The Art of Surviving Medical Training: An Illustrated Journey

Ryan Syrek, MA


April 25, 2019

Grappling with burnout and the newfound emotional toll of patient empathy while drowning in information, medical trainees grasp at anything to stay afloat. Computers and textbooks are predictable tools, but many have also found the power of a paintbrush.

A recent piece in Heart Views titled "What Has Art to Do With Medicine?" seems to answer this question with "everything." Recent studies have shown that a visual approach remains students' preferred learning method and that art observation can sharpen clinical skills and help establish the foundations of a patient-centric view of medicine. It can also offer a much-needed release of pent-up anxieties and help communicate the seemingly inexpressible experiences of medical training to those outside the profession.

In artistic terms, a triptych is a set of three associated works that combine to express one theme. In this spirit, what follows is a triptych on the use of art by medical students and residents. To explore art as a means of coping with stress, we spoke with Mai Stewart, a fourth-year medical student at Temple University whose cartoons highlight common frustrations. To explore art as a means to approach empathy, we spoke with Dr Ginny Bao, an internal medicine resident at California Pacific Medical Center whose visual narrative about caring for dying patients was published in the Annals of Internal Medicine. To explore art as a learning resource, we spoke with Dr Armando Hasudungan, a physician trainee with a YouTube channel filled with illustrated medical education videos.

Reading about and seeing the way in which these students and residents use art during training provides not only an insight into how the modern challenges of medical education are being met, but also provides a window into who the doctors of tomorrow hope to become.

Better to Laugh Than Cry

Three years before launching her popular account, Mai Stewart "had no idea what Instagram was." Now, more than 14,000 followers commiserate with her cartoons that depict the turmoil and tortures of medical training.

Stewart had always dabbled with doodles, but when the stresses of medical school began to take their toll, she turned to art as a way to release the steam building inside of her. "People don't really talk about how grueling the process is or how much it takes away from us psychologically, financially, and physically," Stewart explained. "I think students want to share that kind of thing, but maybe they feel like they're alone in this or they feel like they're being weak."

Although surveys consistently show high levels of burnout during medical education, even some faculty remain unaware of the levels of stress their students experience. Stewart's cartoons offer a safe space for her to vent and for others to laugh and learn. More important, no matter how exaggerated, the drawings provide a valuable context for frustrations sometimes forgotten by those now established in their medical careers and wholly unknown to those outside of it.

"I think everyone can understand burnout in the sense of working or studying too many hours, but I think that psychological pressure is actually more contributory to burnout than just working a lot." Stewart's illustrations are a way of making the invisible internal self-doubt and panic become external and tangible. What's more, her over-the-top style provides appropriate cover and comfort beneath which she can share insecurities that are commonly held but rarely discussed. "Everyone feels for an hour like they made the wrong choice sometimes."

Stewart described how some students have thanked her for saying out loud what they have long worried about. What's telling is that many of them do so via private messages, in order to avoid publicly commenting on her work where others may see. Doctors-in-training remain acutely worried about their image. Stewart's caricaturized depictions allow them to see themselves, but not abrasively or invasively. They aren't "looking the mirror" so much as they are a whimsical window into inner thoughts.

When asked whether she will continue her comedic cartoonist escapism into practice, Stewart is uncertain. "I think as a student, it's acceptable to vent in this manner. But I will have to see how social media will integrate into my career." She plans to keep drawing in some capacity though, especially as she sees it as a means to help close the knowledge barrier with patients. "I think everyone is interested and curious about things that happen in their body. But there's a barrier to getting resources to learn more about it." Like the other trainees covered here, Stewart sees art as a great equalizer, a means to share with peers and bridge educational gaps. The right question may be whether or not this tool is one that remains too underutilized.


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