Anxiety and Stress in Medical School
By: Samhita Nelamangala
I could not believe I had to show my face at rounds again. I was a fledgling third-year medical student rotating on my first week of Neurology, and it was NOT going so well. I had absolutely bombed a patient presentation the previous day, and things were not looking too promising for my next attempt. I had arrived at the hospital nearly an hour before rounds to prepare, but I still couldn’t figure out how to summarize my patient’s complex story in a succinct way. Even after studying the night before, I felt like I was struggling to answer questions about my patient’s rare pathology, and my care plan was still incomplete. It felt like I had one shot to make an impression, and I had sure made it – I was the nervous and underprepared medical student of my nightmares.
The rest of the week passed by, and I still could not shake the feeling of dread every time I walked into morning rounds. Why wasn’t I good at this? I got along well with my patients…but did that even matter? Did I even belong here? How did the other medical students make it seem so effortless? Normally I took pride in my resilience, but for some reason I just could not bounce back from this. Was I the only one struggling?
Medical school is stressful, and there’s no easy way around it. With endless amounts of content to learn and relearn; arduous board exams; and rapidly changing clinical duties to fulfill, the day-to-day can be exhausting. Now, add on family obligations, the uncertainty of COVID-19, maintaining some semblance of a social life, caring for pets, getting an occasional workout in, managing extracurriculars, doing research – all of a sudden you’ve got yourself an overflowing plate. Earlier on in medical school, I wish I had recognized that many of my classmates were experiencing the same stresses I was. Whether it was combatting impostor syndrome or struggling with time management, my peers and I were all trying to navigate many of the same challenges. But unfortunately, medical school can also be quite isolating. With so much material to cover at such a fast pace, it can be easy to seclude yourself and keep your nose to the grind.
Ah!!! So what’s a med student to do?
Reflecting back on my experiences, I wish I had done the following:
- Reached out earlier and more often to my peers to discuss how we were coping
- Used the sources of professional support my school provided (Deans, wellness representatives, counseling/psychological services, etc. )
- Recognized that most of my anxiety came from the amount of pressure I put on myself
I now recognize that if I am not feeling well in terms of my own mental health, there is no way I can be an effective learner or a helpful member of a care team. My sister always used to say to me when I would call her after a particularly challenging day, “If they expected you to know everything, you would be the attending! You are there to learn!” Once I finally embraced a learning mindset, I was able to handle the day-to-day challenges of being a medical student much more graciously.
So, how did my neurology rotation go? I decided to reach out to a close friend in the class ahead of me about my concerns. He suggested I chat with the residents on my team about my performance to see if they had any feedback for me. I mustered up all my confidence the next day and chatted with a senior resident who to my surprise said I was doing well (again, the pressure I felt was mostly internal!) I also confided in a physician mentor of mine who went the extra mile to validate my concerns and help me think of actionable steps I could take to prioritize my own mental health during my third year. While it definitely took some time for me to prioritize my own self-care, I eventually found a routine that allowed me to de-stress and therefore be the best student I could possibly be. It still takes effort to keep everything balanced, but I no longer shy away from seeking out support when I know I need it.
Medical school is an incredibly rewarding, yet incredibly difficult experience. You will face challenges; this is an unavoidable truth for all who wish to learn the art of medicine. You will be humbled by many of the experiences you face but with some grit, compassion for yourself, and hard work, you will come out stronger, smarter, and prepared to provide care for your patients.