Guest Blog: Dr. Rachel Sullivan Reflects on Her Military Family Psychiatric Experience

Guest Blog: Dr. Rachel Sullivan Reflects on Her Psychiatric Experience as a Military Family

This past November was Military Families Month, and in keeping with PRMS’ mission to support the greater behavioral health community, we invited Rachel Sullivan, MD, Assistant Professor in the Department of Behavioral Health and Associate Program Director for Psychiatry Residency at Tripler Army Medical Center in Honolulu, HI – and a past PRMS Psych-cess speaker – to share her thoughts, advice, and experiences working as a military hospital psychiatrist and finding flexibility between her career and family life.

What’s the best way to balance residency/your psychiatric career with a family?            

When we tie ourselves to the concept of work/family balance, we set ourselves up for failure. Balance implies that there is some mythical way that will allow us to be perfect at both, mastering both equally and effortlessly. If anyone out there has figured this out, please write to me and let me know; I’m pretty certain it’s impossible! Instead, I’ve found the concept of work/family flex much more useful. For example, one day I may have put in a 14-hour day and barely made it home to kiss my kids goodnight. I’m definitely not “balanced” on the mom side that day. But another day, I make it a point to take off work for an important doctor’s appointment, to volunteer at my kids’ school, or be home when school is out.  On those days I’m telling work, “Sorry, you can wait. My kids come first today.” That’s what I mean by work/family flex.

My kids don’t need me to be with them every second of the day for them to know that I love them; that’s done through building a warm relationship with them, being fully present when I am home, and doing meaningful activities with them instead of overloading ourselves with extracurriculars. And while my work is incredibly meaningful and important, I can step away here and there and my patients, practice and colleagues do just fine.

One last piece of advice on making everything flex as best as possible: hire help! We have a yard and housekeeping service, and they are the best money I spend every month. They make sure my time is spent where it is most important. Even when I had just graduated and we were living frugally to build a nest egg, this was still worth doing.

Is there a ‘right time’ to start a family?

When I was considering medical schools, a physician mentor sat me down and told me her thoughts about this question. She said that, for her, it never felt like the right time. She couldn’t do it during medical school – who could possibly handle both? And of course, residency wasn’t the right time either – so much to do, so much to learn. Then she was a brand-new attending and she needed to consolidate her skills and build her practice. And…suddenly she was 40 with no child, and an onerous road of IVF ahead of her. And it STILL felt like it was going to be impossible to fit in to her busy life! Her advice to me was simple: it will never feel like the right time. If you and your spouse/significant other want a child now, do it now.

My husband and I took that to heart, and we had our first child six weeks before medical school, and the second one during my third year (timed to deliver not long after USMLE Step 2, so I could take the test pregnant instead of when I’d be sleep-deprived with an infant). While it felt completely nuts at the time, I now see my colleagues having high rates of infertility, complicated pregnancies, children with developmental delays, and all of the other downsides of waiting. I have two happy, healthy high schoolers and will be able to retire early, right around the time they finish college. Having made it to my early 40’s now, I have no desire to have done things differently, and I can assure you I have even less energy to chase a toddler now than I did back at 24.

What support systems have you leaned on throughout your education and psychiatric career with a family?

One of the things I love about psychiatry is the connection to colleagues that our field embodies. There were times when I hired the stay-at-home spouse of a colleague to babysit, borrowed a friend’s truck to move furniture, and plopped myself onto a trusted friend’s couch to vent about a particularly challenging patient encounter. Extended family and grandparents weren’t available to us, but that would be a great solution as well, and one that I’ve seen work perfectly for colleagues. One idea that I’ve picked up is that the most successful of us spend time building our team instead of just putting nose to the grindstone, powering through everything alone. My current team is built of my mentors who guide me, my colleagues who support me, my fellows who help me do all sorts of things I couldn’t otherwise accomplish, my administrative staff who keep me sorted, my husband who keeps everything going, and lastly, my dog trainer (it’s true – we have a 6-month-old puppy, and therefore the whole household, would be a mess without her!).

What are a few of the benefits and things you enjoy most about being a psychiatrist for a military hospital and receiving your education from a military institution?

The best thing about military medical practice and training is the interconnectedness of our community. Even though I’m currently living in Hawaii, I have friends from various medical specialties here with me, some of whom go all the way back to medical school. I have had friends from previous assignments show up a year or two later, or I move to where they’ve gotten to first and they can easily show me the ropes. Whenever I meet someone new we’re bound to have at least acquaintances if not good friends in common. Need some information on how the hospital in Germany is running things to compare to our practices? No problem; I can think of three people to ask. Military physicians are now my “tribe,” and that tribe is both local and global. It is a true delight to feel so connected to my community while getting to have the adventure of serving and seeing the world.

Any other tips or advice to share with fellow psychiatrists?

Whenever I have an opportunity to learn from industry, I try to do so. The medical field has so many wonderful things about it, but efficiency and promoting the wellbeing of physicians are areas of growth for us, not areas of mastery. One very useful study to come out of Google, of all places, is how to keep their workers most engaged, happy, and productive. They ended up giving various coders different amounts of time for “passion projects” in addition to their assigned duties. What they found is that giving 20 percent of time for things that really excite that coder keeps them engaged in the more mundane tasks 80 percent of time, with a high job satisfaction rating. A 30/70 percent split doesn’t make them happier, but 15/85 percent made things much worse with a risk of burnout. So, using this concept, I try to make sure that everyone on my team – including myself – has that 20 percent to keep us fired up no matter what other drudgery awaits us. For me, this is staying engaged in my district branch of the APA (Society of Uniformed Services Psychiatrists), teaching, and running the Ethics Committee at my hospital. For others, that may look like planning wellbeing activities for their colleagues, doing research, or finding ways to make our clinic more efficient and patient-centered. So, I encourage you to carve out time for your passion and negotiate for it when you’re looking for that first or next right job.


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