Squeeze the Sponge: Wring Out the Stress of Clinicals
Three days ago, I thought about posting “I am dropping out of Medical School,” as an April fool’s joke. But, not going to lie, I was a little worried too many people would have taken it seriously. It’s been a tough time! God, I’m so sick of saying it’s been a tough few years on everybody in medicine, but I feel I may need to mention it again with a lot of life back to normal. What I think is easy for those outside of the medical field to remember is that there has been no working from home for physicians. For the better part of two years, physicians have been stretched thinner than in their entire careers. What I think is easy for people to forget though, is the trickle-down of stress. An attending starts a new shift after just being on call, the third time this week. Maybe they need their residents to pick up extra patients because of it, residents already running on empty. And because of that, maybe the Med students on rotation are overlooked. Or worse, mistreated.
Look, I’m not at all comparing the plight of the med student to that of the physician. But somebody’s got to speak up for them, and as one myself, I feel it’s important to say the stressors of a hospital workforce are not isolated to just those on staff. As a medical student, once you begin rotations, you are expected to maintain a similar schedule to your residents or attendings, and learn in the moment aspects of medicine you’ve never been exposed to in your previous two years, all the while finding time off-shift to study for boards. You now have the full-time job of a student combined with the full-time schedule of an employed physician. So, being able to take in any additional stress from the team you’re on is not accomplished by the faint of heart. You’re a dripping wet sponge, and somehow, you’re expected to soak up the entire sink.
So, what’s a poor little med student to do? Find a magic lamp? Stage a coup? Write a strongly worded letter to Tom Brady asking for a favor to visit your unit and brighten spirits and maybe toss around after work and ultimately become best friends? Sure, all valid and equally plausible strategies. But, if you’re looking for something a little more low-key and cost-effective, consider trying some of these out:
It's time to change…how you study
I’ve mentioned before just how different med school is from college. But a major change many students face is the need to toss aside the study habits they’ve grown so used to. This can be exceptionally uncomfortable, as often these habits helped you thrive the first two years (or even got you into medical school in the first place). But the pace of rotations is a completely different race than the pace of pre-clerkship. Quite simply, you have less time to study under wonky hours. Gone are the days of a routine schedule of lectures followed by structured study blocks at your leisure. Biggest advice: be adaptable. Let yourself be ok with turning in a study hour for a few practice problems here, a few there over the course of the day. Before where you might have preferred reading material, making hand-crafted notes, and re-reading those to lock down info, allow yourself to be uncomfortable with minimal notetaking (or even none at all). It’s ok! You’re not learning less, I promise. Cut yourself a break and breathe. Let yourself become enthralled by the real-life learning of the wards, and take every patient you meet and make effort to apply them to a disease or concept. This will go miles for keeping up with the pace, and not have you scrambling to keep up with the time-consuming study ways of the past. You’re transitioning into real-life medicine, finally. Start practicing real-life learning.
Exercise doesn’t have to be at the gym, but it has to be present
Make the world your gym. Your apartment is now a yoga studio. Make a quick change out of your scrubs and extend the walk to your car to a quick run around the area. People say exercise is one of the first things to go when starting med school because students are fighting for time. If that’s true then, it’s exceptionally true in clinicals. You might not have time to stick with the old routine of driving back and forth from a gym every day. 30 minutes. Every day, even if it’s 15 in the morning and 15 before bed. I promise you the days you can’t do anything active are the days where the ward stress feels the heaviest. Be creative, be ready to take the opportunities when they are presented to you, and try something new to keep moving. Your brain will thank you for it later.
Spring Cleaning…your brain and heart
It’s time to get rid of the unwanted weight. If you’ve gotten this far in your pursuit of medicine, I’m willing to bet it’s because you are an incredibly intelligent and capable individual with a history of “taking on too much,” as others lovingly put. You’ve thrived off taking the extra step, going the extra mile in being involved in extracurriculars, being an early research hound, or leading projects in your limited free time. I’m here to tell you I am incredibly proud of you for putting in that effort. I’m also here to say: Pick. Your. Battles. It is not weak or “going easy” to lighten your load in clinicals. In reality, think of clinicals as taking on 4 extra (insert type A medical student interests here). Pick the project you feel most passionate about. Keep leading the club that you’ve given the most time to. The rest, allow yourself to allow someone else to take the reins. Let a first-year get their chance. It’s ok to take a step back from the things furthest from your heart. Residencies aren’t going to fault you for it. Clinicals are your full-time job, so treat them that way and (maybe for the first time in your life) be ok with saying “I can’t do everything.” Medicine will continue to get more complicated, so it’s good practice now to learn how to say no. I promise you’ll feel better for it.
I could take this last one a step further and apply to people, but I don’t want the message to solely be cut out those bringing you down. I want you to hear, “Keep those close to you that lift you up.” Focus your limited time and energy on maintaining the relationships with those who help you get through the day. Who actively take away that stress and anxiety you may feel and give you the jolt to keep running. It’s impossible to go through clinicals alone. I know the stress of being dropped in can be crippling. You may find you don’t have the time to keep up with everyone in the same way you used to. That’s fine, that’s life. But whatever you do, don’t kid yourself by trying to be a robot through all of this. It’s kind of beautiful in a way, when your time becomes so limited it has a way of showing you what people you couldn’t live without. When the anxiety rises too high, tell them. I promise they’ll want to be there for you, the same way you would for them.
If you had to take away anything from this, please don’t hear me saying clinicals are a nightmare. I want you to take away that it’s ok to be human. Sure, clinicals are difficult, but they’re incredible. Finally, for the first time since you decided you wanted to apply to med school, you’re there. In the trenches. You’re seeing patients and working alongside the people you’ve been waiting to become. It’s wonderful. But it’s also stressful, and I know from first-hand experience just how that stress and anxiety can build. Give your brain a break and go for a 20-minute run. Don’t worry yourself with making study guides, let your patients be those guides. And above all, don’t go through this thinking you’re alone. You’re not.
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