How to Deal with Stress in Medical School

Medical students across the country have to navigate the ups, downs and long hours of the rewarding but high-demand nature of training to become a physician. In some cases, a rigorous school schedule and other demands can sometimes take a toll on medical students’ mental health.

Nearly 30 percent of medical students suffer from depression or have symptoms of depression, according to a 2016 analysis in the Journal of the American Medical Association that reviewed several studies involving more than 129,000 medical students across 47 countries. That’s significantly higher than the 9 percent of the general population of 18- to 25-year-olds nationally that suffers from depression, according to the National Institute of Mental Health.

Common stressors

Stress can stem from a variety of sources, but often at the forefront for medical students is the pressure to succeed in school and keep up with classmates. Medical students are high achievers who are accustomed to being one of the best-performing students in school, but in medical school not everyone can be at the top of the class anymore. That is stressful in itself.

Some other common sources of medical school stress include the following:

• Financial issues, particularly debt from student loans
• Lack of sleep due to time spent studying
• Limited time for relaxation
• Relationship demands from family, friends and significant others
• Learning to navigate patient interactions and how to deliver bad news

And then there’s preparing for the United States Medical Licensing Examination, choosing a specialty and landing a residency, all of which can be life-changing milestones. The residency process decides where students will spend the three to five years of their lives training for a specialty after graduating from medical school.

When does medical school stress cross the line?

Nobody’s day is completely stress-free, but too much of it can interfere with a student’s ability to stay focused on school work. The following are some signs that a student may be overextended:

• Anxiety
• Depression
• Binge eating
• Binge watching TV
• Excessive alcohol use
• Using performance enhancement drugs, particularly stimulant medications
• Isolation
• Trouble sleeping

If stress becomes overwhelming, students are advised to reach out to a professional for support. There may be counseling resources on campus that make it convenient for them to get the help they need while limiting costs and travel time.

Since medical students are training to take care of others, they may believe seeking help would make them unfit to be a physician. But everyone gets overwhelmed and experiences a dip in mood or an increase in anxiety. Medical students need to manage their own mental health so they can be in the best position to provide help to others.

Dealing with stress in medical school

There are plenty of easy, healthy and fun ways to deal with stress in medical school. Exercise can be an excellent way to decompress, and some schools may have fitness centers or classes on campus.

Combining exercise with healthy sleep and eating habits goes a long way in dealing with stress in medical school. Starting with that healthy baseline will put students in a much better place if stress becomes intense.

Maintaining a strong support network and taking time to socialize are also crucial. Students are encouraged to cultivate meaningful relationships, whether it’s with a classmate, family member or a workout buddy, especially while they're going through difficult periods of education and training.

Participating in a study group, student organization, volunteer work or recreation time away from school are all good ways to stay connected and de-stress. “Give yourself permission to have a life that isn't medical school — to have a family life, to have a leisure life,” says Jay Behel, PhD, associate dean of student affairs at Rush Medical College.

No need to stress about all stress

A small measure of stress is realistic and is often helpful when training to become a physician. A healthy amount of stress can keep students engaged at an optimal level, sharpening their attention and allowing them to perform their best on tests and in the clinic.

This type of stress can include a student’s inner desire to be their best self, prodding from nurturing faculty or the pressure that comes with making decisions that will have an effect on someone’s health.

“Some pressure to perform is absolutely necessary, because they’re going to be doctors who are going to be in operating rooms and emergency rooms, and they’re going to make a lot of high stakes decisions,” says Elizabeth Baker, MD, MHPE, senior associate dean of education at Rush Medical College. “So they have to be the kind of individuals who are resilient and can deal with stressful situations.”

It’s the unnecessary stress that can be problematic — when students push themselves beyond their limits.

“I will hold myself to a higher level if I’m working with an attending physician who expects more of me. That motivates you,” says Emily Kelly, a fourth-year student at Rush Medical College. “But you also want to compartmentalize — leave that in the clinic or the classroom so you’re not taking that stress home with you. Managing that balance helps create physicians who are healthy personally and professionally. It helps us provide the best possible care to our patients, which is why we’re all going through the training in the first place.”