Medical students strive for balance amid stress of medical school

Ask any doctor, or doctor–in– training, and they'll tell you just how stressful medical school can be. Long hours cramming for tests, little sleep, transitioning to a new city without an established support group, feelings of isolation: All can lead to a deterioration of physical health and are serious risk factors for mental illness. When patients' lives very literally hang in the balance, “me time” can seem like a luxury, but two second–year medical students, Melissa Koci and Kevin Keith, say self–care is anything but selfish.

“If you're not careful, you can lose so much of who you are in medical school,” Keith said. “Going to the gym, going out with friends, calling your family, hanging out with your dog: Those are the things you give up.”

Koci agreed. “You have to know when to close the books and take care of yourself,” she said.

The pair are co–chairs of the new College of Medicine Student Wellness Council, which is comprised of student wellness leaders from each year of study.  As a key component of the program, the Student Wellness Council seeks to promote programs and learning experiences related to academic, physical, financial, cultural and emotional wellness on campus, addressing some of the unique challenges of medical school.

“Time management is one of the biggest challenges,” Keith explained. “Every day, there are at least four hours of lectures, and in the afternoon another two–or three– hour workshop or anatomy lab or teaching rounds, in addition to studying. There's a wide volume of information students have to ingest in a very short amount of time. Almost every student is working 12 hours a day between classes and studying, and also trying to manage their personal lives, while spending thousands of dollars on tuition and trying to budget for rent and food. In addition, for many first-year students, this is their first time in Charleston, away from their social networks; they're trying to navigate a brand new place and type of education.”

With so much to deal with, it's easy to see why wellness takes a backseat for many medical students. What's more, Koci said, many don't know how to ask for help when they need it. 

“These are people who stereotypically haven't had to ask for help,” she said. “They've been the ones on top, always with the right answer, always doing very well. There's a cultural expectation that we're always on top of things, always doing fine, and that asking for help and support is a weakness.”

Asking for help when one needs it is actually a strength, Koci explained, and knowing how to be vulnerable enough to ask for support is a skill that needs to be taught and cultivated. She hopes the Wellness Council's programs will do just that. 

“We have a student–led program that we call Lunch and Chill, she said. “We're doing it three times a semester. Lunch is free and it's a chance for students to participate in some interactive exercises with topics like time management, physical fitness, mindfulness, interpersonal relationships and conflict resolution. It's a chance to discuss the things that affect us day–to–day while we're in school, but that we haven't gotten training or help with in the past.”

Koci continued. “Another program we're calling #realtalk is a chance for some of the deans and faculty to participate in informal roundtable discussions with students and get to know them on a more personal level.”

The council is also working with MUSC's Urban Farm to create a community hub for wellness and social events, such as the smoothie giveaway last month, which invited students to drop by for a morning pick–me–up and helpful tips on keeping healthy. 

Keith and Koci said they would have appreciated programs like these during their first year of medical school.

Koci explained how “chasing the H,” her term for striving for honors recognition, led to anxiety and exhaustion that first year. 

“I got caught up with grades and started having panic attacks,” she said. “I traded my well–being for grades, and it was not worth it. I realized that's not a trade–off I'm willing to make.”

Keith said he never went through that, but only because he had seen many of his friends make the same mistakes, and knew what to avoid. “People get to medical school because they set themselves apart, and so they continue to try to measure themselves against other people,” he said.

They hope by having wellness programs “baked into” the medical school experience, they can start to change that mentality. 

“It needs to be mainstream to take care of yourself,” Koci said. “That's crucial. People will say to me, 'It's just the first two years, then I'll be fine,' or, 'Once I get to residency, then I'll be okay.' There's a prevalent line of thought that goes: ‘When I get to blank, then I'll be happy.’ No, you'll be exactly as you are now because you've practiced it. If you're a workaholic now, you will be later. There's not some magic time when you learn to be a balanced person. It's got to happen now.” 

Donna Kern, M.D., senior associate dean for medical education, couldn’t agree more. She saw a great need for such a program. “Medical school is a time of significant personal development for our students,” she said. “We want to do everything possible to nurture self-discovery and healthy living. The goal is not merely to survive medical school but to thrive here. We want the students to develop a resilience that will serve them throughout their careers.”

Myra Haney Singleton, assistant dean for Student Affairs, helped launch the program, which she hopes will create a culture of wellness and empower students to be self-managers of their health. “The medical school curriculum is rigorous and demanding,” she said. “Providing excellent student support is imperative.” 

For information on the Student Wellness Council program, visit: http://academicdepartments.musc.edu/com/WellnessProgram.