Plan Ahead to Reduce Medical School Stress

Make sure to fill prescriptions and get a referral before starting medical school to stay healthy.

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Future doctors should plan ahead to make sure they stay healthy during what can be a stressful and busy medical school program.
Future doctors should plan ahead to make sure they stay healthy during what can be a stressful and busy medical school program.

Medical students are generally optimistic, goal-oriented and confident. While these traits can bring great success, they also may hinder realistic planning.

Medical students need to make time during their rigorous studies to focus on their own health, and not just the health of their current and future patients. Many of these future doctors frequently do not take the steps needed to ensure they are physically and mentally healthy, but there are some simple and important steps they can take to make sure they stay strong during medical school

[Learn to smarten up about medical school success.] 

Dedication to a medical career is not enough to protect against the intense stress of medical school. Students who have tripped at some point in the past are those who need to plan ahead. If you have ever been recommended for counseling, psychotherapy or any kind of medical treatment for emotional concerns, please consider this carefully as you enter medical school. 

Rather than trying to hide these experiences, seek out support services at your new medical school. Even if you believe that your symptoms will never return, most medical school deans can provide examples of students for whom they did. The wise student will get the name of a good professional and contact them before needing help. 

If you currently are on medication, please ask your provider to refer you so that you won't have a lapse in refills. 

One student asked during orientation week how she could get refills for her attention deficit hyperactivity disorder medication. A letter from her physician summarized her care and offered to help in the transfer of care. There was no gap in her medication, and her concentration allowed her to proceed successfully. 

Keep in mind getting an appointment may take time. Another student was naive in thinking that any physician would write him a prescription for his psychostimulant. In Ohio, psychostimulants must be prescribed every month and not called in by telephone or prescribed for extensive periods. This student allowed his prescription to run out before requesting a refill. 

No physician would do that without an appropriate evaluation. His new physician noted the student had not had appropriate testing in the past and had an additional diagnosis. That student struggled for months because he had not accepted responsibility for preparing in advance. 

[Consider ways to balance personal life and medical school.] 

Eating disorders are another frequent concern. Students often believe that, although they struggled in high school or college, they have permanently conquered the problem. Stress, however, has an impact. 

When everything else in life seems out of control, an eating disorder can re-enter to take control. It may take time to acknowledge the problem, and classmates and faculty are often swirling in their own issues and may not identify a student in denial. A care plan can take time to arrange, and if the student isn't treated quickly, he or she may lose ground. 

Major depression and bipolar disorders can stop academic progress or cause the student to drop out. Even a panic disorder, left untreated, can cause students to fall behind. 

These illnesses can shatter students' confidence. Students may lose their concentration and watch their performance slide. A student who requests a transfer of care from their home physician to a new one is proactive and can avoid negative consequences. 

A sneakier problem is seasonal affective disorder. Students who have grown up in sunny areas and attend medical school in a northern latitude with fewer hours of winter sunlight and frequent gray skies can experience seasonal affective disorder. 

In Cleveland, we offer presentations on seasonal affective disorder and light box therapy so students can continue the conversation with their own primary care physician. Once students learn how to manage this condition by sitting with a light box in the morning, they function well. 

[See how medical schools are fighting against student fatigue.] 

I can recall multiple students who became depressed when they were no longer able to follow their former athletic or workout discipline. The solution is to be creative. 

Instead of running outdoors, some run on a treadmill or swim laps in the pool. One of my students ran up and down the back stairways of the hospital during clerkship rotations when free time was nearly nonexistent. 

Lastly, a healthy diet, solid sleep and exercise are your prescription for good health. Don't be vulnerable to fast food. We are currently planning new demonstration kitchens for our medical school that will teach students how to prepare healthy foods quickly. 

If you're serious about medical school, you must take steps toward preventive medicine, just as you will advise your future patients. We now have treatments for brain disorders that, in the past, often kept people from starting or completing medical school. 

Help push back against the stigma of mental illness, applaud those who get care when they need it and attempt to live a healthy lifestyle, physically and mentally. 

Kathleen Franco, M.D., is associate dean of admissions and student affairs at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. She previously served both as director of residency training and director of medical student training in psychiatry at Cleveland Clinic. She is board-certified in psychiatry, geriatric psychiatry and psychosomatic medicine and attended Medical College of Ohio – Toledo.