down the speed of their lives, promote health, safety, and mindfulness, and prevent burnout and health care errors. There is no time established to pause, but it would be necessary for health faculties and institutions to consider it and help lower some of the existing barriers. Also, mental health is fundamental in any stage of our lives while studying or working. It will support our decisions and actions in any place and any situation. Therefore, we all need to pause to satisfy our mental health.

Five pullout quotes:

Burnout is present in medical students and health care professionals.

Timeout is a vital way to prevent mental health disturbances in health professions.

Social judgment might prevent from taking pauses.

Students face a shortage of opportunities to enter higher education.

Mental health is a real problem, and we need to fight against it.

References

. Rothenberger DA. Physician Burnout and Well-Being. Dis Colon Rectum. 2017;60:567-76. https://doi.org/10.1097/DCR.0000000000000844

. Lee JY, Szulewski A, Young JQ, Donkers J, Jarodzka H, van Merriënboer JJG. The medical pause: Importance, processes and training. Med Educ. 2021;55:1152-60. https://doi.org/10.1111/medu.14529

. Norredam M, Album D. Prestige and its significance for medical specialties and diseases. Scand J Public Health. 2007;35:655-61. https://doi.org/10.1080/14034940701362137

. Mandal A, Ghosh A, Sengupta G, Bera T, Das N, Mukherjee S. Factors affecting the performance of undergraduate medical students: A perspective. Indian J Community Med. 2012;37:126-9. https://doi.org/10.4103/0970-0218.96104

. Brower KJ. Professional stigma of mental health issues: Physicians are both the cause and solution. Acad Med. 2021;96:635. https://doi.org/10.1097/ACM.0000000000003998

Notes

Author notes

^aCorresponding author: Herney A. García, Calle 4B # 36-00, Cali 76001, Colombia. Phone: +57 3212195102. E-mail: herney.garcia@correounivalle.edu.co