How to Avoid Medical Student Syndrome

How to Avoid Medical Student Syndrome: 5 Powerful Tips

There’s some controversy surrounding the concept of “medical student syndrome” and it’s many names. But whether it’s an actual condition or not is besides the point. How do you avoid it? You become a better, more knowledgeable clinician. You use your powers of reason. You accept and embrace it as best as you can.

But there’s also a lot more to it than that! As you’ll see this in broader discussion.

So first things first.

What is Medical Student Syndrome?

Also known as “medical student disease”, “intern syndrome”, “second year syndrome”, “third year syndrome” or “insert-year here syndrome”, it’s a condition that directly affects those studying in med school. Obviously.

According to Wikipedia though, it’s defined as [med students] “perceiving themselves to be experiencing the symptoms of the disease that they are studying.” As if we didn’t have enough stress already.

It’s also something I know I’ve experienced personally many times. Especially reading physiology and wondering about all the aches and pains I had (probably just my age showing) and freaking out I had Guillain-Barre syndrome. But also something I know my colleagues have experienced too.

Especially a certain mature Indian one who’s had malaria, dengue and every infectious disease under the sun! He’s always in and out of the doctors office trying to get confirmation of his mystery self-diagnosis.

Perhaps the mature med’s are hit by it more than most. Mortality is far closer after all.

Medical Student Syndrome Vs Hypochondria

The controversy surrounding the condition however comes from its classification. Isn’t it just another form of nosophobia, the irrational fear of contracting a disease? Or is it a more specific form of hypochondriasis?

If it is the latter and we’re just being unduly worried about having a serious illness, how does this separate us from the rest of general society? The people out there walking around. Enjoying a supposed abundance of free time from not being a med student.

The truth is it probably doesn’t.

But there has been some scientific research surrounding it. Specifically fairly recently in the Journal of Curriculum Theory, put together by Dr Brian Hodges (2004). Here, he states it’s recognition as a “thing” can be traced back to the 1960’s. And that there’s a ton (70-80%) of med students suffering from it.

“[The] phenomenon caused a significant amount of stress for students and was present in approximately 70 to 80 percent of students… papers written in the 1980s and 1990s conceptualized the condition as an illness in the psychiatric spectrum of hypochondriasis…Once this representation is formed, symptoms or bodily sensations that the individual is currently experiencing which are consistent with the schema may be noticed, while inconsistent symptoms are ignored.” [1]

Hodges’ research is also echoed in Dr Bernard Baars’ book In the Theater of Consciousness (2001). Here, there is direct reference to “medical students syndrome” as a potential diagnosis. Although he says it’s only a temporary form of hypochondria.

Medical students who study frightening diseases for the first time routinely develop vivid delusions of having the ‘disease of the week’ – whatever they are currently studying. This temporary kind of hypochondria is so common that it has acquired a name, ‘medical student syndrome.’

And the research continues. More of which is detailed in this excellent article in Psychology Today.

But the bottom line is pretty simple. Whether it’s hypochondriasis, a temporary form of it or even nosophobia? This is a debate for the psychiatrists.

For us studying medicine though, given how much of it is focused on disease and incorrect physiological function, we know it to feel real.

And that can be very anxiety-provoking.

How to Avoid Medical Student Syndrome?

So how do we stop feeling this way? Or avoid “contracting” it?

Well, firstly we can learn from how doctors actually treat hypochondria or nosophobia. And perhaps apply some of those things.

Especially if we find ourselves waking up in a cold sweat thinking our moles are melanomas. When the anxiety or overwhelm gets too much.

The two common first-line treatments then, for both conditions, is exposure therapy and cognitive behavioural therapy (CBT).

The first, exposing us to the direct source of anxiety, we basically have to do anyway. Every time we step into a hospital. Palpate a patient. Or read about some particularly nasty pathology in a book.

The second, CBT, is a bit more complex. And involves us actually talking through our anxieties and concerns with another human being.

Note; not a fellow clueless colleague. Who’s also probably freaking out from medical student syndrome too.

So it’s definitely an option. But one that does require time, commitment and – if not supported by your med school – money. So maybe not perfect.

Rationality & Knowledge

As for what you can do to avoid medical student syndrome without going down the CBT route? You have a couple of options. And I don’t mean throwing psychotropic drugs at it either.

Because those should always be last line.

My first recommendation then? Involves tackling it by actually becoming an exceptional student of medicine (double-win). And applying what you learn about pathologies and how to spot them, to expertly help calm your fears.

Doing this, and studying effectively to expand your knowledge, can help you discern between actual clinical signs and common complaints. The latter being the types of things associated with living life in this crazy human world.

An example (borrowing on the aforementioned) might be studying skin cancer. Then looking, with more depth and care, at your nevus (cool word for mole) in question.

And then applying the ABCDE’s:

  • asymmetry
  • border irregularity
  • colour variation
  • diameter
  • evolution

To see if it checks out.

Which it most likely won’t. Because your fear is (probably) irrational.

Embrace and Acceptance (Get Used To It)

Another way to overcome it, cliched I know, is just to embrace and accept this syndrome as part of medical school life.

And also to understand, that as you progress, the anxiety it provokes will most likely die down.

Now, I don’t want to suggest here it will ever go away. Even top clinicians will be the first to tell you it reoccurs from time to time. Just like this article states.

But you’ll probably be able, based on prolonged experience, to spot, with greater clarity, if you’re feeling unnecessarily concerned or not.

And accept that sometimes, given the nature of the job (seeing disease all day), those feelings are natural. That you’re bound to turn your attentions inward from time to time.

Suddenly get a bit panicked.

So accepting that it’s there and it’s not going away? Could be a useful mental trick to calm yourself.

Preventative Measures

Another thing worth mentioning here, especially in this post-Covid world, is the power of precaution.

The following types of actions:

  • Sanitising your hands
  • Wearing a protective mask
  • Following correct clinical procedures

These are important things that can help you avoid anxiety in the first place.

Especially as they minimise your risk of experiencing “real” disease too!

Summary: How to Avoid Medical Student Syndrome

To summarise then, here’s how best to avoid experiencing medical student syndrome so you can better stay on track.

  • Exposure therapy
  • Expand your knowledge of clinical disease and apply it correctly
  • Rationalise with yourself based on your growing experience
  • Accept and embrace it as a condition
  • Take preventive/precautionary measures to reduce your chance of contracting an illness (and thus reducing the fear) in the first place

Hopefully those can help!

One last thing to offer though? This.

Perhaps medical student syndrome isn’t so bad after all.

Being anxious about a disease? Could make you more empathetic.

Better able to understand, serve and change the lives of your patients too.

Footnotes

[1] Hodges, Brian. (2004) Medical Student Bodies and the Pedagogy of Self-Reflection, Self-Assessment, and Self-Regulation, JCT Rochester (Journal of Curriculum Theorizing) 20(2)41.