Lessons in Wellbeing from Medical School

Dear Reader,

I am honoured and humbled by this opportunity to share some of my experiences and reflections from my medical school journey. As a current TI, I like to think that I am slightly wiser than I was as a preclinical student. I hope that my stories will be something that can provide you with some guidance and something to relate to!

 

  1. Disillusionment and Competition
  2. Clinical Crying
  3. Where I’ve found support

 

1) Disillusionment and Competition

In my preclinical years, I felt disillusioned with medical school and I was disappointed by the ‘competitive atmosphere’.

The ‘competitive atmosphere’ I refer to is a subtle thing. I see it as an aura or ooze that some medical students seem to radiate. You can see it whenever medical students congregate. They seem to engage in a game of one-upmanship where they brag about something in the form of a complaint. For example, “I am so bad at musculo… all I know is that X, Y and Z” (where X, Y and Z are super specific things that I have never heard of) or “I am the worst at cranial nerve exams. I always forget to test for A or B” (where A and B are weird things with eponymous names that I am only now hearing for the first time). In my experience, being in those environments make me feel anxious and less sure of myself.

Advice current me would give to past me:

“Men are born for the sake of each other. So either teach or tolerate”
        -Meditations by Marcus Aurelius

A close personal friend of mine shared this quote with me and it has helped me frame the way I view ‘difficult’ people.

If people are behaving in a way that affects you negatively, you have a choice. If you do not do something about it then you are choosing to put up with it. Doing something can take lots of forms – speaking to the students directly, choosing to spend time with other people or embracing this culture by changing my own thinking.

I found choosing to spend time with other people to be my best solution. I believe that we end up like the people we choose to surround ourselves with. And I am happy to say that through medical school I made some amazing friends that have (metaphorically and hopefully not literally) big hearts.

Embracing the way others operate to change my own thinking is not as complicated as it sounds. All I had to do was to put myself in their shoes and try to understand where they might be coming from. For example, I guess if I had spent the night reading about XYZ I would feel the urge to share that with other people. What’s wrong with that? And can I really blame them for how I feel about it? Majority of people out there do not purposely try to make others feel miserable. Chances are they are not even aware of how I felt.

Lastly, speaking to other students about my concerns and the way I feel around them is something I was not brave enough to do. On reflection (4 years wiser than I was at the time!), I believe that if I approached someone and told them ‘hey, I don’t know if you are aware, but when you do this it makes me feel this’ that would have led to one of those human connection moments that only come from positions of vulnerability.

 

2) Clinical Crying

“I give myself a good cry if I need it, but then I concentrate on all good things still in my life.”
        -Tuesdays with Morrie by Mitch Albom

This quote is from a book that many of my role models adore. It reminds me to not be afraid to embrace my emotions and also to keep focused on the many good things that are in our lives.

So, your consultant marked you as ‘some reservations’ in the clinical knowledge part of the Clinical Supervisor Report? What can you do?

  • a) Do not panic. You are a student. This is your time to learn! You can leave the ‘knowing everything’ act for when you are a doctor. This is a perfect opportunity for you to work on yourself and grow your knowledge.

 

  • b) Be kind to yourself. No matter how or why you ended up on the wrong end of a CSR – you deserve some kindness. Beating yourself up will not be helpful. Try a self-compassion meditation. A simple and easy one I use is taken from ‘The mindful path to self-compassion’ by Christopher Germer:
    • May I be safe
    • May I be happy
    • May I be healthy
    • May I live with ease

      Relax. Take a few deep breaths and just repeat those phrases to yourself. I don’t know how but something about saying those words makes them come true. Either that or I’ve finally lost it!

  • c) Do not compare yourself to others. Someone will be smarter than me. Someone will know more causes of hypokalaemia than I do. Someone will be better at finding the patient notes on the ward than I am. Someone will pick up on the soft ejection systolic murmur that I missed. I do not find those comparisons helpful.
    The comparison I would recommend: ‘Is today’s me better than yesterday’s me?
    This is something I have control over. This is something that my actions today will help me achieve tomorrow.

 

  • d) It is ok to take a ‘mental health day’. To me, a mental health day is when for whatever reason (feeling low, feeling anxious, feeling overwhelmed) I think it would be better if I stayed home that day. Usually it is because I am not in a good state of mind to learn. You can tell your team that you are feeling unwell or you can openly tell them it is a mental health day. In my experience most people are accepting of this.

 

  • e) Talk to the clinical education fellows about practical steps you can take to get better. That is literally part of their job. Helping students like me and you!

 

What study resources did I find helpful?

    • Medicine at a Glance. Good textbook with easy-to-read 2-page summaries
    • OSCE book. Newest form is ‘Essential Examination’ by Alasdair KB Ruthven. If you are stuck in a tight spot, armed with this book + 30 mins for each exam you need to learn + someone to practice on you can achieve a lot!
    • Talk to some students in the year above you/some friendly HOs. They are the ones who will know which resources are best. Also, there are frequently sets of notes that get passed around electronically among the class (eg long case notes or past O&G osce stations) so make sure you stay in the loop.

 

3) Where I’ve Found Support

“How could the end be happy? How could the world go back to the way it was when so much bad had happened? But in the end, it’s only a passing thing… this shadow. Even darkness must pass.”
        -Samwise Gamgee in The Two Towers by JRR Tolkien

This is a quote from one of my favourite, and in my opinion grossly underrated, fictional characters. It helps me maintain my resilience when times are tough and I feel like I’ve embarked on an impossible mission.

Where to find support/how to maintain resilience:

  • Your friends. This might be a guy thing, but whenever I am with my friends, a large majority of our interaction is some form of joke or banter. I was moved to tears by the tidal wave of compassion and support hiding under the surface of ‘what’s up?’. I believe that people are inherently kind, and we are born with an inner desire to alleviate suffering in others. I regret that it took me so long, and that I let things get so bad, before finding the courage to turn to my friends.
    Everyone goes through hard times and I would not be surprised to hear that many people have stories similar to mine in their family. I found that many of my friends had their own insights to share and were willing to do things for me that I considered way above and beyond. For example, ‘don’t worry about it, I’ll bring you guys dinner for the next 3 days. I love cooking anyway’ and ‘just go home if you need to. I’ll take good notes and go through the lab with you later’. Honestly, I feel so lucky to have friends willing to do so much for me and as much help as I give to others that are struggling – I feel as if I am not even close to paying forward the kindness shown to me.

 

  • Your friends. I feel this is worth stating twice! If the first person you turn to is busy/does not understand/will not help, then find another! Do not give up because you are worth it and no matter what you may think, you WILL talk to someone that makes the difference to you.

 

  • University Health and Counselling services. This is a free service to students and they can actually be quite flexible around appointment times. I remember having trouble focussing on study and feeling anxious in hospital in my 5th year of medical school and speaking to someone from counselling services about it. They were able to accommodate for my clinical schedule (we met Tuesday afternoons at 3pm. This meant I did not even have to get permission to leave early since I was usually done by then anyway). I went in feeling a bit silly for talking to someone about my own issues that I felt like I should be capable of dealing with by myself. I left feeling empowered because I had a plan for how to tackle my problems.

 

  • University staff members.  I can say that based on my own experiences they always made me feel like they truly cared about students, they had many insightful personal stories and were very good listeners.  

 

  • Telephone services. If you are having some kind of acute meltdown, and are having difficulty finding someone to talk to, there are a number of telephone services that are available at any time like 0800 LIFELINE

 

Take home message is: life can be tough, everyone struggles with things from time to time, it is OK to ask for help. One of the warmest memories I have with a med student was when I told him I was worried about going to a mutual friend’s birthday because I had just found out that I would be repeating a year and did not know how people would react around me. He said ‘I might not understand exactly what you’ve gone through, but we know who you are and no one is going to think any less of you because you have had some hardships’

 

THE END!

Thank you for reading. And remember to be kind to one another! We are not doctors yet – but you don’t need to be a doctor to care ☺

Feedback and comments for the writer can be directed to kkaw096@aucklanduni.ac.nz