How to Survive Medical School and Residency in 10 Ways

The last week has been a little surreal. My KevinMD post: Should we encourage people to go into medicine went viral in a way I hadn’t anticipated with more than 2000 shares!

It’s been a roller coaster of conflicting emotions:

• Happiness that my writing resonated with so many people
• Horror that someone called me a “thought leader” for the millennial generation
• Guilt for making people in med school/residency aware of their regret for going into medicine

I’ve received a lot of feedback (thank you!) and this email in particular stopped me in my tracks:

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Hello,

I’m a new subscriber; I just recently saw your article on how to react to new-comers to the medical field coming to for your advice. I immediately identified with that piece; you explained my feelings perfectly.

I’m a final year medical student, due to graduate in a month, and going through your pieces, I see myself in your words. I’ve already reached that level of I’m tired, and it scares me, because how am I gonna get myself through residency with that?

Did you have the same feelings as a medical student, then resident? If so, how did you ignore it/ tape your self back up?

Any advice?

B

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After reading B’s email, I thought to myself,

I’m the last person who should be answering this question!

I didn’t reach out and ask for help at all during med school or residency… I put my head down, did my work and just tried to power through via sheer willpower.

Nobody knew. Every time I heard, “You’re always so put together!” or “You’re superwoman!”, I’d build an even stronger fortress around my emotions that were failing to perpetuate this persona I had created for myself.

It’s terrifying to think of now, but I was one of those sleepers. One of those people you’d “never see it coming.”

So, maybe I am the right person to address B’s concerns – I understand where he could be coming from.

How did I make it through med school and residency?

Looking back now, I realized I instituted several things to help make it through without even realizing it. I also polled my other fellow millennial doctors and after some lively discussion, this is what we came up with.

1. Make sure you make connections with your fellow residents.

These are the people you’re going to be spending A LOT of time with for the next couple of years. In fact, I spent more time with them than I did my husband during my intern year. You’ll be going through the same experiences as they are so you’ll understand what they’re going through and vice versa.

Support each other.

Go out after work and have long philosophical conversations until you both fall asleep on the couch. Make them dinner. Play video games together. Have impromptu karaoke nights at your place.

These are my favourite memories of residency – the friendships I made then are so important and dear to me, even now. Your fellow residents really do become family, but only if you let them.

2. Hold on to at least ONE hobby that is non-medical

The crappy patient encounters, the attendings beating into you that you don’t know enough, the endless studying.. all of that will take away from you.

Have one thing you can return to, something that no one can take away or diminish.

For me, that was playing piano and photography. For others, it was playing on an adult co-ed kickball league, reading or doing silks.

Find your thing.

Don’t have a thing??

Boy, that’s a tough one but something I hear all too frequently.

Imagine you have absolutely nothing to do (it’s tough, I know). Push aside all the medical journals and articles you feel like you should be reading at this very moment but instead you’re time-wasting/procrastinating by reading my blog (thanks!!), forget the mountain of laundry and dirty dishes you need to clean, ignore the workout you were pretending to do today.

What would bring you the most joy in this very moment??

I’m talking about the joy of a 6 year old on Christmas morning. You’re allowed to have that, even in adulthood.

Just do it.

And schedule time for it at least once a week so you have something to look forward to.

3. Surround yourself with non-medical people

They will keep you grounded and prevent you from becoming consumed by everything medicine.

They will remind you there is a world beyond those fluorescent lights and incessant alarms. A world you will eventually return to after over a decade of training.

They will stop you from becoming too self-involved and self-important. It’s too easy to become wrapped into your ego when you wear a white coat – let them see the person beyond that uniform.

4. Prioritize sleep

I’m a person who needs at least 7 hours of quality sleep to be a decent human being. Most people need 6-9 hours of sleep, and this is what I counsel my patients now.

However, on my intense months during training, there were arguments (ahem, discussions) with J trying to get me to go to bed and me stubbornly refusing even though I was physically, emotionally and spiritually exhausted. The kind of exhausted that only 2 years of being on the other side of residency training can cure.

I would delay going to sleep because if I went to sleep early, it would only speed up the time until I was next due to go into work. It made my life feel like groundhog day, every day for that rotation.

If you feel like this, sleep anyway.

Life gets better after that month, I promise. But it takes a lot longer when you’re exhausted.

5. Eat. Real food.

Doctors in training are the worst at actually fueling their bodies right.

One of my friends in residency once admitted he had starburst and gatorade for dinner. Another time, I caught him at the grocery store with frozen chicken nuggets in his cart. I judged him real hard. Incidentally, this is the same guy I judge for having a nice car.

Yes, we’re still friends. J and I had him over for dinner several times after his admission, so it was a win-win situation for everyone involved.

Don’t depend on frozen dinners or eating out. Actually eat breakfast – the extra time in the morning is worth it. Don’t rely on granola bars, muscle milk or smoothies to get you through.

Fuel your body right.

6. Make sure you take ALL of your vacations

If you have any say in your schedule, try to make sure you have an elective/easier month every 3 or so months, that way you’ll be able to take a breather.

Please actually GO ON VACATION.

No stay-cations. No “catching up” on housework or research or studying. Go somewhere and don’t think about medicine.

7. Limit your interactions with toxic people

You are going to have limited time to yourself during residency.

Don’t spend it on people who take energy away from you. You know who they are.

If you feel drained after you interact with certain people, give yourself permission to push them to the back burner until you’re at least done with residency. If you still want to connect with them after residency, then that’s great.

But you may not have the reserves to deal with them during residency or even ever, and that’s OK.

8. If you have a really important person in your life, make sure you nurture that relationship

They will be your support person during your entire journey, and they’ve probably been that even before residency. Don’t neglect your relationship, because that’s really easy to do when you’re in residency (and really, at any time in your life).

You MUST intentionally schedule time with that person.

It’s not going to just happen because you’ll always find so many other things “better” and productive to do.

Don’t take the people in your life for granted.

9. If you’re a spiritual/religious person, reconnect with that

A lot of people remarked on the importance of this during our discussion.

Go to church/synagogue/temple/mosque whenever people of your faith congregate, if you can. Join a Bible/other book of worship study group if that floats your boat.

If that doesn’t appeal to you, apparently CrossFit is the new church for millennials according to The New York Times.

However, don’t go if this is driven out of guilt that your parents are piling on you. That’s not the right reason to go to church. If it becomes another soul-sucking thing on your to do list, scratch it off.

10. If you feel like you can’t pull yourself together, then stop trying to power through by yourself and ask for help

Go to your program director if you feel comfortable. Find a mentor. Go to counseling. Get on meds.

The main thing is, don’t feel ashamed for asking for help.

We spend a lifetime working on developing skills to help others. You can’t help them if you are not in a good place yourself. If you need to take a sabbatical during residency, then take it. In the big scheme of things, a few months off is not going to set you back forever. But if you have a mental breakdown, that may bring you down a path that will take much longer for you to come back from.

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I could go on and on forever, but this post is already long enough and a list of 10 seems to be catchy enough to be click-baity. The main takeaway I hope you gain from this is how imperative it is for you to Diversify Your Life. Do not allow your career to take over your life.

I’ll leave you with a few quotes from the discussion I had with my fellow millennial doctors:

Don’t put off for tomorrow what you can do today. There will never be more time. You gotta make time.

Above all else, protect your heart.

Don’t forget that you will live and die like everyone else and the universe doesn’t revolve around you getting your work done on time. It’s good to just enjoy some down time.

I think the most important thing to remember is that mental health is still health and you need to take time off to recover from burnout just as you would from the flu. Otherwise it’s a downward spiral.

Residency is temporary.

I kind of wish we had more of this conversation in residency but I also think our perspective was skewed at the time…

Please start having these conversations with yourself and with others. Those of us on the other side realize their importance now and regret not being more conscientious of this early on in our medical careers.

What else helps you regain your balance in life?  Let’s talk about it!  Leave a comment below or on the Facebook page!

***Photo credit: Photo by Li Yang on Unsplash