Burnout and Stress in Medical Students

Most medical students start medical school armed with passion and idealism to become instruments of healing. This idealism can be defined as the pursuit of better quality of life and alleviation of suffering for all humankind [1]. Medical students aspire to provide health care service to the underprivileged and disadvantaged populations.

During the first years of training, medical students thirst and crave for new learning and clinical experience. But somewhere along the way, several medical students start to lose the enthusiasm in learning the art and science of medicine. The unending saga of written examinations, nerve-racking OSCE, numerous deadlines for research projects and manuscripts and long hours of clinical rotation somehow put a great challenge in preserving the enthusiasm and idealism of medical students. I have witnessed this happen in some medical students here in the Philippines after only one year in medical school.

The medical profession is intrinsically demanding and stressful. A lot of our professors say that in medicine, nothing is served in silver platter. Medical students have to work really hard in order to survive and become a clinician. It is prerequisite that they are ready for a lot of frustrations. These demands and pressures in medical school appear to leave many medical students at risk of stress and burnout. These can some after the idealism give way to pragmatism or even apathy and the enthusiasm with medical practice and the act of service become mechanical – mere routine work that students repeat over and over because it is required to get the medical degree.

Stress is a psychological and physical reaction to the ever-increasing demands of life [2]. To a certain extent, stress is a normal part of medical education and it can be a motivation for some medical students to better themselves. But the same pressure that turns a piece of coal to a diamond can also crumble and turn it into dust. Some coal will never be able to handle the pressure applied on them and just shatter into dust while some coal will fight through it and become a diamond. The same thing can happen to medical students. Some of the will be able to handle the demands and pressure while some of them can experience burnout. Burnout is a state of mental and physical exhaustion related to work or care-giving activities. It is characterized by a triad of emotional exhaustion, depersonalization and a decreased sense of accomplishment [3].

More attention should be given in this phenomenon of stress and burnout in medical students as this could lead to poor academic performance, suboptimal patient care and decreased personal health and well-being [4]. There are also evidences that suggest association between burnout in medical students and suicidal ideation. A study by Dyrbye et al. (2008) showed that medical students experiencing burnout were two to three times more likely to be among the students who had considered suicide in the past [4]. Medical schools are in a position to promote students’ well-being and introduce potential intervention to prevent and reduce burnout [5].

On October 29, #HealthXPh will tackle this pressing issue of stress and burnout in medical students. Here are the questions that we will try to answer during the tweetchat.

T1. What are the factors contributing to stress and burnout in medical students?
T2. What are the manifestations of stress and burnout in medical students? How do they cope / escape stress and burnout?
T3. Propose solutions to decrease stress and burnout and improve medical education. What would you want changed in medical education that would make medicine more interesting?

About the Author –

Ourlad Alzeus G. Tantengco is a third year MD-PhD in Molecular Medicine student at University of the Philippines College of Medicine. He finished BS Biology in the University of the Philippines Diliman. He loves doing research and some of his research interests include public health microbiology, parasitology, natural products and ethnomedicine. He also blogs about health and diseases, his experiences in medical school, literary works and faith at Doktor Doktor Lads (www.drdrlads.com)

1. Mader Em et al. The temporal decline of idealism in two cohorts of medical students at one institution. BMC Medical Education 2014; 14:58
2. Tyssen Ret al. Suicidal ideation among medical students and young physicians: A nationwide and prospective study of prevalence and predictors. J Affect Disord. 2001; 64:69–79
3. IsHak WW et al. Burnout during residency training: a literature review. J Grad Med Educ 2009;1:236–242
4. IsHak WW et al. Burnout in medical students: a systematic review. The Clincical Teacher 2013; 10:242-245
5. Dyrbye LN et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008; 149:334–41

Cover image courtesy of http://www.trbimg.com/