Dr. Alicia Pawluk is a PGY2 resident in family practice in Victoria and an international medical graduate (IMG). Learn more about what wellness means to Dr. Pawluk and what the experience as an IMG has been like for her.
What does wellness mean to you?
To me, wellness is a constantly evolving process. Of course, being “well” looks different to each person. Throughout my medical training, wellness has looked different, and I believe that it’s important to be flexible.
At this point, wellness means to be spiritually grounded, emotionally fulfilled, and physically healthy. These three constantly fluctuate in importance depending on what else is going on in my life. I feel strongly that wellness is not the absence of any negativity, but rather the ability to cope with it when it arises.
How do you find joy in medicine?
I have found joy in medicine by discovering aspects of the job that bring me fulfillment and happiness. For me, that was doing the Integrative Medicine program at the Victoria site. By having a much larger toolkit to work with, my patients are able to find healing in many aspects of their lives, which I find extremely rewarding.
What have been some of the most challenging aspects of residency for you? How have you managed those challenges?
The most challenging aspects of residency for me were the off-service rotations in first year. While I absolutely love family medicine, the pace and stress of the CTU and cardiology rotations was very challenging.
Although I found it difficult, it was essential to stick to a routine during these rotations to avoid getting behind. I also had to be very diligent with my prioritization and delegation of tasks when appropriate -this was true for both work and home life.
Can you tell us a little about what the experience of being an IMG has been like for you?
Being an IMG was definitely difficult at the beginning, in terms of a difference in applied clinical knowledge. However, having grown up in Victoria (where I am doing my residency), I am very mindful that I did not have to deal with the cultural differences that many IMGs do. That being said, not having done clerkship in Canada meant that I had a few struggles on the ward as I transitioned to the Canadian system. For example, I spent the first month wondering what a “Lasix” was -it sounded like a cool laser system. I was very disappointed when I found out it was just furosemide.
What do you think are some of the unique challenges facing IMG residents?
As mentioned above, one of the unique challenges is the change to Canadian culture. It may be difficult for people who may have spent their whole lives working in Canada to appreciate how challenging this can be. For example, we use a lot of informal language, and we often underestimate how confusing this can be. From your attending telling you they’ll be “down in a jiffy”, to a patient describing being “boarded” during a hockey injury, it can be difficult to keep things straight. This is not even to mention other Canadian customs and traditions that can be vastly different from other parts of the world.
How do you engage in self-care?
As I touched on in the first question, my wellness can be varied depending on my circumstances. That being said, the things that I have found incredibly helpful during residency have been:
1. My lovely co-residents. They are some of the strongest, smartest, and most caring people I know. I could absolutely not have made it through residency without their support, guidance, advice, and hugs.
2. The Resident Wellness Office. Our job is emotionally draining, and we face challenges that are difficult to handle alone. Having the support of trained counsellors throughout my residency has been invaluable. Booking an appointment in advance during anticipated stressful rotations can be a helpful commitment to yourself.
3. Movement. Whether this takes the form of yoga, rock climbing, hiking, or kayaking, getting out into nature and moving can be restorative.
4. Being outside. There is good reason that the Japanese have a word for this “Shinrin-yoku”, meaning forest-bathing. It is said to promote both emotional well-being and is used as preventative medicine.
5. Meditation. I use the free app “Insight Timer”. The key is to be forgiving!
These are the things that I have found most useful. However, I feel it is important the remind people that self-care can be simple. Preparing a nutritious meal, packing a water bottle, and doing the laundry can all be acts of self-care.
If you were to give one piece of advice to new residents, what would you say?
Start a wellness practice that fulfills you. My simple suggestion is to write down three things you are grateful for every day. Remember that you are not alone, and that there is a multitude of supports available. Put the BC Crisis Line number (1-800-784-2433) in your phone now. Even if you don’t need it, you might have a patient that does.
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