Started Med School - Burnt Out

[Kalifornia]

I got accepted to medical school this year and I am currently in my first year. But I spent the past years exhausting myself, working my ass off, pulling allnighters, stressing out, going through bouts of depression, doubt and hopelessness so many times till I finally got here. I'm very, very grateful that I finally got in and that all that hard work paid off. But now as I'm starting medicine, the material gets extremely intense. There are so many hours of lectures daily and it's tough to keep up. I'm surrounded by the brightest of students, and I feel like I'm so burnt out from my hard work in undergrad. I'm already feeling so overwhelmed about how I'm going to go through this new journey while still being exhausted and in withdrawal mode from undergrad. Did anyone else feel this way when you first started medical school? What did you do about it?

 

Any advice would be really appreciated!

[Bambi]

If possible, stop attending lectures if you provided with notes. It takes fraction of time to scan lectures for what is important. Use lecture time to study!! You will figure out your time management and all will be fine. 

[Intrepid86]

1. Prioritize sleep. Try to get at least 8 hours a night. Unless the test is tomorrow, there should be no reason to not do this. A lack of sleep is the most common reason why people burnout.

2. It's been said that God made the world in 6 days and rested one. If you can do better than that then props to you, but it's not sustainable. Try to have a day in the week where you do relatively less, or nothing at all.

3. Not everything in your lectures is equally important. If you're pressed for time then work through the most conceptually difficult parts first and leave the easier/more straightforward items for later.

4. Keeping on top of material is ideal, but being slightly behind is normal. It doesn't mean that you're slacking.

5. Don't isolate yourself from your peers. The journey will be lighter if it feels like you're all in it together. You should have at least one good friend to talk with and vent your problems at.

 

It gets easier. Hope this helps.

[ralk]

I got accepted to medical school this year and I am currently in my first year. But I spent the past years exhausting myself, working my ass off, pulling allnighters, stressing out, going through bouts of depression, doubt and hopelessness so many times till I finally got here. I'm very, very grateful that I finally got in and that all that hard work paid off. But now as I'm starting medicine, the material gets extremely intense. There are so many hours of lectures daily and it's tough to keep up. I'm surrounded by the brightest of students, and I feel like I'm so burnt out from my hard work in undergrad. I'm already feeling so overwhelmed about how I'm going to go through this new journey while still being exhausted and in withdrawal mode from undergrad. Did anyone else feel this way when you first started medical school? What did you do about it?

 

Any advice would be really appreciated!

 

You're far from the only one who goes through this experience. Many of your classmates - even the ones you think are the smartest, most capable people in the world - will be feeling very much the same. Medicine is vast and schools tend to throw a ton of it at you right off the bat. The important thing to realize in 1st year of medicine is that you don't need to know everything you've been presented with. This isn't undergrad, you don't need to ace every test or be the best of your class. Schedule time off for yourself on a regular basis. Regardless of how important the next test might seem, there will always be another test after it that will seem equally meaningful - if you don't take time out for yourself, you'll never get it.

 

If you're finding yourself falling behind in school, get help earlier rather than later. Draw on classmates, student reps, instructors, coordinators, whoever you feel comfortable approaching. If you got into medical school, you're smart enough to finish medical school, but it may take a different strategy than you used in undergrad.

 

If you've dealt with depression before, have a low threshold for seeing a professional about it while going through your training. I'd strongly recommend having contact with some professional, even if just a counselor or Family Doc if these feelings persist or become recurrent. The work only get tougher from here, so having supports in place is essential. The good news is that while tasks get more difficult, you'll get more adaptable and better able to handle these challenges. Burnout is affects a lot of students, but it doesn't have to be a permanent state of being.

[Arztin]

I got accepted to medical school this year and I am currently in my first year. But I spent the past years exhausting myself, working my ass off, pulling allnighters, stressing out, going through bouts of depression, doubt and hopelessness so many times till I finally got here. I'm very, very grateful that I finally got in and that all that hard work paid off. But now as I'm starting medicine, the material gets extremely intense. There are so many hours of lectures daily and it's tough to keep up. I'm surrounded by the brightest of students, and I feel like I'm so burnt out from my hard work in undergrad. I'm already feeling so overwhelmed about how I'm going to go through this new journey while still being exhausted and in withdrawal mode from undergrad. Did anyone else feel this way when you first started medical school? What did you do about it?

 

Any advice would be really appreciated!

Hi, there. I faced burn out too in med 1 multiple times so I can relate. I have't read replies from others but here are my own personal advice.

1- Your own health first. That includes physical (sleep, exercise, eat well) + mental health.

You can't take care of others if you don't care to take care of yourself first.

Sleep hygiene is important. Find a way to sleep more.

For mental health (not saying you are crazy in any way), have a low threshold to seek help, counsellors or ressources your school has if you need help with anxiety/depression, which is very common among med students. A few of my friends crashed and burned, and sought help and it helped them a lot. I persuaded some people to seek help, and they haven't regretted getting professional help.

2- Toughen up. It sucks to hear this, but at the end of the day, you need to find a way to toughen up.

3- Medicine is a team game. Unlike undergrad, where you don't need such a strong social network, you absolutely need one in med school. Make sure you have a support network, friends, family, partner, or people you can trust, to whom you can talk to. It's a must. You can't survive without a solid one. Solo mode is a no no.

4- Don't stress so much about lectures. It's overwheling at the beginning but you'll find a way to survive preclerkship. It took me personally about 6 months before being ''used to'' preclerkship. By the end of first year, many people were not attending lectures anymore. Preclerkship is simply a whole new experience where you have to figure out a whole way of studying. Don't stress because other people are studying for USMLE at the same time, or some people are reading extra. I personally pretty much never attended lectures, and I'm doing just fine now in clerkship. Most of my friends who went to class now realize that they probably wouldn't attend class if they could do it again. So don't feel bad for skipping.

5- don't compare yourself. There is no point. Some people will seem bright. Some people will seem to gun hard. Some people definitely will work harder than you. Some people will look better than you. Some people are more likeable than you. Some people will seem to be better in some ways than you. At the end of the day, you're you, not that xyz person who's better in you in whatsoever way. So accept yourself, and accept the fact that it's okay not to be a top student grades wise, or the best person in xyz aspect, or the best looking person. From experience, I can tell you that many students who appear "perfect" are actually not so "perfect". They might say they're not studying, but at home they're studying a crap ton. They might seem always emotional fine, but many people cry during med school at some point, including those. Many people posting stuff on facebook like #SelfieWithMyNewStethoscopeThatIDon'tKnowHowToUse are actually kind of sad inside and are looking for validation, although they might get hundreds of likes. So again, don't compare yourself. If you made it, you belong. Accept this fact, and accept yourself.

6- help your peers. I have "crashed". I have seem every single one of my closest friends during med school crash at some point, preclerkship or clerkship. (even though it's just my 9th week of clerkship). A classmate in deed is a classmate in need. Help others too!

 

These are the things I can think of now. Sorry this is probably disorganized. Gaah, lack of sleep

Good luck. If you ever feel like you need to PM me, feel free to.

[newstudent2016]

Hi, there. I faced burn out too in med 1 multiple times so I can relate. I have't read replies from others but here are my own personal advice.

1- Your own health first. That includes physical (sleep, exercise, eat well) + mental health.

You can't take care of others if you don't care to take care of yourself first.

Sleep hygiene is important. Find a way to sleep more.

For mental health (not saying you are crazy in any way), have a low threshold to seek help, counsellors or ressources your school has if you need help with anxiety/depression, which is very common among med students. A few of my friends crashed and burned, and sought help and it helped them a lot. I persuaded some people to seek help, and they haven't regretted getting professional help.

2- Toughen up. It sucks to hear this, but at the end of the day, you need to find a way to toughen up.

3- Medicine is a team game. Unlike undergrad, where you don't need such a strong social network, you absolutely need one in med school. Make sure you have a support network, friends, family, partner, or people you can trust, to whom you can talk to. It's a must. You can't survive without a solid one. Solo mode is a no no.

4- Don't stress so much about lectures. It's overwheling at the beginning but you'll find a way to survive preclerkship. It took me personally about 6 months before being ''used to'' preclerkship. By the end of first year, many people were not attending lectures anymore. Preclerkship is simply a whole new experience where you have to figure out a whole way of studying. Don't stress because other people are studying for USMLE at the same time, or some people are reading extra. I personally pretty much never attended lectures, and I'm doing just fine now in clerkship. Most of my friends who went to class now realize that they probably wouldn't attend class if they could do it again. So don't feel bad for skipping.

5- don't compare yourself. There is no point. Some people will seem bright. Some people will seem to gun hard. Some people definitely will work harder than you. Some people will look better than you. Some people are more likeable than you. Some people will seem to be better in some ways than you. At the end of the day, you're you, not that xyz person who's better in you in whatsoever way. So accept yourself, and accept the fact that it's okay not to be a top student grades wise, or the best person in xyz aspect, or the best looking person. From experience, I can tell you that many students who appear "perfect" are actually not so "perfect". They might say they're not studying, but at home they're studying a crap ton. They might seem always emotional fine, but many people cry during med school at some point, including those. Many people posting stuff on facebook like #SelfieWithMyNewStethoscopeThatIDon'tKnowHowToUse are actually kind of sad inside and are looking for validation, although they might get hundreds of likes. So again, don't compare yourself. If you made it, you belong. Accept this fact, and accept yourself.

6- help your peers. I have "crashed". I have seem every single one of my closest friends during med school crash at some point, preclerkship or clerkship. (even though it's just my 9th week of clerkship). A classmate in deed is a classmate in need. Help others too!

 

These are the things I can think of now. Sorry this is probably disorganized. Gaah, lack of sleep

Good luck. If you ever feel like you need to PM me, feel free to.

 

 

 

This is a great post, im dealing with same feelings as OP and reading  this post really helped. 

[older]

It may help if you find  tips (this forum and elsewhere) how to study in med school. Lots of anxiety is caused by too extensive but inefficient studying.

 

It is different in med school than in undergrad, so your previous study habits may not be the best here.  And you burned out in undergrad... you need to change how you manage your time,  and make sure you get enough sleep, rest and socializing.

[Horace]

Did anyone else feel this way when you first started medical school? What did you do about it?

 

 

 

Yes.

It eventually gets better.

 

Altough, it is normal, at first, to feel overwhelmed. it will never be to feel hopeless, sad, depressed...

If you feel really feel like this, seek mental help. 

[sangria]

To those who suggested seeking help in mental health, would you recommend the counselling within the Faculty or the school's health services? I would like to see someone, but I'm afraid of confidentiality (yes I know that's what they promise, but I'm still somewhat hesitant). 

[MSWschnoodle]

To those who suggested seeking help in mental health, would you recommend the counselling within the Faculty or the school's health services? I would like to see someone, but I'm afraid of confidentiality (yes I know that's what they promise, but I'm still somewhat hesitant). 

 

 

Hey Sangria,

 

My background is in this area and depending on where you live I might be able to give you some specific community-based resources, you can PM me if you want. Full disclosure - I am a U of C student. If you are also a U of C student you don't have to tell me who you are and I won't try to figure it out. My overall answer to your question about whether in-faculty services or private services are a better choice, it really depends on which one you feel more comfortable using.

 

In terms of the concerns you have about confidentiality... this is a tough one because I totally understand how you feel. What you talk about in the session with the student affairs person or school-funded counsellor should be entirely confidential aside from the normal limits of confidentiality for your province (if the counsellor does not offer this information at the start of the session then you are more than entitled to ask them what their limits to confidentiality are). If there are any additional limits to confidentiality they should be disclosing those but, again, if you are concerned you can always ask. Many students access counselling services through school, so you certainly wouldn't be alone. Many faculty have likely also seen a counsellor or therapist on their own time as well. One of the things I think all medical students should hear is "put your own oxygen mask on FIRST". If you don't take care of yourself, you cannot possibly do your best job when it comes to taking care of someone else. Seeing someone is not, and should not be seen by the faculty as a sign of problem or weakness, if anything it is a sign of your commitment to ensure excellent and ethical patient care starting in the earliest stages of your career. 

 

That being said, if your school is set up like mine then the offices for the counsellors/student affairs people are in the actual medical school. This naturally reduces some of the confidentiality you can expect because it is totally possible that people may see you waiting for an appointment or going in to an office. If someone does ask and you don't want to talk to them about it you can always use career advising as a fall back. Now, if you feel like your concern about confidentiality is so large that you may avoid talking about the things that are important to you then that is an important consideration, because a good counselling/therapeutic relationship starts with feeling safe. If you do decide to use the school services don't be afraid to bring up any concerns you have - you won't be the first person to have them and you have every right to ask whatever questions you need to ask.

 

Depending on how your school is set up, you may also have an option to see a counsellor through a wellness centre on main campus or through the student's union (this will vary by university). They won't have the same specialized understanding of medical students but they certainly will have an understanding of university students and are likely covered through your student health plan. 

 

Now, on to 'outside the school' services. Whether or not you should go private depends on a few things. Here are some of the pros and cons of private services:

Pros:

• Privacy - Just as with your school service provider, have a conversation with the community provider about the limits of confidentiality at the start of your session. If you are worried about staff/classmates seeing you accessing services at your med school then this reduces that risk (there's still a small chance you run into someone in the outside world, but it's small)
• Options - You can shop around to find someone who is an ideal fit for your needs. There are lots of different therapy/counselling styles and every provider will have their own personality. 
• Convenience/Availability - evening and/or weekend appointments are more likely available from private providers compared to medical schools (every school may vary so it's worth checking this out)
• Objectivity - A private provider has no vested interest in your school. Ideally the services at the school should also be objective, but a private provider absolutely has more separation from the situation if that is important to you.

Cons: 

• Cost - Private services can be quite expensive if you don't you have private coverage for mental health/counselling services separate from the school, though there are a fair number of places and practitioners that will offer sliding scale rates for students. Only you can know if you are in a position where you can afford to pay at least a little out of pocket.
• Quality - a vast majority of service providers are excellent and will offer you high quality services. A small number of providers are not as great. Hopefully the school is vetting the people they are hiring to ensure they are qualified, licensed and skilled. If you go privately the onus is on you to do that.
• Location - Being able to pop into an office at your school may be more convenient then having to travel somewhere else.
• You have to know what you want to shop for it - if you have no idea what you are looking for in your counsellor/therapy provider then it makes it much more difficult to shop for. In a large city you will have hundreds, if not thousands, of qualified providers to choose from. That can be a hard pool to narrow down unless you know what you want.
• Specific situational awareness - psychologists etc. hired by the medical school likely have at least some specialized knowledge about the types of things medical students most commonly experience. A community provider may not have this. Any good provider should take the time to understand your specific situation, but a school-based provider may know about resources that a community provider would never have a reason to learn about (like medical association services for members).

 

At the end of the day there are pros and cons to all of the options so your choice should really be based on which pros and cons matter the most to you. If money is a concern, then school-offered services are a wonderful choice, but if being able to search out a very specific style of therapy is important to you then unless your school-based provider happens to have that style you may find private services are the way to go. If having a strong separation between your school and counsellor is important then private services will likely appeal more, but if convenience of location is key for you then the school-based options really can't be beaten in terms of ease of access. Neither option is a bad choice, so it really comes down to deciding which choice is the best for you.

 

I hope this helps!

[Lactic Folly]

Depending on how your school is set up, you may also have an option to see a counsellor through a wellness centre on main campus or through the student's union (this will vary by university). They won't have the same specialized understanding of medical students but they certainly will have an understanding of university students and are likely covered through your student health plan. 

 

The university's (rather than faculty's) services would likely feel enough at "arms-length".. could try it out and seeing how it goes - the experience of a preclerkship medical student overlaps enough with that of other undergrads.

[codebar]

To those who suggested seeking help in mental health, would you recommend the counselling within the Faculty or the school's health services? I would like to see someone, but I'm afraid of confidentiality (yes I know that's what they promise, but I'm still somewhat hesitant). 

 

Go to your family doc. It's faster, easier, you have nothing to be afraid of in terms of confidentiality and they are able to prescribe drugs if needed (some Faculty mental health service refuse to prescribe drugs).  Fam docs aren't mental health specialists but they do deal with a lot of patient with mild to moderate mental illness : burnout, anxiety, depression disorder, ADHD, etc... and they got trough medschool themselve too. 

IMHO, the best choice for a medstudent.

[LittleDaisy]

If OP has a family doc, I believe, IMO is the best option for confidentiality.

As for counselling services offered by medical school, I personally have used it a few times for career advice. The therapist is usually a psychiatrist or a psychologist, or a family doctor; it is confidential, and they do not take any notes at all. If you are worried about confidentiality issues, probably start by asking questions if everything you say is confidential. I am not worried at all if my fellow students see my waiting for counselling, I am doing this for my personal health 

Take care of yourself first, and then the patients

Go to your family doc. It's faster, easier, you have nothing to be afraid of in terms of confidentiality and they are able to prescribe drugs if needed (some Faculty mental health service refuse to prescribe drugs).  Fam docs aren't mental health specialists but they do deal with a lot of patient with mild to moderate mental illness : burnout, anxiety, depression disorder, ADHD, etc... and they got trough medschool themselve too. 

IMHO, the best choice for a medstudent.

[GH0ST]

Hi, there. I faced burn out too in med 1 multiple times so I can relate. I have't read replies from others but here are my own personal advice.

1- Your own health first. That includes physical (sleep, exercise, eat well) + mental health.

You can't take care of others if you don't care to take care of yourself first.

Sleep hygiene is important. Find a way to sleep more.

For mental health (not saying you are crazy in any way), have a low threshold to seek help, counsellors or ressources your school has if you need help with anxiety/depression, which is very common among med students. A few of my friends crashed and burned, and sought help and it helped them a lot. I persuaded some people to seek help, and they haven't regretted getting professional help.

2- Toughen up. It sucks to hear this, but at the end of the day, you need to find a way to toughen up.

3- Medicine is a team game. Unlike undergrad, where you don't need such a strong social network, you absolutely need one in med school. Make sure you have a support network, friends, family, partner, or people you can trust, to whom you can talk to. It's a must. You can't survive without a solid one. Solo mode is a no no.

4- Don't stress so much about lectures. It's overwheling at the beginning but you'll find a way to survive preclerkship. It took me personally about 6 months before being ''used to'' preclerkship. By the end of first year, many people were not attending lectures anymore. Preclerkship is simply a whole new experience where you have to figure out a whole way of studying. Don't stress because other people are studying for USMLE at the same time, or some people are reading extra. I personally pretty much never attended lectures, and I'm doing just fine now in clerkship. Most of my friends who went to class now realize that they probably wouldn't attend class if they could do it again. So don't feel bad for skipping.

5- don't compare yourself. There is no point. Some people will seem bright. Some people will seem to gun hard. Some people definitely will work harder than you. Some people will look better than you. Some people are more likeable than you. Some people will seem to be better in some ways than you. At the end of the day, you're you, not that xyz person who's better in you in whatsoever way. So accept yourself, and accept the fact that it's okay not to be a top student grades wise, or the best person in xyz aspect, or the best looking person. From experience, I can tell you that many students who appear "perfect" are actually not so "perfect". They might say they're not studying, but at home they're studying a crap ton. They might seem always emotional fine, but many people cry during med school at some point, including those. Many people posting stuff on facebook like #SelfieWithMyNewStethoscopeThatIDon'tKnowHowToUse are actually kind of sad inside and are looking for validation, although they might get hundreds of likes. So again, don't compare yourself. If you made it, you belong. Accept this fact, and accept yourself.

6- help your peers. I have "crashed". I have seem every single one of my closest friends during med school crash at some point, preclerkship or clerkship. (even though it's just my 9th week of clerkship). A classmate in deed is a classmate in need. Help others too!

 

These are the things I can think of now. Sorry this is probably disorganized. Gaah, lack of sleep

Good luck. If you ever feel like you need to PM me, feel free to.

 

What a legend <3

 

- G