On a December night in a northern suburb of Chicago, the weather outside dipped into single digits with a sub-zero wind-chill. Safely situated indoors, a group of medical students wandered into a classroom where five tables were covered by plastic tarps with another laden with pipe cleaners, acrylic paint and brushes, and a stack of blank masks. Licking the emotional wounds left by a sleep-deprived exam week that ended only three days prior, the students eyed the art supplies. They were hopeful for a means for reconcile their psyche tattered by cold and a semester of school.
Whenever I go to the hospital, I wear my grandpa’s socks. They looked distinguished on an older man, but a little childish on a me, a 25-year-old medical student. I’m okay with that. Feeling like an overdressed kid on Easter helps to balance the overwhelming pressure of becoming a physician.
Mental health has been on my mind lately, but not only because of the “Physician Mental Health” and “Resiliency Training” lectures we’ve been receiving during this block. A few weeks ago, one of my best friends from home texted me to say one of her medical school classmates had committed suicide a few days ago.
It was a tangent during conversation, but I felt my jaw tighten as soon as I heard it. Proposed changes, increase in work hours, for the good of the patients and of the doctors too. It was a Friday evening as I was working on a project with colleagues. As we scuttled toward a new topic, my thoughts were heavy and my hands, anxious. A friend brought up the proposed revisions concerning medical interns’ work hours the Accreditation Council for Graduate Medical Education is pushing to a vote in February. ACGME is looking to raise the number of hours that can be worked consecutively by medical interns from 16 to 24 hours, plus an extra four for patient handoffs.
The topic of burnout is huge in today’s medical community. Multiple articles and studies have been published demonstrating that burnout is prevalent in all levels of medical training from the day-one medical student to the most senior practicing attending.
Whenever I hear the word “burnout,” I’m reminded of the ugly, oh-so-dark side of being a medical student, the side that hides in the shadows, away from the prestige and privilege that comes with the noble profession. Maybe it seems like I’m exaggerating; I mean, it’s just me jumping to conclusions when I associate the feelings of being overworked with the days where I can’t seem to find the bright side of anything, right?
A very important topic is that of mental health in medical practitioners, notably medical students. According to a study in the Student British Medical Journal, 30% of medical students report having a mental health condition — with a majority of 80% stating the level of available support was poor or only moderately adequate. This column was born from these alarming statistics and aims to stimulate conversation on mental health in medical students, from providing suggestions on how to maintain one’s mental health to discussing the taboo and stigma surrounding conversations on mental health in practitioners and students, and how to eliminate it.
Medical school is a notoriously challenging experience during which students undergo tremendous personal change and professional growth. Though the stressors that come along with this are varied and unique to each student’s context and experience, they may be categorized within a few common themes. Harvard psychiatrist Raymond Laurie has previously described the concept of “role strain” with respect to negotiating relationships with their families, friends, partners, peers, attending physicians and patients. Additionally, with regard to students’ concept of themselves, individuals who have high achievement may be challenged in new ways both intellectually and emotionally.
There’s a lot of talk about mindfulness these days — its importance, its effectiveness, the benefits of meditation and even the structural changes in the brain that result from it. (Do you want a less reactive amygdala and increased neuronal density in the hippocampus? Meditate!) It’s one thing to read about the benefits of doing something, but as many know, it’s another thing to actually apply it and understand it. So how can medical students use stress reduction strategies “in the context of the high-stakes, high-stress and time-limited environment of medical school.”
Before starting medical school, I had the opportunity to travel to Japan and visit an array of Buddhist cities peppered with ancient temples and samurai villages. As I explored these breath-taking communities, I discovered the samurai’s commitment to the pursuit of perfection in lifestyle and skill. Now, as I face the challenges of being a medical student, I find myself turning to the canon of the samurai.
As I settle into my second year of medical school, I’m confronted with the fact that I’m one-fourth of the way to an M.D. — that an entire year has passed, and unsurprisingly, all those predictions my deans made at the very beginning came to pass: time flew, we learned more than we thought we ever could, and upon close self-examination, we’re very different from how we were this time last year.
“Neuroanatomy lab exam. You’ve got this. You studied hard. You’re good at anatomy, you know that. Okay, found a tag you definitely know. Start at the one you know. You’ll be okay.” It’s the way I try to start every exam. I try to talk myself up to push away all of the negativity slowly flooding my brain. Anxiety is a tough card to be dealt, especially in medical school. There are only so many ways to cope with the mounting pressure.