Recently, I was able to talk to a Yale medical student, Prerak Juthani, on the Common Sense Medicine podcast, and we were able to talk about topics which get left out of the conversation when talking about medical school students’ mental health. The stigma attached to mental health has become less overt in society, with people trying to be more accepting of people who have anxiety and depression. These disorders once considered “fringe”, are now recognized in many Americans—and by extension many medical students. However, as I reflected on our conversation, I realized that the conversation, now, although it is in the open, is subtly attacked by the biases that many people feel towards people who are candid about their mental health issues. Not only do these biases unconsciously label them as “weak,” they also may get passed over for promotions or awards because they are not “diligent” enough or “disciplined.” Mental health issues are very real and deserve to be treated as an illness just like how we treat chronic diseases that many people have in daily life.
Another topic that we talked about on the podcast that I wanted to highlight was that many medical students come in resilient but leave jaded and on the verge of burnout as they start their residency. This is purely speculation, but I have three ideas of why this may be happening:
- Sleep Deprivation – It’s no secret that medical school is hard. Studying is your main job, and people joke that they will “sleep when they’re dead.” However, it’s something that affects our mood, our nutrition, and our physiology more than we know. There’s a reason why it has been conserved evolutionarily across different species. Getting enough sleep, and the right quality of sleep, is very important.
- FOMO and Cmparison – There’s a cost associated with medical school, both financially and socially. However, social media is exacerbating this feeling of FOMO (Fear of Missing Out) and comparison hundred-fold because it encourages medical students to compare themselves to those who are outside of medical school and with their peers who are launching successful clubs, publishing research, and doing things around them that they feel they cannot do.
- Lack of Self-Care and other hobbies outside of medicine – Self-care culture, to me, treads a fine line between being a real issue and being a bunch of malarkey. However, it is important to take some time for self-reflection before bedtime or after a major life upset because constant reflection is the hallmark of self-improvement. Without the wherewithal of a proper purpose, it’s hard to avoid feeling burnout. It’s easy to get caught up in medicine and studying, but cultivating the hobbies outside of medicine is an important “side project” to continue to avoid feeling like it’s pointless to keep studying.
I think that the reason that we don’t give cultivating good mental health the proper respect that it’s due is because we are very clueless about what it entails. What exactly defines “good” mental health? How can we properly define a routine that helps us cultivate resilience rather than encourage burnout? Prerak mentioned that he likes to find something outside of medicine, basketball, which keeps him happy and encourages him to pursue accomplishments that are not related merely to grades and in a clinical aspect. There are studies which show the power of routines in our life – habits are what make our lives better or worse over time. It is the small habits which define how we instinctually act whenever there is a catastrophe in our lives.
One of the things that I recommend that we should all do is make time for the routines in life, whether that be writing in a journal, making 5 minutes to cultivate gratitude, or even in our relationships by making time to talk to someone that you haven’t been in touch with recently. It’s easy to dismiss mental health as for the “weak” but in fact it actually is proven to help you study better and more efficiently, and in medical school, that is the name of the game. Carving out a routine for mental health can pay dividends when you have to apply to medical school or residency. It can also help counter the sleep deprivation, FOMO, and lack of self-care that most medical students and even pre-meds feel when they are going through their classes.
Advice is easier said than done, and I want to reiterate that this doesn’t happen after one day. It’s a process. As for me, I’m still beginning my journey on this process, as I wasn’t even aware of the harmful effects of sleep until I listened to a podcast by Peter Attia and Matthew Walker, a sleep scientist and the director for the Center for Human Sleep Studies at UC Berkeley. It’s amazing to see that we are capable of change, and the brain, the organ that we are only beginning to understand some facets of, is able to change at a moment’s notice and is able to permanently alter its existence after only a few minutes of reading some article on the internet. So what are you waiting for? Take mental health into your own hands, and establish a routine today. Your future self will thank you.