Take a moment to reflect on how much time you devote to your well-being on any given day. I imagine many of you will find it hard to think about more than 1 activity you did for yourself in the last week. With increasing professional responsibilities, it is unsurprising that many trainees find it difficult to dedicate time to personal wellness. Recent studies report high levels of burnout (75%) and depression (40%) in surgery residents.¹ Given these alarming rates, focusing on our mental and physical well-being is key.

With only so many hours in a day, we must find ways within our demanding work schedules to cultivate our well-being. Numerous residency programs have integrated wellness into their curriculums to address this concern.² Team-based efforts are encouraged, but there is no one-size-fits-all solution. We all must identify and pursue the habits that keep us engaged, motivated, and passionate about our work.

Below are 3 evidence-based methods that can improve both mental and physical wellness. Each is designed to readily fit into a few minutes between cases, during your commute, or in the call room. I encourage you to try them out and find what works best for you—hopefully, you can take away at least 1 method to practice.

Mindfulness Meditation

How to

1. Sit up straight with your feet flat on the ground.
2. Rest your hands comfortably.
3. Close your eyes.
4. Focus on your breathing. Pay attention to each inhale and exhale.
5. Continue for 1 minute (or longer).
6. Gradually open your eyes and resume activities.

Evidence

Mindfulness meditation can reduce stress, burnout, and depression.³ These benefits have been observed even with daily, short sessions (<5 minutes).³

Diaphragmatic Breathing (4-7-8)

How to

1. Inhale through your nose for 4 counts.
2. Hold your breath for 7 counts.
3. Exhale through your mouth for 8 counts.
4. Repeat steps 1–3.

Evidence

Breathing with a low inhale-to-exhale ratio activates the parasympathetic nervous system to promote relaxation.⁴

Targeted Stretching Microbreaks

Targeted stretching microbreaks (TSMBs) are intended to be performed for 1-2 minutes and repeated at intervals of 20-40 minutes during surgery.⁵

How to

Shoulder Stretch: Shrug shoulders up, back, and down. Repeat.

Neck Stretch:

1. Tilt your head back to look up. Hold for 1 breath.
2. Tuck your chin to your chest to look down. Hold for 1 breath.
3. Repeat.

Additional instruction on operating room stretches can be found at ORStretch.mayoclinic.org.⁶

Evidence

TSMB improved surgeon post-procedure joint pain without increasing operative time. Surgeons perceived improvements in both physical performance and mental focus, and a majority (87%) planned to incorporate TSMB in their practice.⁵

Like surgery, these activities require practice. Be kind to yourself and reflect on what daily exercises work best for you. We must remember that, in the words of Carl Jung, “The shoe that fits one person pinches another; there is no one recipe for living that suits all cases.”⁷

Since its inception in 2002, the Residents and Fellows Committee has represented the voice of trainee members of the AUA. The Committee’s mission is to address the educational and professional needs of urology residents and fellows, and promote engagement between residents and fellows and the AUA. The Committee welcomes your input and feedback! To contact the Committee, or to inquire about ways to get more involved, please email rescommittee@AUAnet.org.