Chronic fatigue and rethinking premed

[endme91]

I'm always tired. No matter how much sleep I get or coffee I drink, I'm almost always exhausted, which makes focusing and effectively studying difficult and time consuming.


This was something I was able to work around during undergrad, as I managed to graduate with a 3.8 with several ECs such as volunteering, tutoring, shadowing. However, I they were all light or part time commitments that had hours build up over time - I have no idea how some of you guys pull working 30-40 hours with school, I would be too tired to functionally study! I see some posts where people say they work from 8AM-5PM, workout from 6PM-7PM, and then study for the MCAT from 8PM-1AM just to repeat the process the next day. HOW DO PEOPLE DO THIS?? I would be so tired just working 8-5 yet they're able to further exhaust their body yet still be able to study for hours into the night and only get a few hours of sleep? I must be missing something, I may not be as physically cut out as most people on here. I didn't even have time to take care of myself during undergrad, I KILLED myself for every single grade I earned and EC I kept up with little to no free time left to even think about working out.


What really is making me question this path was my experience with an ER scribe job I had for a short time. I left. Many of the hours were graveyard shifts and those killed me, and I was. Yet my coworkers were able to handle a combination of classes, MCAT studying, and other part time jobs. I can't imagine ER scribing while being a full time student, I barely could do it and efficiently study for the MCAT. Waking up early for shifts, the 40 minute-1 hour commute, being in the ER for 10-12 hours, then commuting back at 30 hours a week was enough to totally wreck my MCAT study schedule and make me too tired to efficiently study. If I can't handle this, how would I ever handle residency, which would often require 80 hour weeks in a hospital? I mean maybe I could do it, but I would be a depressed, socially awkward zombie and consistently make stupid mistakes all due to lack of sleep.


I'm frustrated that I'm not as cut out as I thought I might be for this. If I could barely manage through premed, what the hell makes me think I would survive residency or even be a good physician if I'm perpetually tired and can't optimally function well with few hours of sleep? I thought doing well on the pre reqs would be a bigger hurdle, but it wasn't. Maybe medical school and being a physician isn't the right path for me.

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[Drakozord X]

Perhaps time management and efficiency may be factors? Study smart, not hard. Plan ahead. Prioritize activities. Set small but smart goals. Manage stress.

 

[altblue]

Sending this from my phone so it'll be a bit brief. There may be a medical or mental health cause like OSA, depression, or thyroid related difficulties. You should speak with your physician regarding your symptoms. You'll want to address this fatigue since medical school demands energy and attentiveness

Source: studied for the mcat with untreated sleep apnea (and my bmi is normal )

 

[mk536]

I have serious fatigue issues too, which were debilitating during undergrad. It took time and adjustment, but I have learned to manage it effectively. Here's my advice:

1) You have to increase how much you sleep per week until you have a manageable level of fatigue. On an 80 hour school/work schedule, I had to minimize my outside life to nothing. Exercise was incorporated into my commute, and I minimized food prep to 30 min per week. Socializing was limited to mealtime with my roommate and phone calls with friends/family/parents during my commute. Everything else was sleep. On 40 hours a week, I could maintain a "normal" schedule during the week and one day of the weekend, but would sacrifice a weekend day entirely to sleep, just waking up to stretch and eat.

2) You have to exercise. Build up super slowly, since it's easy to overwhelm yourself and cause more harm than good if you are fatigued. Exercise is key to increasing your energy and activity tolerance. I aim for 3 days a week currently, just trying to get moving for 20-30 min without tiring myself out.

3) You can't compare yourself to your peers. Many of them will always be able to do more than you. Focus on what you need in order to get your stuff done. If you can't manage good MCAT prep while working, then you need to plan how you're going to afford to do it during vacation or leave of absence. I would try to do it alongside work, since learning how to manage quality study time on fewer hours of study is a skill you'll need in medical school. Some of my classmates can study productively for hours on end on top of our required activities. I can't. So I have to be able to succeed at the same courses while only studying a few hours a night and on only one day of the weekend.

4) You won't have every specialty open to you. Unless your fatigue improves, a number of specialties will have a lifestyle that is incompatible with your health. You may also have to accept that a high step score is out of reach on the amount of time you can study compared to your classmates. Be happy with those limitations or don't pursue medicine.

5) Go see your doctor. There may be a fixible underlying cause.

 

[Astharia]

I have serious fatigue issues too, which were debilitating during undergrad. It took time and adjustment, but I have learned to manage it effectively. Here's my advice:

1) You have to increase how much you sleep per week until you have a manageable level of fatigue. On an 80 hour school/work schedule, I had to minimize my outside life to nothing. Exercise was incorporated into my commute, and I minimized food prep to 30 min per week. Socializing was limited to mealtime with my roommate and phone calls with friends/family/parents during my commute. Everything else was sleep. On 40 hours a week, I could maintain a "normal" schedule during the week and one day of the weekend, but would sacrifice a weekend day entirely to sleep, just waking up to stretch and eat.

2) You have to exercise. Build up super slowly, since it's easy to overwhelm yourself and cause more harm than good if you are fatigued. Exercise is key to increasing your energy and activity tolerance. I aim for 3 days a week currently, just trying to get moving for 20-30 min without tiring myself out.

3) You can't compare yourself to your peers. Many of them will always be able to do more than you. Focus on what you need in order to get your stuff done. If you can't manage good MCAT prep while working, then you need to plan how you're going to afford to do it during vacation or leave of absence. I would try to do it alongside work, since learning how to manage quality study time on fewer hours of study is a skill you'll need in medical school. Some of my classmates can study productively for hours on end on top of our required activities. I can't. So I have to be able to succeed at the same courses while only studying a few hours a night and on only one day of the weekend.

4) You won't have every specialty open to you. Unless your fatigue improves, a number of specialties will have a lifestyle that is incompatible with your health. You may also have to accept that a high step score is out of reach on the amount of time you can study compared to your classmates. Be happy with those limitations or don't pursue medicine.

5) Go see your doctor. There may be a fixible underlying cause.

Just curious... What are those specialties incompatible with the chronic fatigue?

Sent from my Pixel 2 XL using SDN mobile

 

[mk536]

Just curious... What are those specialties incompatible with the chronic fatigue?

Sent from my Pixel 2 XL using SDN mobile

Well, as an MS1, I may not be the biggest expert at this point, but I don't anticipate anything requiring nights or >60 hrs/week to be all that compatible in the long run. I'm fine with developing strategies to survive residency, as I have in the past with work and school commitments, but I'm not okay with making those sacrifices for my whole career.

 

[Catalystik]

I'm always tired. No matter how much sleep I get or coffee I drink, I'm almost always exhausted, which makes focusing and effectively studying difficult and time consuming.


This was something I was able to work around during undergrad, as I managed to graduate with a 3.8 with several ECs such as volunteering, tutoring, shadowing. However, I they were all light or part time commitments that had hours build up over time - I have no idea how some of you guys pull working 30-40 hours with school, I would be too tired to functionally study! I see some posts where people say they work from 8AM-5PM, workout from 6PM-7PM, and then study for the MCAT from 8PM-1AM just to repeat the process the next day. HOW DO PEOPLE DO THIS?? I would be so tired just working 8-5 yet they're able to further exhaust their body yet still be able to study for hours into the night and only get a few hours of sleep? I must be missing something, I may not be as physically cut out as most people on here. I didn't even have time to take care of myself during undergrad, I KILLED myself for every single grade I earned and EC I kept up with little to no free time left to even think about working out.


What really is making me question this path was my experience with an ER scribe job I had for a short time. I left. Many of the hours were graveyard shifts and those killed me, and I was. Yet my coworkers were able to handle a combination of classes, MCAT studying, and other part time jobs. I can't imagine ER scribing while being a full time student, I barely could do it and efficiently study for the MCAT. Waking up early for shifts, the 40 minute-1 hour commute, being in the ER for 10-12 hours, then commuting back at 30 hours a week was enough to totally wreck my MCAT study schedule and make me too tired to efficiently study. If I can't handle this, how would I ever handle residency, which would often require 80 hour weeks in a hospital? I mean maybe I could do it, but I would be a depressed, socially awkward zombie and consistently make stupid mistakes all due to lack of sleep.


I'm frustrated that I'm not as cut out as I thought I might be for this. If I could barely manage through premed, what the hell makes me think I would survive residency or even be a good physician if I'm perpetually tired and can't optimally function well with few hours of sleep? I thought doing well on the pre reqs would be a bigger hurdle, but it wasn't. Maybe medical school and being a physician isn't the right path for me.

Whether you decide to pursue medicine, or not, see your physician and ask for an evaluation.

 

[Moose A Moose]

Get your thyroid levels checked.

 

[Catalystik]

Get your thyroid levels checked.

Keeping in mind that we can't give medical advice on this forum, if you're going to get specific, surely you can come up with a broader ddx than that? 😉 (At least think about it.)

 

[ExcitatorySynapse]

You've worked really hard and seem committed to medicine, I wouldn't give up hope. As the 2nd poster said, see your doctor and get your bloodwork done. Anemia, thyroid, B12 deficiency, vitamin D deficiency etc. can all contribute.You can also discuss with them if you have any mental health issues. I used to be so fatigued all the time, I wanted to just stay in bed and had to drag myself everywhere. After I started taking a dopamine reuptake inhibitor, that reversed almost overnight.

Aside from that, I second the "find how much sleep you really need" by going to bed early and adjusting your schedule for that. Exercise also helps to build stamina. I suggest a combination of cardio and weights, even 2-3 times a week is good. Another thing you might consider is that you might be mentally burnt out. You sound like you've been doing a lot, and taking a real break could help a bit. There's no point comparing yourself to others. You have to shoot for doing your best and manage the challenges that come your way.

 

[The Knife & Gun Club]

I'm always tired. No matter how much sleep I get or coffee I drink, I'm almost always exhausted, which makes focusing and effectively studying difficult and time consuming.


This was something I was able to work around during undergrad, as I managed to graduate with a 3.8 with several ECs such as volunteering, tutoring, shadowing. However, I they were all light or part time commitments that had hours build up over time - I have no idea how some of you guys pull working 30-40 hours with school, I would be too tired to functionally study! I see some posts where people say they work from 8AM-5PM, workout from 6PM-7PM, and then study for the MCAT from 8PM-1AM just to repeat the process the next day. HOW DO PEOPLE DO THIS?? I would be so tired just working 8-5 yet they're able to further exhaust their body yet still be able to study for hours into the night and only get a few hours of sleep? I must be missing something, I may not be as physically cut out as most people on here. I didn't even have time to take care of myself during undergrad, I KILLED myself for every single grade I earned and EC I kept up with little to no free time left to even think about working out.


What really is making me question this path was my experience with an ER scribe job I had for a short time. I left. Many of the hours were graveyard shifts and those killed me, and I was. Yet my coworkers were able to handle a combination of classes, MCAT studying, and other part time jobs. I can't imagine ER scribing while being a full time student, I barely could do it and efficiently study for the MCAT. Waking up early for shifts, the 40 minute-1 hour commute, being in the ER for 10-12 hours, then commuting back at 30 hours a week was enough to totally wreck my MCAT study schedule and make me too tired to efficiently study. If I can't handle this, how would I ever handle residency, which would often require 80 hour weeks in a hospital? I mean maybe I could do it, but I would be a depressed, socially awkward zombie and consistently make stupid mistakes all due to lack of sleep.


I'm frustrated that I'm not as cut out as I thought I might be for this. If I could barely manage through premed, what the hell makes me think I would survive residency or even be a good physician if I'm perpetually tired and can't optimally function well with few hours of sleep? I thought doing well on the pre reqs would be a bigger hurdle, but it wasn't. Maybe medical school and being a physician isn't the right path for me.

If it makes you feel better I’m an M3 and have been fatigued all the time since college. You sound similar to me. I could never handle those crazy hours, studying late into the night, working a job with classes and social commitments.

See your doctor and have a work up done. Maybe even get a sleep study - I know 2 people in their 20s who were diagnosed with sleep apnea and it changed their lives for the better.

But if there’s not something medically wrong, you may just be a tired person, like me. If that’s the case, you just gotta accept that some people have more stamina than you, and that’s ok. I could never work + study more than 12 hours a day, in college, MCAT, gap year, or med school. So I don’t. I study and work as much as I can and call it a day when I’m done.

If there’s one thing I’ve learned over the years it’s to not just push your body harder. The trick to medicine is efficiency not brute force.

 

[deleted647690]

After I started taking a dopamine reuptake inhibitor, that reversed almost overnight.

I've been dealing with sleep issues over the past few months, though I'm not sure what the cause is.