Take Care of Yourself: Consider Professional Help

Preparing yourself for the intensity of applying to and attending medical school is important. This week we’ll highlight healthy behaviors to incorporate into your schedule.

Get professional help. Even if you're not feeling extreme turmoil right now, this could be something to explore. "Studies suggest medical students experience high levels of mental distress during training but are less likely than other students to access care due to stigma and concerns regarding career progression," according to a 2020 study published in BMC Medical Education. The University of Cambridge developed a mental health program for medical students. Cognitive Behavioral Therapy, Interpersonal Therapy, Eye Movement Desensitization Reprocessing Therapy, or Cognitive Analytic Therapy was provided to 189 students. Stress, anxiety, and suicide risk were "significantly reduced" and students' functioning "significantly improved."

Take Care of Yourself: Prioritize Sleep and Movement

Preparing yourself for the intensity of applying to and attending medical school is important. This week we’ll highlight healthy behaviors to incorporate into your schedule.

Sleep. When sleep is in your control, try to maximize the opportunity. A study published in the December 2021 Journal of Clinical and Diagnostic Research found that anxiety and stress directly impacted medical students' sleep during the second wave of COVID-19. One thing that you can do to combat that right now is to put away your phone every night. You've heard it before—but it's especially relevant to you. In a study published in the January 2022 Journal of Affective Disorders, medical students’ anxiety was associated with problematic smartphone use and sleep deprivation.

Move. Do whatever you comfortably can do; this is not ableist advice. You don't need to have six-pack abs to be a strong candidate for medical school or med student—exercise is just another way to reduce your risk of a meltdown. A study published in Academic Medicine in 2017 surveyed 12,500 medical students across the country and found that those who met the CDC's exercise recommendations had a lower risk of burnout and a higher quality of life.

Take Care of Yourself

This isn't advice you expected to get from us, we know. And we're not going to share any simplistic Instagram #selfcare adages here—but if you're going to dedicate your life to healthcare, start at home.

This might seem like a non-priority right now, but it is serious. Medical students have a significantly higher rate of mental illness than similarly aged postsecondary graduates, according to a 2019 study in Academic Medicine. One harrowing quote: "Higher rates of distress and burnout in physicians and medical learners have been linked to poor academic performance, increased thoughts of dropping out of medical school, lower levels of professionalism, decreased empathy, increased medical errors, increased substance abuse, and increased suicidal ideation."

Preparing yourself for the intensity of applying to and attending medical school is important. Practicing mindfulness, getting rest, and being a person in the world are part of being ready for a rigorous academic environment. This week we’ll highlight some of these healthy behaviors.

Stay social. This is not to say that you should be partying the night before retaking your MCAT. But you do need to leave your desk—or at least have a Zoom that isn't a study group. Even if you're a natural introvert, if you want to be a physician, you will benefit from speaking to people regularly. This advice might not apply to you—you could be a social butterfly. But trust us, some applicants need to hear it, including one of our all-time favorites. (Yes, we have favorites.) Keeping your relationships strong also provides a safety net in hard times and helps you to be empathetic and less self-centered.

Establish a Self-Care Routine Before Starting Medical School

This blog is the third in a series that we are publishing on the soft skills and self-care rituals that all premedical students should work on developing prior to starting medical school.

The toll that medical school takes on students is well-documented. A 2020 article published in Medical Education Online summarized research findings on the impact of starting medical school on student wellness. “Prior studies suggest that mental health is especially affected, with higher levels of anxiety, depression, and perceived stress among medical students compared to age-matched non-medical student peers,” the article noted.

If you’re thinking, “Sure, medical school is stressful, but it’s temporary…,” you may be underestimating the problem. The American Medical Association references physician burnout as an epidemic, noting that just under two-thirds of doctors report signs of burnout including “emotional exhaustion and depersonalization.” In 2017, as a response to the gravity and universality of physician burnout and its negative impact on patient care, the World Medical Association amended the Geneva Declaration’s Physician Pledge, a modernized companion to the Hippocratic Oath, to include (among other things) the line “I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard.”

You must take care of yourself, to take care of others.

This is why we recommend that aspiring medical students do not wait to consider integrating self-care practices into their schedules. Because, while school is temporary and residency is temporary and fellowships are temporary—practicing medicine is not and it will continue to bring stress throughout the many phases of your career.

Although self-care looks different for everyone, there are some basic practices we recommend you consider. The Harvard Health Blog offers “four ways to nourish your body and soul,” that overlap considerably with the AMA’s recommendations for medical students.

• Physical Activity. Finding a regular exercise routine is a powerful way to ensure that you stay physically healthy, but it can be difficult. Harvard’s blog recommends that, no matter how, you make it a practice to incorporate movement into your day as much as possible. Park further away, take the stairs, stand up and stretch routinely while studying, discuss your coursework while taking a walk or flip through flash cards while on an exercise bike. The minutes and benefits will add up.

• Good Nutrition. Eat as plant-based and colorfully as possible. Try to avoid high-carbohydrate and sugar snacks, and don’t try to compensate for a poor diet with supplements and vitamins. Practice what you will (eventually) preach to the fullest extent possible. The AMA also recommends that students try to avoid high-sugar energy drinks and vending machines in favor of proper, nutritious meals.

• Obtain calm. Take at least a few minutes every day to engage yourself in something that calms you. This could be meditation, yoga, painting, reading, knitting, baking, or playing an instrument. What works best to soothe your busy mind?

• Sleep. Yes, even in medical school. Routinely get the amount of sleep that you need. Usually that’s around eight hours. And be sure to stay away from electronic devices and/or alcohol directly before bedtime. Erin Ayala, PhD, and the lead author of the medical student self-care study, provided the AMA with the following tips to improve medical student sleep:

  • Track your sleep so that you understand the amount you’re actually getting and what improvements you need to make.

  • Create a routine based on consistent bedtime and wake-up times.

  • Relax prior to going to bed, and don’t use your bed as a study spot.

  • Consider your caffeine and alcohol intake and how those may impact your sleep.

Read the rest of the series:

• Learn How to Accept Critical Feedback Before Starting Medical School

• Before Starting Medical School: Create a Study Routine that Works for You

Some Students Don’t Match on Residency Match Day. Do they Need More Support?

Match rates improved across all applicant types in the 2023 National Match. U.S. MD seniors garnered a 93.7 percent match rate (+0.8 percentage points from 2022) and U.S. DOs achieved an all-time high with a match rate of 91.6 percent (+0.3 percentage points from 2022). Among international medical graduates, who historically match at lower rates, U.S. citizens achieved a record high match rate of 67.6 percent (+6.2 percentage points from 2022) and non-U.S. citizens matched at a rate of 59.4 percent (+1.3 from 2022).

The Match generally brought positive feedback for the improving rates, but what about those who don’t match? “After the match, of course, there's an uptick [in calls] every year," said Pamela Wible, MD and Founder/Operator of a mental health helpline for doctors and medical students. "Matchless medical students reach out to me who don't know what to do with their lives, sitting on $300,000 of student loans, sobbing on their couch" continued Dr. Wible, in a MedPage article published after the 2021 Match.

A recent MedScape op-ed considers the challenges for matchless medical students and urges the medical community to provide more proactive and structured advice and guidance on how to navigate not matching to a position. The authors suggest the following ways that medical schools or national medical organizations can offer more meaningful support: 

• Prior to Match Day, organizations can facilitate webinars/meetings that both normalize not matching to a position and also provide guidance on useful actions. The meeting might include topics such as how to adjust career plans, approach loan repayment, enter the SOAP process, explore alternative positions in research or other fields, and reapply to a future Match process. 

• Medical schools should focus on providing mental health support services and ensuring that students know how to access these resources both prior to, on, and after Match Day. In addition to providing access to emergency counseling services, the authors suggest that schools offer stress reduction workshops/tips and opt-out mental health services prior to the Match.

• Finally, schools and the medical community must work together to destigmatize not matching. Students should feel comfortable and safe pursuing next steps knowing that their school and the wider medical community will support them as they determine how they will continue to pursue their dream of practicing medicine. 

“Stay in touch with your dean and others at your medical school and ask them for help…Also, get involved in a research project. Look for mentors at your medical school who are working in the field of medicine you want to work in and volunteer to help,” said Margarita Loeza, MD, MPH and Assistant Dean of Student Affairs and Admissions at the Charles R. Drew University of Medicine and Science in AMA article published last month.