Handling Residency Burnout While Studying for Boards

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If you’ve been in residency for a while, chances are you’ve heard about “residency burnout”—and probably experienced it yourself. While there are plenty of tips and tricks for managing burnout, the reality of residency is there never seems to be enough time to recover. And by the time board prep rolls around, you might already be operating at 1%.

Below is a letter from Dr. Roopma (“Roop”) Wadhwa, the Psychiatry Lead at Rosh Review who faced this same situation while studying for boards. Now that she’s on the other side of board prep (quite literally writing our board questions!), Roop shares her advice about how to manage daily stress and anxiety at the end of the finish line.

My Burnout Backstory

Hello dear residents,

I’m Roop, a psychiatrist who graduated residency in 2019. I remember the day I received my Match results—the energy, the excitement, the sense of fulfillment and accomplishment.

But after years of residency, this feeling soon became fatigue—worn down by long calls and frustrated by the screeching pager.

If you resonate with this feeling while also trying to be the “perfect’’ physician, I see you. I said “yes” to all of the above while I was a resident, too!

In my early years of residency, I used to log into my Rosh Review Qbank between patient admissions, hoping I could squeeze in a few questions while the emergency room was quiet. But I couldn’t focus. I kept trying, but I wasn’t absorbing any information.

In hindsight, it’s clear that I was drained by compassion fatigue, or the emotional burden of hearing my patients’ traumatic experiences. I was trying to hold space for everyone else, and didn’t understand the toll it was taking, and how it drained my capacity.

My own health took a backseat. I didn’t hydrate, prioritize exercise, or make time for myself. It was easier to ignore my own needs than confront them.

What I didn’t know at the time was that I was experiencing burnout. And it wasn’t just from the stress of my new job.

The Hidden Lives of Residents

We all discuss the long hours of residency, especially in the PGY-1 year, and stress about calls and the annual PRITE exams, but we don’t have enough discussions about what else we’re carrying in our lives.

Raise your hand if any of these apply to you:

You’re a new parent.
You’re pregnant and experiencing nausea and exhaustion.
You’re grieving or caring for someone who is sick.
You’re silently struggling with anxiety or depression.
Or perhaps you’re just tired and longing for a break.

What Burnout Looks Like

Burnout isn’t always dramatic. It can be quiet, or subtle.

It can look like:

An inability to focus
Increased forgetfulness
A decreased empathic capacity
Feeling overwhelmed
Physical symptoms like headaches, fatigue, or exhaustion

Burnout often happens as a result of feeling too much, too often. This is especially true in psychiatry. Compassion fatigue sneaks in when you spend all day absorbing trauma and supporting others, without having a support network to rely on yourself.

How to Study Through Burnout

To help you navigate board prep under the stress of burnout, here are a few useful tips I learned over time, and wish I had known as a resident studying for boards.

1. Choose consistent, smaller goals over larger ones.

In my early residency years, I had unrealistic expectations for myself. The constant pressure to improve felt productive until it didn’t. Eventually, I realized that even absorbing the content of 2–5 questions during downtime was a win. Setting smaller goals is fine. As they say, a win is a win!

2. It’s okay to use review mode.

I used to think I wasn’t truly learning unless I challenged myself with test mode. But I was wrong! Gradual learning using review mode is still valuable, especially when you’re tired and your bandwidth is low.

3. Find your “happy place.”

We all have (or maybe have yet to discover) our own happy place. It could be as simple as a 10-minute walk, spending time in nature, some sunlight, a favorite snack, or a playlist that lifts your mood. Try to add it to your daily routine. It helps your brain reset, and you’ll feel less stressed.

This one is hard. Maybe you had a difficult rotation or witnessed a tough patient outcome. Just naming the feeling and sharing it—with a therapist, colleague, friend, or even in your journal—can release some of the weight. Many residency programs offer employee assistance programs or wellness retreats. Use these resources if they’re available.

5. Lower your expectations when you feel overwhelmed.

Some days, “good enough” is more than enough. Take time to rest and recharge. Our brains are sponges, absorbing emotions and energy from our environment. We cannot care for others in a meaningful way if we’re disconnected from our well-being.

How Rosh Review Helped Me as a Resident Struggling With Burnout

When I used Rosh during residency, it became one of the few things I could rely on.

The explanations were thorough, but not overwhelming.

The Rapid Reviews became my go-to when I didn’t have the focus for full paragraphs.

I’d revisit the same questions, learn, and relearn at my own pace.

Now things have come full circle. I write the questions, with you in mind.

Why I Joined Rosh Review

When I joined Rosh, I didn’t just want to create content. I wanted to help rebuild trust in your study time.

At Rosh Review, one of our goals when writing Qbanks is to take some of that burden off your shoulders. When you’re battling exhaustion, you shouldn’t have to worry if your Qbank is current or relevant. That should be a given to make sure your time is well spent.

To make sure you have access to the best possible Qbanks, I’ve been:

Reviewing and updating every psychiatry question

I go through older questions one by one, check the content for clinical accuracy, and update anything outdated or unclear.

Aligning content with the DSM-5-TR

All diagnostic criteria and vignettes are revised to reflect the latest diagnostic standards, so you’re not studying outdated terminology or definitions.

Adding and refining Rapid Reviews

If a question doesn’t already include a concise overview in bullet points, I write one. So even if you only have a few minutes, you walk away with high-yield points.

Updating psychopharmacology content

I stay current on new medications, safety updates, guideline changes, and ensure these are reflected in every relevant explanation.

Clarifying explanations

I streamline dense explanations to make them easier to absorb, especially when your energy and attention might be low.

Making vignettes clinically realistic

I ensure that the vignettes reflect the kind of patients and decisions you encounter in your inpatient unit or your clinic.

Tailoring content to the PRITE format

The Psychiatry Resident Qbank also incorporates the PRITE outline. Since PRITE questions tend to be shorter and more fact-based, I work to ensure that a significant portion of our questions reflect that structure so what you see in the Qbank is relevant, and test-like.

The rest of our content team follows similar guidelines to update questions for other medical specialties, too! Get a glimpse into how a Rosh Review Qbank is made.

When You’re Ready

If you’re tired or simply doubting yourself, please remember that this journey of becoming a competent, compassionate physician is challenging but meaningful. I believe that medical education should center around the people living it, not just the tests we take!

If you feel ready to explore something designed with that in mind, try Rosh Review for free. We’re constantly improving our content with you in mind.

—Roop

Psychiatrist & Psychiatry Content Champion at Rosh Review

Rosh Review is a board review company providing Qbanks that boost your confidence for your boards and beyond. Get started with a Rosh Review free trial to the Qbank of your choice (no credit card required!) and gain access to board-style practice questions, detailed explanations, beautiful medical images, and more.

By Roopma “Roop” Wadhwa, MD

Dr. Roopma (“Roop”) Wadhwa is a board-certified adult psychiatrist and obesity medicine physician with a focus on integrative, patient-centered mental health care. She completed her psychiatry residency at East Carolina University and worked at the South Carolina Department of Mental Health, where she provided compassionate care to underserved individuals living with severe mental illness. She later held a faculty position at Harvard Medical School while working at Massachusetts General Hospital. Her clinical foundation is enriched by a passion for holistic wellness, including the use of whole food plant-based nutrition, lifestyle medicine, and mind-body practices to support emotional and physical well-being.
As Psychiatry Content Champion at Rosh Review, Dr. Wadhwa brings a unique blend of clinical expertise, academic leadership, and creative vision to her role. With over 60 peer-reviewed publications—including work at MD Anderson Cancer Center—she is deeply invested in evidence-based learning and educational innovation. Her work helps shape the future of psychiatry by developing high-quality board prep content that supports residents, students, and lifelong learners.
Dr. Wadhwa is also the founder of Wellness Psychiatry, a private practice in New York City, where she blends psychopharmacology, psychotherapy, and integrative medicine to offer personalized care. She finds deep meaning in mentoring and advancing a more compassionate, prevention-focused model of psychiatric care.
Outside of her professional work, Dr. Wadhwa enjoys plant-based cooking, exploring integrative wellness practices, and finds beauty in quiet moments, minimalism, and intentional living. She believes that sustainable lifestyle choices and a sense of daily joy are essential to lasting mental well-being.