Fears of first-year medical students: How to cope

At the beginning of the school year, we asked our incoming first-year medical school students about some of their fears. It was surprising that many of these fears reflected our own feelings.

Some of these fears are often difficult to express, maybe because we feel as though we have to stay strong for ourselves, our peers, and our patients, or because we don’t even realize that these fears are the sources of our anxiety as medical students.

We asked Drs. Mary Brandt, Heather Goodman and Jamie Loveland, a few of our trusted faculty and mentors at Baylor College of Medicine, for advice on how to cope with these fears.

Student A: I will have a hard time making time for friends and family.

Dr. Brandt: The best way to think about the first year of medical school is that it is a 60-hour per week job. (Thank you, Dr. Jerry Goodman for the concept!) Those 60 hours include your classroom time, which, if you do it right, becomes active learning time. If you view the first year of medical school as a “job” and schedule those 60 hours on a calendar, you won’t have a problem finding time for the important things outside of school. Here’s a breakdown:

168 hours/week:

…. minus 56 hours for eight hours of sleep every night

…. minus 60 hours for your “job” of being a medical student

= 52 hours/week for your friends, family and yourself.

Dr. Loveland: There are ways to stay in touch with friends and family that might not seem ideal but will help you maintain your relationships.

• If you can’t go home as often as you’d like, make a point of maintaining monthly calls on specific dates. If your friend is equally busy, set up a regular call when you’re both commuting.
• If you’re leaving a group of friends behind, set up a Google Hangout account that lets you talk with up to 10 people at a time.
• Schedule regular “check-ins” through WhatsApp, Facetime, Skype, or Snapchat and remember – a call or video chat doesn’t have to be long to be meaningful, but be consistent.

Student B: I may accidentally kill someone.

Dr. Brandt: This one is easy.  No. You. Won’t.

During all of your training you will be given responsibility that’s appropriate for the level of your training. During medical school, these responsibilities will be to “practice” more than “do,” and the risk to patients is essentially zero.

It’s also important to remember that no matter where you are in your training, from first-year student to senior resident, there will always be someone above you who is ultimately responsible for the patient and there to supervise.

Dr. Goodman: This fear is common and relates to how we all feel anxious with the responsibility that comes with medicine, along with our insecurity with that responsibility. The good thing is you will have others with more experience working with you, looking over your shoulder and making the decisions while you focus on learning.

Student C: I wasted a spot [in medical school] when another candidate would reach more lives in medicine.

Dr. Brandt: Everyone who starts medical school looks around at their classmates and thinks, “These people are much smarter than I am. I know the admissions committee made a mistake. I’m not supposed to be here.”

So, if you are thinking this way, it’s completely normal! There are many people who think this is actually a healthy response to stepping out of your comfort zone… which is, of course, the first step in growth. So, sit back and relax. You are most certainly supposed to be here, and you will reach and touch many, many lives.

Dr. Goodman: You may think you don’t belong at times, but people with experience and expertise made the decision for you to be accepted here. Have faith in their judgement and take advantage of the opportunity!

Student D: I will lose my humanity for the sake of efficiency.

Dr. Brandt: I have seen this happen to some physicians. I can also tell you that it’s 100 percent preventable. All you have to do is remember the “why” of what you are doing every time the “how” starts to get overwhelming. What you are describing is what I call a “spiritual deficit disorder.” The treatment is paying attention to your spirituality.

Find something bigger than yourself. Spend time every day cultivating a sense of awe. If you don’t have a specific faith, find other ways to nurture your spiritual self and do it regularly. Spend time looking at beautiful things, play with a child or learn to meditate (I highly recommend Headspace).

Dr. Goodman: There may be times when it feels like it’s all about documentation, memorizing material, getting people in and out, making it through call, etc. This can lead to feelings of burn out. Remember to take time to recharge  and be mindful of the special moments you have. When a patient thanks you or shares something special with you, acknowledge the value of that to yourself and enjoy it.

Dr. Loveland:  We maintain our humanity by behaving humanely, which means that our focus is directed outside of ourselves without expectation of reciprocity. Model forgiveness, show genuine care beyond your job responsibilities, and express understanding for the situations people find themselves in.

Student E: Too much material to memorize!

Dr. Brandt: Learning medicine is like learning a new language. In the first part of basic sciences, you are learning vocabulary and, yes, some of that is memorizing. The second part of basic sciences, when you learn about diseases and their treatment, is practicing the “grammar” of this new language. When you get to the clinics, you are actually learning how to “speak” it.

So, while building your vocabulary, make flash cards, lists, notes, whatever you need to learn these new concepts. However, don’t learn them without knowing why! For each lecture, do two things to make sure you get the “big picture”. 1) Explain what you learned in the lecture to a real or imaginary eighth grader. 2) Make a one-page summary of the lecture.

Student F: What if I fail?

Dr. Brandt: There may be a few people who decide that medicine isn’t for them and choose a different path, but it’s rare that anyone fails medical school. You may get a grade or two that aren’t what you hoped for. If that happens, don’t beat yourself up. What you should do is look at the system you have in place for studying and adjust. Consider increasing weekly study time. Whatever you do, avoid using time set aside for family, working out, resting and taking care of yourself to study more than 70 hours per week.

Dr. Goodman:  Some students will fail classes – it’s a fact. It’s also not the end of the world. It’s something that can be overcome by taking stock, learning where things went wrong, accessing support, and coming back at it with a new perspective.  There are resources at Baylor to help, so take it by the horns — and don’t be ashamed. Don’t hesitate to reach out to your deans, mentors and professionals in the Office of Student Services. We have your back!

-By Jacqueline Olive, Doha Aboul-Fotouh, and Julia Wang, editors of Progress Notes