Nicole N.
Photo provided by Nicole N.
If you’re reading this, remember that being a medical student or future physician is not your entire life or identity.
It is an important part of who you are—one that you value deeply and will dedicate a significant amount of time and energy to—but you are so much more than your career. Never lose sight of yourself, your friendships, your family, and the parts of your life that exist outside of medicine.
When you enter your first year of medical school, it is very easy to forget what life felt like before you began. Now, as I work through my psychiatry Sub-Is, I honestly struggle to remember a time when I was not working toward the goal of becoming a physician. Medical school has changed me and shaped me in ways I am incredibly grateful for, but it has also taken a lot of trial and error and self-reflection to get to a place where I feel I can balance the field I love with the life I love outside of school and my career. Talking about medicine, connecting with friends and colleagues through shared experiences, and even becoming a mentor can be incredibly fulfilling.
At the same time, I urge you to keep strong roots in hobbies, friendships, and family relationships that exist outside of medicine. Medicine can become something you eat, sleep, and breathe, and that kind of enmeshment between career and identity can contribute to burnout. For me, some of the most grounding parts of life have been spending time with friends in moments where we do not talk about school or career plans, practicing yoga and meditation, baking and cooking, exploring new cuisines, traveling, and experiencing new places and cultures. I recently had a conversation with one of my psychiatry attendings who reminded me that human communication was never meant to revolve around sitting at desks or spending our lives within the walls of buildings. We communicate to understand one another, share emotions, connect, and experience life together. Our lives may look very different now, but I think it is important to remember that we are not our work and our lives extend far beyond our career aspirations. Keep your love of medicine, but equally protect your love of life outside of medicine.
If you’re reading this, go touch grass. Sit outside and take in the world around you. Let the sunlight hit your face and remember that you are more than your grades on an exam, your performance in a simulated patient encounter, or the number of hours you spent studying this week. Being a medical student or future physician is an important part of who you are, but it is not the entirety of who you are.
Nicole N., Fourth Year Medical Student
Q: Have you ever sought professional help or counseling for mental health support during your time in medical school? If so, how did it impact your overall well-being?
A: One thing I have realized throughout my medical training is that no one is immune to stress. People respond to it, react to it, and cope with it in completely different ways. Even if you are at the top of your class and excelling academically, there are still aspects of medical school that can place a significant strain on your mental health.
Before starting medical school, I felt like I had my mental health pretty well figured out. I had struggled with significant anxiety throughout childhood and young adulthood, but over the years I had developed healthy coping strategies that helped me work through difficult periods and eventually find my way back to a comfortable baseline. Medical school, however, presented more challenges at once than I had anticipated. I was 20 years old, moving away from home for the first time and living somewhere completely unfamiliar without my usual support system. I was navigating a new relationship, experiencing a Kansas City winter after growing up in South Florida, studying constantly, and trying to absorb a volume and complexity of information unlike anything I had encountered before. Eventually, toward the end of my first winter, everything seemed to catch up with me. I felt overwhelmed in a way I had never experienced before, and I realized that I needed support from someone outside of my family and friends.
For the first time in my life, I started therapy through my medical school. I expected therapy to immediately make things easier, but initially, it was challenging in ways I had not anticipated. Some sessions were incredibly emotional, and I would leave a morning appointment feeling drained and unable to focus on studying for an upcoming exam. That would create even more anxiety because I would find myself thinking, “I do not have time to deal with my mental health right now. I need to study.” Taking care of myself began to feel like another responsibility competing for time in a schedule that already felt impossible. Because I had never been to therapy before, I was also trying to understand the process while simultaneously working through everything I was experiencing. At times, an hour did not feel like enough time to explain everything that had happened since my previous appointment. In medical school, two weeks can feel like two lifetimes, and I often felt as though I was spending the entire session simply trying to catch my therapist up on what had happened.
I share this because therapy was not an instantaneous solution for me, and there were times when beginning that process while already overwhelmed felt more difficult before it felt helpful. What the experience ultimately taught me, however, is something I wish I had understood before starting medical school: the best time to find a therapist may actually be when you are doing well.
If I could give one piece of advice to students preparing for medical school or currently in their preclinical years, it would be to consider establishing that relationship early. Finding the right therapist can take time. Different personalities and therapeutic styles work for different people, and it is much easier to explore those options before you are in the middle of an especially difficult period. Entering medical school with an established relationship and a strong foundation for taking care of your mental health can be incredibly valuable. Then, if the overwhelming moments do come, you are not starting from square one. You already have a trusted professional who understands you, knows some of your history, and can help you navigate the challenges ahead.
Q: How do you envision incorporating self-care practices and prioritizing mental wellness into your future medical career?
A: This is something I think about often, and it was an important consideration when deciding what specialty would best fit the life I want for myself in the future. Yoga became a meaningful part of my routine during my first few months of medical school, when two yoga-certified students on campus began leading weekly classes. I had practiced yoga occasionally before, but medical school was when I began to appreciate how helpful it could be for stress relief, meditation, and recentering. Since then, I have become more consistent with my practice, and one of my future goals is to complete yoga teacher training so I can deepen that practice and eventually share it with others. I see yoga as something I can continue carrying with me throughout my career as a way to protect my own well-being and maintain balance during stressful periods.
Another thing that has been incredibly important to me is continuing to say yes to the people and experiences that bring me joy, even when life feels overwhelming. It can seem counterintuitive to step away from studying or work when you already feel behind, but I found that isolating myself and trying to “lock in” often left me feeling more exhausted and lonely. Instead, if a friend or family member suggested dinner, a workout class, or an evening walk, I tried to say yes. I almost always came away feeling refreshed and better able to handle the rest of the week. Spending time with people I love feels like recharging my battery, and learning to make space for that even during the busiest seasons of medical school has been one of the most important ways I have maintained my mental wellness.
I have also learned that not everything in your life has to fit neatly into the identity of being a physician. During medical school, it can sometimes feel like every interest, activity, or use of your time needs to be productive, professional, or somehow connected to healthcare. But physicians are also simply people trying to build lives that make them happy and fulfilled. Recently, I have gotten more interested in electronic music and discovering new artists, and I want to continue finding new hobbies and experiences throughout my career simply because I enjoy them. I hope to keep reminding myself that not everything I do has to fit into a professional box. Making time for the things that genuinely make me happy will ultimately help me become a more grounded person and, in turn, a better physician.
Q: What do you wish other people knew about the stressors of medical school/medical training?
A: I wish more people understood that it is not just the medical training itself that makes medical school difficult. The coursework is rigorous, but for most students, the challenge is not simply whether they are capable of learning the material. It is having to meet the demands of medical school while continuing to navigate everything else that happens in life, often with very little room to step away, slow down, or fall behind.
Over four years, I watched friends navigate some of life’s biggest and most time-consuming experiences while simultaneously trying to become physicians. People got married, had children, started new relationships, lost loved ones, dealt with family problems, and experienced countless other changes that had nothing to do with medicine. Whether you are in an easier block or studying for one of the most important exams of your life, everything outside of school continues moving.
Medical school requires a deep commitment to learning an enormous amount of information so that one day you can safely care for patients and, at times, help save their lives. At the same time, you are still responsible for maintaining your own life and making sure the other pieces of it do not slowly fall apart.
I think that is the part many premedical students do not fully appreciate. Most medical students are not struggling simply because learning medicine is “too hard.” It is studying for a board exam for nine hours a day during the summer while everyone on social media seems to be traveling through Italy or taking a cross-country road trip. It is missing events, weekends, and time with people you love. It is learning how to make room for your relationships, your family, your health, and the hobbies that make you feel like yourself while still giving an enormous amount of your time and energy to medicine. It is the sacrifice of time away from the things you love in order to pursue a career you love. All of it is manageable, but the adjustment is enormous, and it took time for me to learn how to balance the demands of medicine with the parts of life that mattered just as much.
Several studies have revealed that medical students, physicians, and healthcare professionals experience mental health symptoms at rates significantly higher than the general population. Stethos[Cope] is a chapter of IfYoureReadingThis designed to help medical students and professionals cope with the unique stressors of medical training and change the narrative of mental health in medicine.
To read more letters and interviews from students, and to learn more about mental health in the medical community, visit the Stethos[Cope] home page.