December is supposed to be the time of year filled with family gatherings and holiday good cheer. For medical residents, quite the opposite is true.

There are no school breaks during residency. Being a medical resident is a real job, and a stressful one at that. Residents work long shifts, as long as 24 hours straight and sometimes even 28 hours when needed for patient handoffs.

For many of our trainees — especially those fresh out of medical school — this will be the first holiday season without time off.

It’s well known among residency program directors like me that interns, trainees in their first year, enter the doldrums as daylight wanes and that they have to come to and leave the hospital in cold darkness.

At holiday time, interns are approaching the midpoint of their year. That’s long enough to feel committed to their chosen path but not nearly far enough along to see the finish line’s banners. Doubts amplify.

Combine the low emotional ebb with the knowledge that more of our patients die at this time of year, and interns feel understandably vulnerable. Many wonder at this point if they’ve made the right professional choice. In extreme cases, they wonder if they’ll survive.

I remember lamenting my first December having to work straight through. A wise mentor helped me reframe my self-pity. “It’s a privilege to work on Christmas,” he told me. “Our patients count on us. You may not want to be in the hospital, but think of what they’re going through.” He smiled, as if he were welcoming me to a special club, one that I wasn’t wholeheartedly ready to join. “Your mere presence helps reduce each patient’s sense of loss.”

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Illustration: Katherine Streeter for NPR