For all the deeply rewarding moments medicine offers, it is also a profession often intensely challenging on both systemic and personal levels. Our guest in this episode is Caroline Elton, PhD, an occupational psychologist who has devoted her career to counseling doctors and medical trainees in the National Health Service and various medical schools in the UK. She is the author of Also Human: The Inner Lives of Doctors, which discusses the physical, mental, and emotional toll of medical training and practice. Among other issues, she writes about how doctors deal with guilt and shame, gender and racial discrimination in health care training, the erosion of the clinician-patient relationship in modern medicine, and how clinicians can build emotional resilience. Over the course of our conversation, Dr. Elton shares what led her to this work, exposes the many shortcomings in how doctors are trained today, and explores how we can create a more humane path forward.

In this episode, you will hear about:

• What led Dr. Elton to her unique work in counseling physicians - 2:04
• Reflections on both the compassion and the callousness Dr. Elton witnessed as she observed physicians (her patients) in their working environments - 10:01
• A review of medical training in the UK versus the US - 15:16
• A discussion of Also Human: The Inner Lives of Doctors and the concept of moral injury - 19:51
• The kinds of patients Dr. Elton sees in her present work - 25:00
• How institutional cultures can come to valorize toxic, brutal expectations placed on physicians - 27:03
• How Dr. Elton’s managed her first patient, a doctor who was planning on quitting medicine just weeks after beginning her postgraduate training - 32:49
• A discussion of how sexism and other forms of bigotry factors into burnout - 38:20
• Why the screening process for selecting future doctors should be improved - 43:37
• How a trainee can prepare themselves for the psychological demands of a medical career - 48:00
• Advice to administrators and executives of how best to serve the psychological demands of their medical workforce - 50:34

Dr. Caroline Elton is the author of Also Human: The Inner Lives of Doctors.

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