Taking a holidayBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7190.2 (Published 17 April 1999) Cite this as: BMJ 1999;318:S2-7190
If you're a doctor you have as wide a range of choices of holiday as anyone; but do you choose wisely? William Sellar has some hints for attaining emotional equipoise on vacation
A few weeks of holiday are invaluable - a chance to relax, recharge the batteries, and return refreshed to work. But often the reality of holidays is of anxious planning, a late and harassed departure, exhausting travel, illness, and frayed tempers. The multiple demands on holiday time can be as stressful as they are at work. Some forward planning can be helpful.
Although your own desire for a break and relaxation may seem paramount, you also need to consider the needs of those with whom you share your life. A holiday that suits them may allow you to relax as well, relieve tensions, and allow you to enjoy what may not have been your first choice of destination. Perhaps the most important person to consider is your partner, who may also have strong views on the sort of break he or she needs. It may be helpful to draw up lists of what you each would like on your holiday and where you each would like to go, but be prepared to compromise if necessary. For example, your partner may feel that a break from cooking is paramount while you may prefer being chef de cuisine on holiday.
Children change everything. For small children, long distance journeys and hot climates may be stressful, which tends to have spin off effects on the parents. Most small children are happy with water, sand, hay, bicycles, and trees to climb. Worldly wise parents who argue that overseas holidays will foster cross cultural appreciation in their offspring are surely misguided, especially on a Mediterranean beach where they are only exposed to the dangers of ultraviolet radiation. Caravanning, or an old fashioned week or two by the sea or in a farmhouse in the countryside can offer many interesting learning experiences to small children. These types of holidays also offer the convenience of lower budgets and shorter travelling distances with a base to retire to when everyone is exhausted. Older children often enjoy similar breaks in areas where they can cycle, ride ponies, camp, or try water sports. All of these types of holidays avoid the need for long and expensive flights, passports, vaccinations, and difficulties with foreign languages. It is surprising how few people in the British Isles have visited other parts of these same islands. Yet delightful coastal resorts are virtually empty and the magic of places like the north coast of Ireland and its lakes are never discovered.
Activity holidays are often a good excuse for quality time with teenagers before they fly the nest. Skiing in winter or cycling holidays in East Anglia or the Netherlands give plenty of room for time together and a sense of purpose or achievement. Camps are also helpful options for teenagers when working parents are unable to take enough holiday themselves.
For the unattached, activity and specialised holidays and treks can offer purposeful relaxation from the routine of work as well as the chance to meet people outside the usual circle of medical contacts.
Sorting out your needs
Several short breaks v one long trip
Family time v personal relaxation
Time at home v time away from home
Travelling companions and friends
Combining conference attendence and holidays
Types of holiday:
Activity or special interest holiday
Catered or self catering
Packaged or self determined
Exams, decorating, renovating, and gardening
Working holidays: taking or giving
One long, or many short?
Taking several short breaks may be a better way of relaxing and pacing yourself rather than taking one long trip. None the less, if one has relatives living abroad, it is sometimes necessary to take a long break to make the most of expensive long haul flights. However, it is difficult to work for 11 months without any break, so saving a week's holiday for another time of year is wise.
Ask yourself if you really want to or can afford to go away on holiday. There is a lot of media and peer pressure to take foreign holidays but if you are away from home all day, you may actually appreciate being about the house, enjoying the garden at its best, catching up on decorating or renovating, having day trips out, rummaging in book or music shops, buying clothes at leisure, and going to the cinema or theatre as well as having time to read, eat out, or see friends. Catching up on a list of long undone jobs at home may be more useful than an exotic holiday, and it may relieve you of the stress engendered by a backlog of jobs that would still have remained undone had you gone away.
Working holidays can help to pay off debts but the added stress of new and short term circumstances may leave you burnt out on returning to your normal work. Some strategic planning and learning to live within your budget, rather than relying on additional locum work to bail you out financially, may work out less of a strain.
That said, some doctors do have the energy required. There is a lot of satisfaction to be gained from voluntary work overseas. Short term help can often allow a doctor working for an aid agency to take a break, or provide additional specialised skills which are not available locally. Even the families who accompany the doctor benefit greatly from such experiences.
Early consultation with colleagues who have to cover for you is very important, especially if longer periods of absence are involved. Plan at least six months ahead to allow everyone on your on call rota to have the time they need, to allow adjustments to be made to clinics, and for locums to be arranged if required. Early holiday planning is especially important in preregistration and SHO jobs. With new working arrangements, breaks may be stipulated for you, although they can often be swapped. Make allowances for colleagues with children who may be bound by school holidays. If you are not bound to certain dates for holidays by school aged children, take advantage of cheaper off season rates and the accompanying extra space on flights or boats.
Once you have decided on your destination, compare possible travelling options. Flying or sea travel is often best value when packaged with accommodation, but check the convenience of departure and arrival times and how long transfers take. A 10 minute transfer on arrival may sound convenient but may involve a beach resort under an aircraft flight path. Driving offers the convenience of having a car while on holiday but a long return journey can ruin the effect of a fortnight away. Short sea crossings may seem cheap but may involve more driving; a longer overnight ferry crossing may seem more expensive but affords a night's rest and avoids the bother of finding accommodation en route. Bear in mind that destinations such as the Netherlands, Ireland, and Norway can have good summer weather and are more accessible than the south of France, Italy, or Spain. Plan your route with the help of a motoring organisation, and take out cover for roadside assistance, especially if your language skills are limited. Allow for delays on public holidays and plan to stop at interesting places en route, especially if you have children.
Plan leave 6 to 12 months in advance
Consult with colleagues
Arrange cover for your absence
Plan your destination and route
Check the convenience of travel connections
Shop around for value: book early
Book with a reliable travel agent
Take out annual travel insurance
If driving, allow extra time for breaks
Read up on where you are going
Learn some of the language if possible
Remember vaccinations and disease prophylaxis
Pack well in advance, especially if you have children
Before you go
Early booking may provide discounts and involve little risk if you have cancellation insurance. Take out annual travel insurance if you take more than one holiday each year. Such insurance should also cover illness and the loss of belongings as well as your travel to conferences. It will not cover your vehicle abroad nor off piste skiing. Book with a reliable travel agent and avoid sending large cheques to bucket shops which may cease trading just after cashing your cheque. Make sure that you have checked visa regulations and vaccination requirements. Update passports and arrange foreign currency or Eurocheques on time.
For security, arrange for someone to use your home or look after it while you are away. This is taken care of if you try a house swap; this can be a fairly cheap way to have a holiday, allowing you to gain an insight into someone else's lifestyle and culture while offering the benefit of their home comforts.
Read up on where you are going. British tourists are notorious for their failure to grasp the local language. Not everyone understands English, not even if you shout. A year of night classes or a taped language course from the library can open up the heart of a country and disentangle the hidden mysteries of signposted warnings and menus. Attempting to speak to the locals in their own language can lead to surprising experiences and friendly invitations, making your holiday much more enjoyable.
Conferences have become a form of tourism in themselves, and planning an additional week to be taken as holiday once you have got there will cut costs and save making two journeys. Increasing accountability for study leave means it is wise to select congresses for content as well as destination and to keep separate accounts for conference days and additional holiday.
Even doctors need to be reminded to obtain vaccinations and prophylactic drugs on time. Remember to take proper sun glasses and skin protection (creams and dark shirts) for children as well as adults if you insist on a holiday in the sun or skiing. It is prudent to plan graded exercise beforehand if you are planning to take a holiday involving unaccustomed effort such as skiing, cycling, or trekking. And do not lose your commonsense and risk becoming a transcontinental vector for sexually transmitted diseases.
Pack well in advance. Make lists and set aside things you will need on holiday to avoid much of the stress induced by last minute panic, especially if you have children to organise. Teenagers can draw up their own lists of clothes and holiday items, relieving parents of the chore while also teaching them to plan and budget what they take.
Deciding what you want from a holiday, and planning it well, can considerably reduce the anxieties involved and improve the enjoyment you gain and retain from taking a break.