High stakes, sleep deprivation, and stress are almost pathognomonic for med school. Brief bouts of burnout aren’t pathologic, but a normal response to our abnormal environment. Normal doesn’t imply healthy, which is why it is so important to cultivate our coping skills well in advance of burning out.
Almost every resource for avoiding burnout focuses on promoting adequate self-care. While physical health is necessary, it is far from sufficient if your goal is to thrive throughout the rigors of med school. The real key to maintaining a positive relationship with school is fostering what I call habits of the heart. These habits aren’t as tangible as sleep and can’t be monitored with any iPhone app, but they are essential for performing better and living happier now and in the future.
The absolute core is finding meaning in what we do. Whenever I struggle with this, I pull out my personal statement and re-imagine myself as the idealist from my med school application. Remember how lucky we felt to get that acceptance letter in the mail? Remember the applicants who weren’t accepted at all? This search for meaning feeds into the second heart habit of maintaining perspective. The point of maintaining a bigger perspective isn’t to feel guilt that we are stressed, but to maintain a sense of humor despite our justifiable stress. Three days ago I was feeling particularly harried while cramming for a respiratory final exam. I will admit that I was feeling a little sorry for myself as I logged into a practice question bank. The opening line of the first question stem was like plunging into a frozen perspective pond. It said “A homeless man was found dead in an alley.”
I took that moment of perspective to practice gratitude for how lucky I am. No matter what struggles someone has had to overcome to get here, it is fair to say that if you are in med school, you have something to be grateful for. As a general method for cultivating gratitude, I recommend naming specific things you are thankful for every day. Limit yourself to listing three things, though, because you don’t want to feel bad for failing to effortlessly list 20 things to be thankful for. Even one is enough.
The key to avoiding academic burnout is maintaining curiosity. There aren’t enough gold stars in the universe to bribe me into retaining something I don’t want to learn. Thus, there is nothing as vital as an authentic curiosity to keep up the drive to study. Similarly, self-improvement can’t come from outside of one’s self. Even MDs have to stay intentional about becoming better human beings, and by doing so we can achieve professional goals without having to sacrifice our better natures.
I want to at least pay homage to a few of the classic anti-burnout tips. Firstly, optimizing learning habits can minimize the time commitment to master our classes. Never stop becoming a better student. Secondly, remember that we are animals, not brains in buckets. Be a good animal and take care of that body of yours. Don’t eat crap. We all basically know what crap is. Everything in moderation is bad advice when it comes to what we put in our bodies. Exercise every day. We are lugging around these big chemical factories and every day we decide to either make growth chemicals or decay chemicals. The only way to flood our bodies with growth chemicals is to work them until they sweat. Sleep regularly. Somehow we think coffee is a necessity but sleep is a luxury. Let go of the perverse belief that if you are well-rested you are slacking.
Finally, grow in self-awareness, but don’t become obsessed with avoiding burnout. That’s like driving by focusing on where you don’t want the car to go. If the negative becomes the focus, then you’ll latch on to any sign of burnout and grant it a disproportionate amount of significance. Have you ever sneezed and thought “Oh no, I’m getting sick, and this is a terrible time for me to get sick!” The fact that you then got sick may well have been a self-fulfilling prophesy. In the same way, fixating on the first sign of burnout can actually just manifest more stress and perpetuate burnout rather than avoid it.
If you can sense the inevitable crash approaching, my advice is to change direction. Engineering a lifestyle of gratitude, healthy habits, and effective learning can make med school manageable (and even enjoyable). Professional psychiatric help is available for free through the university, but don’t forget the organic support network that has already helped you to get this far. There is no shame in saying you need help, and you’ll make your mom’s day if you give her an unexpected phone call.