Medical school, in my own opinion, is one of the more stressful experiences I’ve ever had in life. All the time that goes in to staying on top of studies, the commitment and responsibility involved in getting through classes and exams, adds up. And this is coming from someone who had a life before becoming a medical student after 30.
You have to take this with a pinch of salt of course. My perspective is based on my role as international student. Something that puts me at a greater distance from my family who are more than 3000 km away.
So maybe it’s less stressful the closer you are to supportive friends and family. But that’s just a theory. I’m sure there are an equal amount of stressors in other medical students lives also!
This article aims to take a look at some of them. It also looks to shed light on the topic of mental health in med school more broadly.
The Common Stressors of Medical School
Some of the more common stressors of med school, outside of the actual classes and lectures are as follows:
- Money: studying medicine, given the length of most programs and the fees of individual schools is expensive. Most US-based students have to take out huge loans to cover the cost of their study with the average graduate debt, according to Credible.com, being around $230,000. Students outside of the US (like myself and other international students) face a similar situation. Living costs and private school fees aren’t cheap and thinking about them puts a serious toll on your mental health.
- Time: medical degrees are longer than your average University degree and usually take anything from four to six years to complete. Knowing you’ll be out of the job market for that time and be spending money rather than earning it, can sometimes hurt. Especially when you see non-medical peers go out into the world, start families, buy houses etc, while you’re still stuck in school training and hammering away at passing exams. Then there’s the issue of free time in med school. That’s not exactly easy to come by either.
- Distance: I already mentioned the physical distance that comes with being a med student far from home. Another typical stressor however is the emotional distance that comes with being a student embroiled in an intensive full-time study schedule. Personal relationships, those with friends and family etc that are most likely to help keep us sane, become challenging to maintain. The bubble of med school – and all the time and days spent with colleagues, patients and other doctors – is hard to break out from.
Personally, I always find the transition back into full time study the hardest aspect of med school life. Summers bring a nice break and the chance to spend time with family and friends. As well as (temporary) respite from many of the stressors outlined above.
The pit in my stomach before the start of each semester? Not exactly palpable. But anxiety is running high!
Is Studying Medicine Stressful?
Studying medicine is stressful at the best of times but can become even more so with poor habits and organisation. The volume of material to learn and the number of exams you need to pass is huge. Without effective strategies and the ability to be consistent with your study schedule most students will run the risk of either burning out or failing.
There’s nothing inherently difficult about mastering the concepts of medicine. Nor you do have to be especially smart or gifted in terms of intelligence. The whole endeavour is about the hours you put in more than anything.
That’s why time management is so critical to managing your stress levels in medical school. Understanding what’s worth your attention and why, as well as knowing what subjects, classes or lectures to prioritise, helps to achieve that. This is why I always recommend asking students in the years ahead of you for their own perspectives on how best to plan for the year.
Asking them what the more difficult subjects and exams are, and where you can relax a little and maybe skip out on lectures and other commitments, can really help. They’ll also be able to give you the most relevant information about particular examiners or professors too. So that you know what their expectations are of you ahead of time.
How Do You Handle Stress in Medical School?
There are many approaches to handling stress in medical school and what’s effective for one individual might not necessarily be for the next. Personally exercise is the big one for me. As well as having some kind of creative or intellectual outlet outside of medicine (like this website and other work-related projects).
Speaking to several of my colleagues, the following ideas also come up:
- Sports: badminton, football, tennis, triathlon; these are just some of the sports several of my friends and colleagues participate in on a weekly basis to help blow off some steam outside of studies. Finding clubs to participate in brings a social element to sport too. As well as a chance to meet people outside of school so you don’t have to keep having the same repetitive conversations!
- Games: board games, role playing games and video games. All are useful past-times that can help students relax and escape into another world for a while. Video games can be tricky to manage though due to their addictive nature (just ask my PUBG Mobile crew).
- Reading/podcasts: general reading (my housemate enjoys a lot of fantasy fiction) is another way to kick back. I also love to listen to non-medical related podcasts (Joe Rogan, Jocko Podcast etc) on my way walking to and from hospital as a way to chill before the real work starts.
- Mindfulness: yoga and meditation are big ones here. I’ve dabbled with the first one without any real consistency but have a lot of experience with the latter. When the overwhelm and anxiety really ramps up, 10-15 minutes sitting silently, watching my breath, always helps calm the internal chatter.
- Clubs: sometimes you just have to go out and hit the beers/cocktails. Luckily med school on the Black Sea (MU Varna) has plenty of laid-back beach bars that make for good drinking spots.
- Social meet-ups: take advantage of any University-run social events or meets to get out and introduce yourself to new people. Nothing going on? Start something small, around some kind of theme. Then just see where it goes.
Obviously the key with each of these is to strike a balance. Too much of anything can tip the scales unfavourably in the other direction.
You don’t want to spend more time in school, defer a year or resit exams, if you can help it.
Medical Students Mental Health
Mental health is so important to keep an eye on med school. According to the American Medical Student Association (AMSA), one third of medical students suffer some form of depression at some time during their studies. Studying away from home in a foreign country, like myself and many of my colleagues, could even raise that statistic.
The point is that we all should look out for one another on our journey to becoming doctors. That means checking in with colleagues, regularly asking if there’s anything you can help with and generally just being there to listen when someone feels like talking.
One thing I’d personally like to see more of is a general acceptance from those around me that being stressed and not feeling so great in school is something to be talked about rather than hidden. The more I talk about my own feelings of loneliness, isolation etc, the easier things generally get. I hope others can maybe reach out to me more if and when they’re feeling this way.
International medical schools, especially those in Eastern Europe, put us in an awkward place. Most of us don’t have mental health support or counselling services to fall back on. Nor do we have any real social support that is familiar with our own cultural and racial backgrounds.
It’s up to us to look after each other.
How Can I Be Happy in Medical School?
I’m not sure there’s any reliable solution, just as there is in life as well as med school, to be happy. The emotion itself is too complex and fleeting to ever fully be captured and held for any stretch of time.
There are ways of being positive of course; helping others as much as possible, focusing on things in your control, taking set-backs in your stride etc, but none of these can reliably lead to happiness. What works for me (despite also being a struggle) is to take each day as it comes. And trying not to think, all the time, about all the work and all the years left in front of me.
Of course, having good friends and teachers around helps massively. But a lot of stress surrounding medical school life also comes down to deciding for yourself how to look at things.
On one hand there’s giving into the stress and hating every moment of the process. On the other there’s weaponizing the stress and learning to love the process instead.
Sometimes short-term thinking, rather than dreaming of the end result, is the best way to make it through med school as happy as possible.
That’s what the logical side of me says anyway.
How stressful a student finds med school is largely dependent on their own outlook. While there are many things that can actively cause stress (we’ve touched on them in this article), there’s lots of ways of dealing with them also.
Perhaps the most important thing is to remember that we’re all in this together, aiming for the common good.
Maybe all the stress is justified given the final outcome.
Image Credit: Tim Gouw at Pexels.