|Tami Hendriksz, DO, FACOP|
By Tami Hendriksz, DO, FACOP
I mentor and counsel osteopathic medical students on a daily basis and one question continues to surface: “Why is medical school so hard?”
No one is surprised to find out that medical school is academically challenging. The old adage of learning in medical school being equivalent to drinking water from a fire hose has stood the test of time for good reason: there is an ever-growing amount of medical science that students are expected to learn. This becomes seemingly worse each year because although the amount of material increases, the four-year time frame remains the same. However, the academic rigor is just one piece of what makes medical school challenging. Due in part to the time commitment to study the immense amount of material, as well as periodic high stakes events such as exams, medical school forces its way to the top of students’ priority lists. In this process it may outrank other would-be top priorities, like health, family, friends and life balance.
It pains me to see the burnout with which many medical students struggle. In the first two years, students may lose touch with what brought them to the medical field in the first place. Instead of building rapport and increasing empathy by interacting with patients, they are trapped in seats and behind computer screens. This culminates in the first level of the board exams – which brings forth all of the stress of a high-stakes event, at the point when many students are feeling numbed from two years of intense classroom studying.
The move to the third year can bring some relief and a renewed sense of purpose, but it also brings a new host of learning curves that students need to surmount. Each new rotation starts the students at the bottom of the curve as they learn the typical flow of each day and the likes and dislikes of each new preceptor. Another set of high-stakes board exams takes full precedence at the end of the third year and then comes fourth year. The fourth year of medical school brings with it the stress of to prove one’s abilities and knowledge during audition rotations, sub-internships and residency program interviews. The new stressors and challenges seem to have no end until the early spring of fourth year, when residency match day finally gives the students an idea of their future plans.
I speak with many medical students who struggle with weariness, depression and self-doubt. With the number of primary care physicians dealing with burnout within the first few years of their career, one has to wonder: is the long, arduous, expensive road of medical school worth it? I’ve been blessed with a career in academic medicine where I feel balance between time spent teaching in the classroom and time spent seeing patients. I feel as energized and galvanized by my pediatric patients as I do by the bright new medical students. However, I can see how many medical careers that do not offer that balance. How can we help our medical students and future colleagues avoid burnout? How can we make medical school less hard?
There are some changes in medical education that could help – some as drastic as increasing the length of time of medical school or altering the traditional structure to condense the initial two preclinical years. There are other changes not quite as drastic that could potentially improve student satisfaction and overall well-being. More direct patient contact in the first two years could remind students of their initial intentions as well as to help them to reinforce and integrate their book learning. Understanding how the basic sciences apply to the patient helps to make that material more memorable – the process of learning becomes one of understanding, rather than memorization of seemingly random facts. Encouraging students to talk about their feelings of self-doubt and burnout can help reduce feelings of isolation and increase student connectedness. Decreasing the stigma of depression and burnout can help make students more aware and more likely to intervene and seek help earlier. Offering workshops and courses on finding balance and self-care can have a long-lasting positive impact where students can acquire skills to help them avoid burnout throughout their careers.
The point is not to make medical school easy; there is a reason only a small percentage of people are gifted the opportunity to become osteopathic physicians. The point is to help make the process more sustainable and healthier so that the students who are learning the best practices to care for others are able to fully do so without struggling with their own burnout, fatigue or depression.
Tami Hendriksz, DO, FACOP can be found on twitter@drhendriksz. Send her a tweet about your ideas to help improve current medical education, decrease physician and student-doctor burnout, why you love pediatrics, or anything else.