Physical Fitness for Fellows: Better Late Than Never

As cardiology fellows, we preach the importance of maintaining a healthy lifestyle to our patients daily. However, it is no secret that most of us do not perform the American College of Cardiology/American Heart Association recommended level of aerobic activity (30 minutes five times a week).

Obviously, fellowship poses several unique obstacles that can dissuade us from leading a healthy lifestyle, including ill-defined and long working hours, interrupted sleep, stress, and numerous other professional commitments. Lack of regular exercise is compounded by the unique physical demands of our specialty, especially as we spend many hours standing shrouded in heavy lead protective wear that can leading to substantial stain on our shoulders, back, and lower extremities. By the time we’ve gotten to fellowship, our bad habits with regard to exercise have likely worsened due to years of what is likely an inconsistent and inadequate fitness routine that greatly compromises our own physical and mental wellbeing.

To this end, we realize the importance of achieving and maintaining fitness, but often end up overlooking this aspect of our personal growth while we strive for professional milestones. Not unlike many of my colleagues, I have been guilty of neglecting my health during my training period, but along the way I have learned valuable lessons and mental techniques that I’d like to pass on to you.

1.      Prioritize your health

The first step toward livings a healthy lifestyle during fellowship training and beyond is giving it the importance it deserves and taking steps to prioritize it. Commit to a routine where you engage in physical exercise—maybe it’s joining a sports league or setting your alarm 45 minutes earlier every morning for a run. Don’t let exercise be the last thing you cross off your to-do list, as easy as it may seem. It is no secret that getting to the workout session is half of the effort, and once you are active, it is relatively easy to maintain.

2.      Invest in yourself

Have you ever noticed that when you commit your hard-earned money to something, you tend to value it more? You can do this with your physical well-being also. Financially committing to your health in the form of a gym membership, yoga class package, or even making a bet with yourself (eg, if you don’t meet your exercise goal in a given month, you have to donate money to a cause you don’t support) will help you achieve optimum health. From my experience, the terrible guilt I have felt from paying for an annual gym membership and not going often enough has been a strong stimulus to get me to engage in exercise.

3.      Find a training partner

Doing anything in life is harder alone, and exercising is no different. Finding a partner who shares your passion for fitness or sports can do wonders to your dwindling enthusiasm. Not only can you motivate each other constantly, but also having someone by your side makes the workout more enjoyable and socially fulfilling. My wife carries the same passion for staying fit as I do, and she makes a great training partner. For you, it might be a colleague (even an attending!) or a friend outside of the medical field.

4.      Mix it up

Running on the treadmill or lifting weights over and over can get monotonous very quickly. One very useful tactic is to try different activities. You may have taken a yoga or Pilates class back in college, so feel free to dive back in. Maybe you’ve heard a lot about tai chi or CrossFit but have been reluctant to try them—now’s your chance! Often the enthusiasm and thrill of learning a new activity spurs you to stay fit on its own. Who knows? You might be having so much fun that you even forget that you’re exercising.

5.      Set short-term goals

Setting long-term targets (hello New Year’s resolutions!) that are often unrealistic is not a wise tactic, especially in fellowship when our schedules are so unpredictable. On the contrary, setting very modest and short-term goals (monthly or even weekly) that are easily achievable can keep you constantly engaged and maintain your drive. For example, seek to be able to dead lift a certain weight before Labor Day or strive to run at least 12 miles per week.

6.      Make the most of your time

It’s unlikely that you’ll be able to dedicate large blocks of time for exercise if you’re a cardiology fellow. So given the limited time at your disposal, be creative with how you exercise. Squeeze in a 5-minute workout of squats and lunges between your lab cases. Park at the farthest spot in the lot so that you take a few extra steps to your car before and after work. Take the stairs instead of the escalator. Remember, everything adds up, and something is a lot more than nothing.

7.      Never lose hope

As fellows, we frequently encounter periods of time (ie, busy rotations, boards, research deadlines, vacation, meetings, and interviews) when going to a gym or to the park for a run becomes unworkable. These phases often end with a lull when you lose motivation to start all over again and the whole exercise (pun intended) appears fruitless. It is then we must constantly remind ourselves of how we felt when we were working out regularly, and although challenging at first, know we can still get back there. We must continue to keep trying and remember that it’s never too late when your own health is at stake.  

All in all, it is indubitable that a healthy mind resides in a healthy body. Professional productivity and efficiency are also significantly superior when we feel physically fit. Staying and maintaining fitness in a taxing fellowship is challenging, but commitment to your health and smart time management can help you meet your goals.