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Training to become a doctor can be one of the most difficult periods you’ll ever face. It can present emotional, academic, and physical challenges that seem impossible to overcome at times. For those of you about to start the journey, keep these mental health fitness points in mind as you navigate undergraduate coursework and the MCAT. For those of you in medical school and beyond, take an inventory of your own mental wellness as you read through these points. Always remember, the first patient that you take care of in the morning is actually yourself.
Challenges
Medical school is an eye-opener in many ways. I can recall checking the score report after my first anatomy exam. All the scores were linked to the last 4 digits of your social security number, and I thought for sure that somebody must have had the same ones as me. “F?” “F!?” I wondered how that could be. Maybe there was a mistake in the scoring key? Up until that point, I had thought I was the smartest thing walking around on two legs. Reality set in when two minutes later I received an email from the professor asking me to meet him in his office the next morning before 7 AM class. Even to this day, I can remember the feeling of being lost in the basement of the hospital, carrying my 80 pound backpack, sweating bullets, and looking for his office. Was I going to be kicked out of the class? Do other people know that I failed? What would my family think if I failed out of medical school? When I found his office, the only thing he asked me was “Is everything alright?” Sheepishly, I told him that everything was ok. He told me to do better on the next one. That was all I needed to get into gear. For the rest of the year I didn’t miss any test questions and ended up with Honors in the class. I realized that my perceived effort level was not at the required effort level needed to succeed. Eating some humble pie and realizing the magnitude of the task at hand helped to put things in perspective. The academic challenges of medical school are different from anything you’ve experienced as an undergraduate. The pre-clinical years have been compared to “trying to take a drink from a fire hydrant”, and in retrospect that is pretty accurate. Building good study habits early is important, but reaching out to friends to learn together is even more important.
Emotional challenges also exist, and not just the ones you get from bad test scores. Medical students have to deal with the topics of severe illness and death, many for the first time. There is no system in place on morning rounds to talk about how the 10-year-old girl admitted overnight who is dying from a widespread malignant brain tumor makes anybody feel. Some people may become detached and emotionally separate themselves from the situation. Others find themselves assuming the emotional burden of their patients. I’ve found myself on either side of the spectrum at times, but somewhere in the middle is where most people find a sustainable balance. It’s ok to hug and cry with your patients.
Join the friends and family plan
The stressors of medical school are best enjoyed when shared. Even when you are keeping up with a demanding schedule that is planned out in 15 minute blocks for the entire day, it is important to keep in touch with your friends outside of medical school and family. These are the people that know you the longest and are going to be there for you when challenges come up. Sure, they are not going to be able to help you with memorizing the mechanism of action for antibiotic resistance in extended-spectrum beta-lactamase producing bacteria, but they will be there when things don’t go as planned. Contrary to admissions brochures, real life continues to happen in medical school. Things such as divorce, marriage, illness, death, financial trouble, pregnancy, loss of pregnancy, and addiction have all been known to take place during medical school. Hopefully you’ll only have positive events to share with your support system, but you’ll be happy to know they’ll be there for you no matter what.
Avoid negativity
Negativity is one of the most infectious agents in the hospital. A little complaining on rounds can grow exponentially and spread negativity among a care team like wildfire. Similar outbreaks have been reported in small group learning sessions and even in the lecture hall. Even though not everything is sunshine on campus or in the hospital, it is important to choose your words wisely. Everybody around you is listening, even the patient! Self-coaching with positive thoughts has helped me get through long days of studying and long days in the operating room.
Get help, give help
It is estimated that about 25% of students may suffer from depression in medical school (Givens et al. Acad Med 2002;77:918-921, Rosal et al. Acad Med 1997;72:542-546 ). While there are certain normal emotional responses to the strenuous environment of medical education, it is important to take a breath between tests to see how you are doing. SIG E CAPS isn’t a pneumonic that should be reserved for USMLE review books. How are you doing? How are those around you doing? Mental illness still carries a stigma and people often feel the need to hide it. Depression isn’t a weakness and reaching out for help isn’t going to jeopardize your future success.
Take a break
Using some of your free time to spend on non-school related activities is essential to sound mental health. Even though you may read some doctor profiles (think “20 questions on SDN”) that describe 100-hour work weeks coupled with 5 hours of sleep per night, not everybody requires that type of grueling schedule! What happened to all those activities you listed in your AMCAS like running, cooking, volunteering, and playing the trumpet? When you do have free time from school, spend it on things you enjoy. And at the end of the day don’t forget to get to sleep early- it is essential to good performance both in the classroom and in the hospital.
@LilEngineThatCould @Mr Interesting
Challenges
Medical school is an eye-opener in many ways. I can recall checking the score report after my first anatomy exam. All the scores were linked to the last 4 digits of your social security number, and I thought for sure that somebody must have had the same ones as me. “F?” “F!?” I wondered how that could be. Maybe there was a mistake in the scoring key? Up until that point, I had thought I was the smartest thing walking around on two legs. Reality set in when two minutes later I received an email from the professor asking me to meet him in his office the next morning before 7 AM class. Even to this day, I can remember the feeling of being lost in the basement of the hospital, carrying my 80 pound backpack, sweating bullets, and looking for his office. Was I going to be kicked out of the class? Do other people know that I failed? What would my family think if I failed out of medical school? When I found his office, the only thing he asked me was “Is everything alright?” Sheepishly, I told him that everything was ok. He told me to do better on the next one. That was all I needed to get into gear. For the rest of the year I didn’t miss any test questions and ended up with Honors in the class. I realized that my perceived effort level was not at the required effort level needed to succeed. Eating some humble pie and realizing the magnitude of the task at hand helped to put things in perspective. The academic challenges of medical school are different from anything you’ve experienced as an undergraduate. The pre-clinical years have been compared to “trying to take a drink from a fire hydrant”, and in retrospect that is pretty accurate. Building good study habits early is important, but reaching out to friends to learn together is even more important.
Emotional challenges also exist, and not just the ones you get from bad test scores. Medical students have to deal with the topics of severe illness and death, many for the first time. There is no system in place on morning rounds to talk about how the 10-year-old girl admitted overnight who is dying from a widespread malignant brain tumor makes anybody feel. Some people may become detached and emotionally separate themselves from the situation. Others find themselves assuming the emotional burden of their patients. I’ve found myself on either side of the spectrum at times, but somewhere in the middle is where most people find a sustainable balance. It’s ok to hug and cry with your patients.
Join the friends and family plan
The stressors of medical school are best enjoyed when shared. Even when you are keeping up with a demanding schedule that is planned out in 15 minute blocks for the entire day, it is important to keep in touch with your friends outside of medical school and family. These are the people that know you the longest and are going to be there for you when challenges come up. Sure, they are not going to be able to help you with memorizing the mechanism of action for antibiotic resistance in extended-spectrum beta-lactamase producing bacteria, but they will be there when things don’t go as planned. Contrary to admissions brochures, real life continues to happen in medical school. Things such as divorce, marriage, illness, death, financial trouble, pregnancy, loss of pregnancy, and addiction have all been known to take place during medical school. Hopefully you’ll only have positive events to share with your support system, but you’ll be happy to know they’ll be there for you no matter what.
Avoid negativity
Negativity is one of the most infectious agents in the hospital. A little complaining on rounds can grow exponentially and spread negativity among a care team like wildfire. Similar outbreaks have been reported in small group learning sessions and even in the lecture hall. Even though not everything is sunshine on campus or in the hospital, it is important to choose your words wisely. Everybody around you is listening, even the patient! Self-coaching with positive thoughts has helped me get through long days of studying and long days in the operating room.
Get help, give help
It is estimated that about 25% of students may suffer from depression in medical school (Givens et al. Acad Med 2002;77:918-921, Rosal et al. Acad Med 1997;72:542-546 ). While there are certain normal emotional responses to the strenuous environment of medical education, it is important to take a breath between tests to see how you are doing. SIG E CAPS isn’t a pneumonic that should be reserved for USMLE review books. How are you doing? How are those around you doing? Mental illness still carries a stigma and people often feel the need to hide it. Depression isn’t a weakness and reaching out for help isn’t going to jeopardize your future success.
Take a break
Using some of your free time to spend on non-school related activities is essential to sound mental health. Even though you may read some doctor profiles (think “20 questions on SDN”) that describe 100-hour work weeks coupled with 5 hours of sleep per night, not everybody requires that type of grueling schedule! What happened to all those activities you listed in your AMCAS like running, cooking, volunteering, and playing the trumpet? When you do have free time from school, spend it on things you enjoy. And at the end of the day don’t forget to get to sleep early- it is essential to good performance both in the classroom and in the hospital.
@LilEngineThatCould @Mr Interesting
