Fighting First-Year Stress in Medical School

Daniel J. Egan, MD


January 20, 2012


I have never been this stressed in school before. Is this normal, and do you have any suggestions?

Response from Daniel J. Egan, MD
Associate Residency Director, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York

Medical school, especially the preclinical years, is one of the most stressful times in your life. I guess I should say that it was one of the most stressful times in my life, and retrospectively I realize that I was not the only person dealing with that kind of pressure.

Let's put things in perspective. Like many of your classmates, school has always come easily to you. Studying was necessary but not a huge deal, and you were able to do well on tests.

It could be that studying still isn't a problem for you, but the environment in which you are learning and studying is completely different. In college, you went to school a couple of hours a day and probably even had a day off during your week.

Going to medical school, in some ways, is like going back to high school with school every day again. It's a change from the style of learning you've become accustomed to. Additionally, you may have more classes at once than you had during college. However, the amount of information you have to know (and the detail to which you are expected to know it) makes college seem like it was a walk in the park.

I remember being very stressed during my first year. I felt like I should study all the time. Even in the first month when we had only 2 or 3 courses, I didn't understand how I was supposed to learn everything.

In particular, I can vividly recall how I scored a 76% on my embryology exam. I had never received a grade like that in college and was thrust into this whirlwind of panic thinking that I wasn't cut out for medical school -- that I was only 6 points away from failing my first test, and this was only the first class. It was bound to get more challenging.

Besides academic stress, there are many other stressors that begin to work their way into your life. Perhaps you have moved to a new city and you're trying to make new friends and navigate a foreign environment. You may find yourself suddenly on a strict budget dictated by the financial aid office of your school. There is no more college cafeteria for you, and you might need to learn how to cook. Maybe you are trying to balance your personal relationships with your new marriage to medical school.

How do you cope with this new stress? The first piece of advice, of course, is from the doctor in me. If things are really bad, please talk to someone. Every school has services available for students. It is normal to have some stress, but if you think that it's starting to affect your everyday life, you really should get some assistance.

Turn to your peers. You'll be surprised to find out that many of your feelings are common. Because it's easy to get trapped in the bubble of medical school, it is also important to have a life outside of school. This means that you need to maintain your relationships with family and nonmedical friends. It also means that you should continue to pursue your outside interests, such as nonmedical reading, sports, yoga, and artistic events.

In addition, exercise and sleep are critical. Set a schedule where on most days you get good sleep, and this will help you function during the day (and not fall asleep in class).

Last, think about the activities that you love in life and continue to pursue them. Not only will these help reduce your stress, but they will also keep you well rounded. Good luck. It's only 4 years, and this, too, shall pass!


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