Are you feeling overwhelmed by the demands of medical school, wondering how long are Shelf Exams, and struggling to manage the stress of it all? You're not alone. Discovering effective ways to address medical student burnout can be a game-changer in keeping you on track and maintaining your well-being. This article dives into the heart of this issue, offering insights and practical tips to help you navigate the challenges of medical school burnout. Dive in, and let's explore this together!
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Table of Contents
What Is Burnout?
Burnout is everyone’s business. It has reached epidemic levels, in some studies exceeding 50% of medical trainees or doctors in practice. It’s not exclusive to medical students and residents but workers in all industries.
The Feeling of Constant Exhaustion
Burnout is a form of exhaustion caused by constantly feeling swamped. It happens when we experience too much emotional, physical, and mental fatigue for too long. In many cases, burnout is related to one’s job. But burnout can also happen in other areas of your life and affect your health.
Stress vs. Burnout
Burnout can be caused by stress, but it's not the same. Stress results from too much mental and physical pressure and excessive demands on your time and energy. Burnout is about too little. Too little emotion, motivation, or care. Stress can overwhelm you, but burnout makes you feel depleted and used up.
From Productivity to Physical and Mental Health
The condition isn’t medically diagnosed. But burnout can affect your physical and mental health if you don’t acknowledge or treat it. Burnout keeps you from being productive. It makes you feel hopeless, cynical, and resentful. The effects of burnout can hurt your home, work, and social life. Long-term burnout can make you more vulnerable to colds and flu.
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5 Common Symptoms Of Medical School Burnout
These days, the term “burnout” is common in professions and workplaces worldwide. Some of the factors that can lead to burnout include high pressure, a lack of control, immense and chaotic workloads, and work-life imbalance. With the heavy workload, long hours, and high expectations that medical students face, it’s no wonder that 50% of students report signs of burnout during medical school.
Burnout can be defined as “a reaction to chronic stress that results in a sense of detachment, emotional exhaustion, and a decreased sense of accomplishment/productivity.” Burnout can have many symptoms. It can often be confused with stress or advance to depression. These are signs to look for if you or someone close to you is experiencing burnout:
1. Exhaustion
You may feel drained and unable to emotionally deal with problems around you, both school and personal. You may feel low and experience extreme tiredness, leaving you without energy. These symptoms can show up as physical pain and stomach (or bowel) problems.
2. Alienation from activities
Look out for signs of cynicism and frustration toward work and colleagues. You may start to distance yourself emotionally and feel numb about your work and environment.
3. Reduced performance
Burnout makes it hard to concentrate, handle responsibilities, or be creative at school which can drastically reduce your performance.
4. Mental burnout symptoms
You may feel self-doubt, helplessness, defeat, and failure. You may feel alone, lose your sense of purpose, and feel increasingly cynical, dissatisfied, and incapable.
5. Physical burnout symptoms
You may feel greatly fatigued and without energy. You may get sick often, have body aches and recurring headaches, lose your appetite, or experience insomnia.
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5 Main Causes Of Medical School Burnout
Several theories exist on what causes burnout, the most convincing of which is the Job Demands-Resources Model. In its simplest terms, the Model states that high job demands lead to exhaustion, and low resources lead to cynicism and feelings of low personal efficacy.
Chronic exposure to stress is the main risk factor for burnout. It’s no surprise, then, that medical students and residents in particular are subject to extraordinarily high rates of burnout. It’s common for medical trainees to be deprived of sleep, have a high workload, relatively low salaries, and several responsibilities in their workplace. Additional stressors include carrying the great responsibility for other people's health and dealing with sick people, people in pain, and their families.
Risk Factors for Burnout Among Residents
In a meta-analysis and systematic review by Rodrigues and colleagues, it was found that residents in surgery, like general surgery and ortho, and urgent specialties, like anesthesiology and OB/GYN, demonstrated significantly higher rates of burnout. Interestingly, single students are significantly more emotionally exhausted than classmates in relationships. This doesn’t mean to run out and get into a relationship pronto, but it does highlight the importance of social support in warding off burnout.
1. Increasing Competitiveness
One of the factors contributing to the rise in burnout rates over the past few decades is increasing competitiveness. Medical school has become significantly more competitive, with a significant rise in the number of applicants but not enough new positions in medical school to accommodate the increase. This has led to ever-increasing levels of stress among premed and medical students.
2. Modern Medicine & Technology
Dr. Atul Gawande wrote an excellent piece in The New Yorker about how technological changes in medicine have contributed to burnout. Technological changes in medicine have contributed to burnout. Increasing requirements for computer documentation are highly correlated with burnout, with neurosurgeons being less likely to be burned out than emergency physicians because they spend less time documenting. Decreasing physician autonomy is another major factor contributing to burnout.
3. Demanding Workload & Tight Schedules
The demanding workload and tight medical school schedules, especially during clinical years, are another significant factor causing burnout. Constant exams, clinical rotations, and the pressure to excel academically amplify the mental strain on students.
4. Difficult Patient Encounters
Difficult patient encounters can also contribute to burnout. Witnessing suffering and making life-altering decisions can lead to compassion fatigue and vicarious trauma. Dealing with adverse outcomes such as death, misdiagnosis, mistreatment, or patient harassment can take a toll on a student’s mental well-being.
5. Financial Stress
The financial stress of medical education adds an extra layer of stress. The burden of student loans and the fear of financial instability can weigh heavily on medical students’ minds, leading to increased levels of burnout. Students can often feel trapped by their loans and incorrectly believe that a high attending salary is the only way to pay off the staggering student debt.
9 Ways You Can Address Medical School Burnout
Medical students are our future physicians in training. If the burnout of school is not addressed, it can carry on to a physician’s professional career. A 2014 study found the training years for physicians result in the most burnout, leading to consequences as serious as suicidal ideation. Luckily, institutions are aware of the problem and many medical schools are stepping up to combat student burnout and distress as a whole.
1. Set realistic goals
Re-evaluate your expectations and set realistic, achievable goals. Recognize that no one is perfect, and asking for help when needed is perfectly acceptable. As more and more medical schools, particularly on the preclinical curriculum side of things, are transitioning to pass/fail, there is little need to strive for perfect scores on every test. As they say, P = MD (pass equals medical degree). I’m not saying do the bare minimum, I am simply saying you don’t need to be perfect.
2. Social Support
The most consistent finding throughout the scientific literature is social support reduces burnout. Women are better at this, seeking professional help for burnout on average 31% of the time compared to men at 24%.
My advice to you is two-fold: First, seek professional help if you believe you are burned out, depressed, or suicidal. Second, seek support from your friends, family, and colleagues. I suggest doing a shared activity where you can speak at ease and with relative privacy, such as during a hike, a relaxed sport, or grabbing a meal or coffee.
3. Sleep
Sleep duration is negatively correlated with burnout, meaning the more you sleep, the less likely you are to be burned out. According to the Chronobiology and Sleep Institute at the University of Pennsylvania, in the last two decades, scientists have discovered that sleeping well improves students’ ability to “learn, memorize, retain, recall, and use their knowledge to solve problems creatively.” Getting enough sleep and being well-rested is essential for preventing burnout. So, the next time you’re tempted to pull an all-nighter, just remember that you’re actually better off going to bed!
4. Take breaks
Taking breaks from learning and studying is vital to your well-being. No matter who you are, trying to function at 100% capacity all of the time will deplete your energy and cause burnout to take hold. So, make sure to take breaks. Scheduling them into your daily plan is a good way to make sure you actually take them.
During your breaks, try to do something just for yourself. Whether that’s going for a walk, sitting down with a book and a cup of tea, watching an episode of your favorite show, or whatever makes you feel good, do what you enjoy!
5. Exercise
A 2015 study by Peer J found that cardiovascular and resistance exercise increases “greater positive well-being and personal accomplishment, and concomitantly less psychological distress, perceived stress, and emotional exhaustion.” So, while it may feel like every minute is best spent studying, skipping exercise can ultimately contribute to burnout.
Incorporating regular exercise into your routine will have a positive effect on your efforts outside of exercise, such as studying. This way, you can keep going, achieve your goals, and feel good while doing it.
6. Find study strategies that work best for you
There are a lot of different study strategies and resources available for you to choose from. It’s important to remember that what works best for one med student may not work for you. Finding the strategy that suits you best is the key to efficient studying and preventing burnout. Feel free to explore new resources and ways of implementing them in a routine that works for you.
Whether it’s taking notes or creating flashcards with Otio, doing numerous passes of AMBOSS and UWorld, or watching videos you can, finding a study strategy that resonates with you is vital. It will mean better learning, fewer hours spent studying, and a greater sense of overall achievement.
7. Practice mindfulness
Practicing mindfulness is another great way to combat burnout. Studies have shown that a “mindfulness-based stress reduction program helped quell anxiety symptoms in people with generalized anxiety disorder.” Adopting mindfulness practice into your daily routine can help you focus on the present and make you more resilient during stressful periods.
Some apps that offer guided mindfulness meditations are Headspace, Calm and The Anxiety Solution. You can also find many guided meditation videos for free on YouTube.
8. Don't leave everything to the last minute
It’s easy to procrastinate when you see the amount of course material. I was recently studying the effects of different drugs for a clinical pharmacology exam. I had to learn the details of how a drug would act at the molecular level, how long it would act when it left the body, the necessary dosage, etc.
It felt like a lot of information that would be difficult to remember but instead of putting things off and studying last minute for an exam, losing sleep and putting more stress on my body, I’ve found that dividing the learning material into small, manageable parts and studying a little every day works best. Research suggests that the brain remembers the first 15-30 minutes of studying well, then it needs to relax. You can also apply various methods of information perception, like watching videos on YouTube or Coursera, as well as studying from text.
9. Find yourself a mentor
There are many ways you can find a mentor, but if you have someone in mind who you think you’ll be able to learn from, just ask. Your mentor can share useful literature and articles to aid your learning, and support you in taking the right steps towards my career.
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How Can Medical Schools Promote Medical Student Well-Being
Educate faculty
Educating faculty on the dimensions of distress such as burnout in medical students can help to identify and address the problem in its early stages. If faculty members understand the symptoms of distress and how to approach a student who seems to be experiencing them, students may be more apt to talk about their struggles.
Administer anonymous self-assessments
Offering an accurate and anonymous self-assessment to medical students can help to improve your school’s wellness initiatives. The Medical Student Well-Being Index is a validated nine-question assessment that offers participants custom resources based on their areas of need. Aggregated reports are then available to administrators to see how student well-being progresses over time.
Promote mindfulness
Taking moments in between study sessions and exams to focus on the present can help medical students fight anxiety. Mindfulness sessions help to realign thoughts and take very little time.
Encourage breathing exercises
Mindfulness and deep breathing exercises can go hand-in-hand. There are several meditation apps for mobile phones that remind the user to take a minute and focus on the breath. This can help students to relax before exams or when they’re feeling overwhelmed.
Push for balanced schedules
Medical students can feel so much pressure to continually study that they make little time to socialize or exercise. Having an integrated schedule of school, friends, family, and personal time can make all the difference.
Facilitate support groups
Positive relationships are a vital part of managing the stress that students encounter in medical school. Support groups can reduce feelings of isolation, remove the stigma associated with distress, and greatly improve the well-being of students.
Advocate for healthy diets
Students oftentimes do not have the time or the budget to prepare nutritious meals at home. Balanced meals should be available to students through meal plans or on-campus restaurants. Medical students fueling up on nutritious options will ultimately be happier, healthier, and more productive.
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• Medical Student Stress
• Med School Study Tools
• Best Resources For Medical Students
• End Of Rotation Exams
• Neurology Textbook
• Microbiology Books
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