Emergency Medicine is a demanding specialty. The challenges of physically taxing shift work, compounded by the cognitive and psychological pressure to make rapid, high-stakes decisions with incomplete information, weigh heavily on the shoulders of Emergency Physicians at all levels of training, as well as Physician Assistants, Nurse Practitioners, and professionals across the field. 

The emotional intensity of emergency patient care is coupled with the equally fraught dynamics of collaborating (and negotiating) with consultants of every specialty, teaching multi-level learners, and managing the only department in the house of medicine that is, by definition, always “in the fishbowl.”   

The work is strenuous and expectations are high, while the fractured healthcare system and the very nature of caring for sick, undifferentiated patients seem designed to thwart our efforts. Unsurprisingly, a 2024 report on Physician Burnout and Depression across medical specialties clocked burnout in Emergency Medicine at 63%: the highest of any specialty in the survey. Physician Assistants also experience burnout at unsustainably high levels approaching 40% as measured in a recent study. 

Burnout is epidemic in many fields of medicine. Emergency Physicians and their non-physician clinician colleagues suffer disproportionately, but few physicians in practice today are immune to systemic issues, including excessive administrative burdens, diminished autonomy, disintegration of professional identity, and the impact of electronic health records. 

The aforementioned burdens of this field we are cursed to love are not news to practicing Emergency Physicians of all genders. But for women in EM, the challenges of the specialty come with an extra layer of expectations.  We lead teams, care for patients, and strive to manage the physical and psychological strain as all EP’s do. We stay late and stay calm. 

We also speak up, but not too loudly. We modulate our communication to be perceived as “nice” to everyone, but not too nice. We bob and weave through the complicated minefield of the professional woman’s “double-bind”, contorting ourselves to fulfill our EP role, but always coloring within invisible lines drawn by the systemic gender bias ever-present in the hierarchy of medicine. 

We manage microaggressions and double standards, juggle pregnancies and caregiving, and always show up sharp and steady for the next shift. Unsurprisingly, the abysmal rate of Burnout in Emergency Medicine is not distributed equally across genders: Women Emergency Physicians experience Burnout at a significantly higher rate than men, especially as it relates to emotional exhaustion and a low sense of personal accomplishment.  

So, when the topic of Wellness comes up, it can feel... laughable. Like a luxury for people with more time and fewer responsibilities. But here’s the truth, as well as the irony: Wellness is not fluff. It is not a reward you earn after proving you can handle burnout. Burnout is, by definition, a tragic downstream state that should not and would not be reported by 63% of EP’s, if Wellness were indeed a real and attainable priority. 

Burnout does not just hurt the individual, although it is often framed as a “resilience deficit.” Burnout affects learners, the team, patients, and the institution. Similarly, Wellness is not just “feeling good”. It is the essential foundation for sustainable leadership, safe patient care, and a thriving workforce. 

At FEMinEM, we believe that closing gender gaps in medicine does not just mean promoting women into leadership roles—it means reimagining and building systems where women leaders have the tools and support to stay, lead, and continue to grow. That means rethinking the way we approach Wellness. 

It is a common trope, but one that rings true for EP’s: 

Wellness is more than a pizza party. 

Wellness is not an app. It is not a mass email one day per year, and it is not a free pair of socks from the hospital. It’s protected time. It’s safe staffing. It’s equitable pay and transparent promotion pathways, and flexible family leave policies. It is a system and a culture where you know you won’t be penalized for having a baby or needing support. Wellness is working in a department where someone says, “You’re exhausted—how can we help?” and actually means it. 

If we want better outcomes for our patients, we need to care for the people who care for them. We also need to do it in ways that are meaningful, sustainable, and not punitive.  Change starts by acknowledging that Burnout is not emblematic of an individual’s weakness.— Burnout is a syndrome that signifies a problem with our systems and our culture. Women in Emergency Medicine are the canaries in the coal mine. We feel it first and hardest, as we balance an unsustainable mental load and face down the multitude of gendered barriers to professional wellbeing inherent to practicing medicine as a woman.. 

So let’s flip the script. Let’s stop treating Wellness as an afterthought and start treating it as a leadership strategy. Let’s build departments that prioritize sustainability, inclusivity, and real support. Let’s make space for joy, for rest, for mentoring the next generation to take it to the next level. Let’s all agree that it is not good enough to survive: Wellness is essential for women to thrive at every stage of their careers. 

We deserve nothing less.