In the September 2021 issue of AUANews, Dr. Scott Swanson penned an article titled “Resilient Leadership,” in which he highlighted the many ways the AUA and its members have shown both resiliency and leadership throughout the past year.¹ In reflecting on his words regarding resilient actions, I began to ponder how we develop and maintain this trait. From that, I want to share a few thoughts on ways to cultivate resiliency during residency training.

A co-resident used to ask, “Are you keeping your axe sharp?” The confusion on my face the first time he posed this question must have been obvious. He was from Minnesota, so I figured there would be an interesting backstory for how this phrase came about. Simply put, it was his way of asking if I was taking care of myself. He made the point that dull axes, although they look like they may be effective, can’t do the job for which they were created. He explained that we all have different things that make us tick, that bring us joy, that keep us “sharp.” If we lose sight of those things it’s easy for us to become someone we’re not and, arguably, an ineffective version of ourselves. I smiled and nodded but couldn’t rationalize how I could do anything but residency. How could I do anything else but eat, sleep and breathe urology?

Midway through training, I found myself short tempered, easily frustrated and endlessly tired. I hadn’t been taking care of myself outside of the hospital, and it was becoming obvious to my peers and attendings at work. At some point I was reminded of what my co-resident had said about “keeping your axe sharp” and that to be the best resident I had to be the best version of myself first. I started to make changes and do more things outside of residency that I enjoyed, like playing sports, spending time with friends and cooking. Eventually, I noticed that I was becoming more engaged and focused while at work and more excited to learn about urology both inside and outside of the hospital than I had ever been before. Staying “sharp” allowed me to develop resiliency and, in the process, become a better resident, urologist and person overall.

Resiliency is a trait that we all inherently have, especially as physicians. However, maintaining this necessary characteristic is not always easy. For me, maintaining resiliency comes by “keeping my axe sharp.” I think a fair equivalent to “sharpness” would be wellness. Wellness looks different for everyone, so I encourage you to find what keeps you sharp and embrace it. Find ways to incorporate it into your daily routine or even your clinical work, as our wellness absolutely has an impact on the care we provide. And our personal wellness shouldn’t replace our educational endeavors and interests. Rather, it should bolster them and drive you forward to becoming the best urologist and person you can be.