Source: gcmag.org
Every car comes with an owner’s manual. Take care of it, change the oil regularly, have a mechanic look at it when you hear noises coming from the engine, and the car should serve you well for years. Medical students need an owner’s manual as well. The years of spent in medical schools are exciting but stressful. Medical students need to take care of themselves so that they can make it through the trip and enjoy it as well.
A doctor has to love everything about medicine. Many of us have known for a long time that we wanted to be physicians. Most of us worked extremely hard to be accepted into medical schools. Unfortunately, even if you have relatives who are physicians you cannot actually know what it is like until you begin the journey yourself. Along the way, some of you will find that it is not what you imagined it would be. This can be difficult. You might even discover that there are aspects of medicine that you do not like, or fear of. Some of these reactions are transient and related to being overtired and stressed. Some of these feelings such as likes and dislikes will persist. Feeling that you cannot possibly read another chapter in a textbook, review another handful of class notes, look at another pathology slide, or see another patient does not mean that you do not belong in medical school. It may mean that you have had a bad day, that you need a vacation, or that you would rather go into urology than pathology. Rather than being frightened by these attitudes and feelings, acknowledging and making peace with them can help guide you towards the field or specialty that will be most satisfying and enjoyable in the years to come.
You are different from everyone else. Everyone is unique in their own way. It is challenging enough to be in medical school. Imagine the additional stress you feel as a woman, an ethnic minority, a physically challenged or a homosexual student. Feeling different from classmates, as well as from the rest of society, can be one of the greatest “stressors” encountered in medical school. This stress is accentuated if “differences” interfere with the way people react to you. While medical schools attempt to include cultural content and experiences in the curriculum, this knowledge does not always change misconceptions and related behaviours. In the clinical years, medical students are at the bottom of the pack – attending physicians, fellows, residents, pharmacists, social workers, nurses and even ward clerks all seem to outrank us. We feel powerless in this hierarchy. Rounds, the hallmark of medical training, consists of group visits to patients’ bedsides. While rounds are instructive, the experience can strike terror into the heart of the “lowly” medical student who is asked to play “What am I thinking” by those who are senior who press forth with increasingly complex questions until you reach the limits of your knowledge. You may be embarrassed, feel unsure or even dumb, but try not to let it get to you. All of us have experienced it and still continue to be in the current system.
All of us can rise to an occasional challenge – cram for an exam, pull an all-nighter studying, work throughout the night with a very sick patient, or endure long and arduous work during a catastrophic event. But none of us can remain well balanced or practice good medicine without periods of recovery. Because the study, and later the practice of medicine, consists of a series of strenuous challenges, it is vital to have a plan for preventive maintenance. But alas, our educational institutions, as well as the mystique of medical practice, all seem to value the extraordinary physician who works long hours without a break, who puts his or her personal and physical welfare second, ignoring bodily or emotional needs and functions. Our system encourages behaviours in students and physicians that would be of concern if we see them in our patients. We exhort our patients to eat healthy food, maintain ideal weight, get sufficient sleep, exercise regularly, engage in recreation, avoid smoking, alcohol and other substances of abuse; at the same time, many of us do not come close to practicing what we preach. Just as we need to bring our automobiles in for five thousand mile check- ups, we need to follow our own advice regarding health promotion. We must care for ourselves in order to care for our patients!
Friends – this is probably the most important thing you can do to ensure your survival and enjoyment of medical school. Many schools support social activities and trust building (everything from picnics to outward bound) as part of an initial orientation. Many of these can expand into formal or informal on-going activities. More formal support groups can also be helpful. Retreats, get-togethers for students and partners can build rapport and help alleviate stress and isolation. Classes, small labs and other study groups naturally promote partnerships. Talking about one’s life and stresses is itself a major de-stressor. Isolation adds to the stress of a massive workload and many demands. Colleagues and friends provide consensual feedback, validation and promote balance. Study groups are a highly effective adjunct to the learning process as well as encouraging the teamwork that will be necessary throughout your career.
Look for what you like and do best. The life of a physician can be lived in dozens of ways. In addition to the broad range of specialties from family medicine to emergency medicine, to psychiatry and neurosurgery, clinicians, teachers, researchers, and administrators in medicine all have life styles that are different from each other. Even clinicians in the same specialties can have varying professional and personal life styles. Take a good look at what various physicians do on a typical day as well as over time. Try to assess the attributes and life styles of the people who inhabit each professional niche. Utilize school-based, community and national resources to evaluate your interests, skills and personal needs to choose a specialty area and career pattern that fits your expectations and personality. However do not bend to pressure for premature closure. Give yourself time during medical school to explore who you are and what you want. The choice must be yours. Remember, it is you, not them, who will be the one to live your professional life. If the fit is not a good one, you will spend your professional life disappointed and struggling with your work, rather than enjoying and looking forward to each day.
Be alert. The values subtly and sometimes unintentionally, underlying your education will fight constantly against balance. “Keep working” as the saying goes, do not squander your time, energy or money on anything frivolous. Yet, life is not either-or but a balance that will promote your professional and personal growth and lead to your comfort and success as a physician.
D’Dyanna Lajamin is a 4th year Sabahan medical student currently studying in Kursk State Medical University, Russia. Know more about her under the Young Columnist tab.