10 Mental Resilience Tips to Survive as a Junior Doctor in Singapore

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It’s the first of April, and our next batch of House Officers will be starting work in just a month. There’s no better time than now to roll out a listicle featuring some useful tips touted by Navy SEALs that might help you get through the arduous years ahead.

We all know Navy SEALs are the pinnacle of resilience; quoting former Navy SEAL Brandon Webb, ‘what SEAL training really tests is your mental mettle. It is designed to push you mentally to the brink, over and over again, until you are hardened and able to take on any task with confidence, regardless of the odds — or until you break.’

Sounds a little like working under Master M* doesn’t it? Dumped in terrible postings for 6 months at a time, being subjected to ever-changing manpower allocations and unpredictable schedules, all in the name of ‘cHaRaCtEr DeVeLoPmeNt’.

*an unofficial alias for MºHH, the private corporation managing all local medical grads, leasing them out to work in various public healthcare institutions as indentured servants.

Without further ado, let’s take a look at 10 tips and learn how to apply them the next time you’re on the verge of a mental breakdown halfway through a 4-hour ward round, with 7 families to update and a burgeoning laundry list of changes/tasks.

1. Visualisation

A study showed that basketball players improved their free throw accuracy by 23% from just visualizing the free throws, compared to 24% in those who practiced actual free throws. Powerful innit?

According to self-help sites, the hallmark of a good visualisation is that it must be vivid & detailed, repeated and involve positive imagery. So, picture this:

You’re on call and just finished tracing through your passive list at 2am. Amazingly, there aren’t any deranged lab results – you’re the only deranged one around. You rest your weary head on the desk for all of 3 minutes, before a nurse calls you to set a cannula for an ESRF/dialysis patient.

For some context, dialysis patients have notoriously difficult veins, but maybe (just maybe), repeatedly visualising yourself setting the cannula on your first try might increase your success* from 10% to 11%

*results not guaranteed

2. Emotional control

It’s all too easy to feel absolutely frazzled when you’re called to order Panadol for the 10th patient in a row, or when you check the monthly roster and realise you’ve been rostered for 3 Saturday calls in a month (true story, happened to me once and I nearly died).

The Navy SEALs tout a simple breathing exercise to restore emotional control, dubbed the 4 by 4 for 4 (not very auspicious if you’re Chinese, but ohwells):

  • Breathe in for 4 seconds
  • Breathe out for 4 seconds
  • Repeat for 4 minutes

Google says this helps by ‘switching off your stress hormones and preps the body for relaxation’; I don’t know if it’s evidence-based medicine or pseudoscience, but if you (by some miracle) have 4 minutes to yourself amidst the bustle of ward or clinic work, why not try this out?

I know you’re pressed for time, but unlike boring lectures that you watch at 2x speed (or 3x speed if you enjoy living life on the edge), this is an exercise you shouldn’t try speeding up. If you hyperventilate and faint at work, you might not even be able to take a day off because there simply aren’t enough staff.

3. Reframing

Reframing is all about putting a positive spin on negative events and viewing them as challenges or chances for self-improvement. In other words, brainwashing yourself into being an optimist, even when you’re knee deep in a pile of steaming hot cowdung!

Men are disturbed not by things, but the view they take of them.

Epictetus (not to be confused with status epilepticus)

In the spirit of #toxicpositivity, maybe it’s time to thank Master M for generously allowing us to grow in character and develop excellent mental resilience from years of ward round-induced stress, palpitations triggered by a Priority Tiger Text, and bonding* with our fellow long-suffering comrades?

*for some, bonding to the extent of walking down the aisle together and spawning more children to sell to medical school in 20 years’ time

4. Find your tribe

Misery loves company, and junior doctors love our anti-work cult leader & meme queen @updatemeprn (I do too).

Quoting this article:

Spend some time thinking about what brings meaning to your life. That’s the first step to finding your tribe — your group of people that share similar vision and values.

Bulletproof Mind: 6 Secrets of Mental Toughness From the Navy SEALs

So, what brings meaning to your life?

Is it the 5am alarm we set on our phones just so we can claim that free Grab ride to hospital to pre-round before the sun has risen? Or is it coaxing a delirious post-op patient to take their medications and not pull their cannula out for the 3rd time? Or is it knocking off work at a reasonable time?

Either way, we’re all in this together, and it’s about finding friends who truly understand what you’re going through and can provide mutual moral support. It’s pretty heartwarming to have a buddy to text at 2am – for ranting and/or medical advice – when you’re on call in different hospitals (or at least that’s what my best friend and I did when we were simultaneously on call).

5. Bouncing back

Even when times get shitty – and I don’t mean after doing a manual evacuation (don’t google it) – learning how to bounce back quickly is an essential part of staying alive and maintaining your sanity as a Master M slave.

If you want to be mentally tough, you have to learn how to bounce back quickly from the unexpected. Trick your mind into overriding it’s tendency to argue with what’s happening by telling yourself the following: “Acknowledge; Accept; Adapt; Act.”

Five Navy Seal Mind-Tricks That Will Make You Mentally Tough

If you’re having difficulty remembering the 4 steps, they form a surprisingly apt acronym of AAAA, and here’s how to apply it the next time your registrar roasts you in front of the whole team:

smile and wave boys, smile and wave (through the tears)

6. Eat the elephant

Who needs to eat real food at work when you can eat the metaphorical elephant? The mettle of a real doctor, as boomer Emeritus Professors opine, is how much suffering and starvation one can put up with compared to his or her peers.

I know this sounds like the punchline of a bad dad joke, but bishop Desmond Tutu supposedly said, “There is only one way to eat an elephant: a bite at a time.”

In vegetarian/vegan terms, what he’s trying to say is that we should break down large challenges into smaller and more manageable parts, conquering them one at a time.

For instance, you could think of your current posting in weeks/months, with a countdown app that helps you get through the most ‘sian‘ times (when you’re in a team with an insane 40-something patient list or under a micromanaging boss ugh, the absolute worst). Or you could just dissociate for a few months, although that’s not advisable.

7. Small victories

When you’re on call, morale can sometimes hit rock bottom and the night often feels like it’s going to drag on forever a la 30 Days of Night minus vampires.

You’ll often hear the reassurance that ‘Even the darkest night will end and the sun will rise,’ and it’s all about finding small victories or pockets of joy to boost your flagging morale:

  • 5pm-midnight (running around like a headless chicken attending to CTSPs*)
  • Midnight-4am (tracing through lab results and grabbing late-night supper with your fellow call buddies)
  • 4am-6am (‘let’s try to get some sleep o’clock’)
  • 6am-8am (time to pre-round again, before going home to sleep a few hours later)

*CTSP/Called To See Patient: when you are quite literally called to see a patient for any number of reasons, ranging from medically serious or life-threatening conditions, to things like the patient not wanting to eat his dinner or being ‘too cold’ in an air-conditioned ward

8. Ask yourself what’s at stake

It’s much easier to muster up the strength to outlast tough times when there’s a goal you’re working towards. For some, it’s the promise of a lucrative surgical career; for others, it’s the desire to get into Family Medicine (or any other lifestyle-friendly) residency and/or escape the MOPEX lottery as fast as possible (by moonlighting during NS, then breaking the bond).

Either way, doctors in general are a tenacious and resilient bunch. If you managed to study your way into med school, then spent 4-6 years paying exorbitant school fees to study even more, and are still studying for postgraduate exams, you’re clearly driven enough to know the stakes and persevere.

9. Focus on what’s right in front of you

If you’re an overthinker like me, it’s easy to get distracted and disheartened when you imagine the long road ahead, so it helps to focus on the immediate problems at hand, like your exit rounds at 3.30pm with 101 changes still unfinished.

So go change that catheter, go clamp that drain, or go hold a retractor in a freezing OT for 4 hours until your hand goes numb, YOU’VE GOT THIS!

10. Recite your mental toughness mantra

Every protagonist has their own catchphrase or some really cool mantra, and you should too! When the going gets tough and you start hearing the devil on your shoulder tell you that you suck, it’s time to recite your mantra.

A cool idea for a personal mantra is ‘JUST DO IT’. This timeless and golden mantra was first uttered by alpha chad Shia LaBeouf in this iconic video:

Some people dream of success, while you’re gonna wake up and work hard at it. Nothing is impossible. You should get to the point where anyone else would quit, and you’re not gonna stop there. No, what are you waiting for? Do it! Just do it! Yes you can. Just do it. If you’re tired of starting over, stop giving up.

Pro tip: Silently muttering ‘just do it’ to yourself in the mirror, within the confines of your coffin-sized call room yields a better effect than yelling ‘JUST DO IT‘ in the middle of the ward.

Hope you found this post informative, and now you’re armed with useful tips to make you into a ⭐star⭐ junior doctor to impress that one demanding consultant who doesn’t even remember your name after 2 weeks of morning rounds. Good luck, and may the odds be ever in your favour.

In case it wasn’t already apparent that this is a shitpost and not meant to be taken as serious advice, happy April Fool’s!

For the record, these ARE real tips touted by Navy SEALs, and I did google for these back when I was dying at the start of Housemanship, but let’s hope your work conditions won’t be so dire that you need to use them on a regular basis…

And jokes aside, all the best to the incoming House Officers! Take your time to adjust to working life (and the inevitable culture shock), don’t be afraid to voice out your struggles/concerns to your peers or seniors, prioritise your well-being and remember to be kind to yourself!

To paraphrase Mama RuPaul – If you can’t take care of yourself, how are you gonna take care of somebody else?

Be sure to follow my Insta or Facebook page to stay up to date with my latest posts and life/travel updates. I’m back from my 2-week UK trip (which you can read all about here), so it’s back to our regularly scheduled Locum Lokun series on the 25th of every month – stay tuned!


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