Stress among Medical Students

A sensation of mental or physical distress is referred to as STRESS. Any event or thought that makes you agitated, angry, or anxious may cause it. Stress can be beneficial in acute phase, such as when it helps you escape danger or meet a deadline ⏰. Stress, on the other hand, can be harmful to your health if it gets to the chronic phase. Therefore it is paramount to manage stress in order to improve health and productivity. In this article, we will endeavour to explain what stress is, common stressors in medical school, signs and symptoms of stress, effects of stress and management of stress among medical students. Within each section, you will find a comprehensive summary to help you retain the key points❗

Contents:

1. Introduction
2. Common stressors in medical school
3. Signs and symptoms of stress
4. Effects of stress
5. Management of stress among medical students
6. Conclusion

What is stress❓

 Stress is the total emotional, psychological, mental and physical tension on a person 😔

 Mild or light stress can be encouraging, motivating and sometimes lead to growth in different aspect

 Stress can also adversely affect the physical, emotional and mental health of individuals when it becomes severe or managed with a negative behavioural coping strategy 😊

 Everyone is exposed to stress at some stage in their lives❗

 There are various forms of stress, each of which poses a risk to one's physical and mental health

 A stressor can occur only once or for a brief period of time, or it can occur continuously over time 📅

 Some people are better at dealing with stress and healing from the effect of stress than others

Types of stress

 Acute, episodic acute and chronic stresses are the three forms of stress  😔

Acute stress

 Acute stress, the most common form of stress and may be beneficial in small doses

 It's the body's reaction to a recent or future task or an unpredictable occurrence  😔

 The following are some of the most common signs and symptoms of acute stress:

1. Muscle stiffness 💪
2. Fatigue 💤
3. Back pain 😖
4. Jaw ache 
5. Stomach ache 😖
6. Pounding pulse
7. Increase in blood pressure ⬆
8. Headache 😖
9. Dizziness

 Acute stress can affect anyone at any moment

 Mild acute stress does not necessarily result in mental health concerns ❌

 Acute stress is easily treated and managed ✅

Episodic acute stress

 When a person experiences acute stress on a regular basis, this is known as episodic acute stress

 People in this group are often defined as having chaotic and crisis-filled lives❗

 They are in a constant state of hurry and on the lookout for something that could go wrong

 They are in a disarray environment all of the time

 Having high expectations placed on them (either by others or by themselves) can all contribute to episodic acute stress 😔

 Episodic acute stress, if left untreated, may cause:

1. Irritability
2. Frustration 😖
3. Unintended hostility
4. Relationship problems ❌

 Experiencing episodic acute stress can mean that lifestyle changes are needed

 You may need to lower the expectations you put on yourself and others ⬇

Chronic stress

 Chronic stress is a form of stress that develops over time as a result of prolonged emotional strain ⌛

 A demanding work, an unstable family situation, or financial difficulties, can all cause chronic stress

 When you have chronic stress, your body goes through the fight-or-flight reaction which is too severe for you to recover between episodes ⌛

 Chronic stress causes your nervous system to be constantly stimulated, which is harmful to your health 😔

 Desensitization to stress is the result of repeated exposure to stress for a long period of time ⌛

 The stressed person may have grown accustomed to being stressed to the point that they no longer feel stressed ❌

 They can, however, experience exhilaration of acute stress while ignoring chronic stress because acute stress is new

 Medical students are at risk of experiencing all the 3 types of stress that have been listed above 😔

 Therefore it is important to manage stress appropriately in order to improve one's health and productivity in medical school 🏨

Summary:

Stress is a feeling of emotional or physical tension. The effects of any form of stress should be managed appropriately in order to improve one’s quality of life and enhance academic productivity.

Common stressors in medical school

1) The complexity of medical school 🏨

 Studies have shown higher level of stress in medical students compared to their peer of same age 😔

 This means that medical school itself is a source of stress among medical students 🏨

 Medical school can be overwhelming and exhausting due to the long hours of classes, ward-rounds, project work and studies 

 Pre-clinical students have to deal with a lot of information in pre-clinical courses and get stressed and overwhelmed while trying to study

 Clinical students engage in clinical rotations in the hospital, which include clinical classes, patient clerking, observation, ward rounds, and clinical schedules 🏨

 Although these activities are needed so as to get the clinical clerkship medical students need to develop the expertise and skills they will need in the future

 However, they can be really stressful 😔

 2) Financial constraints

 Financial constraint is another common stressor among medical students 😔

 Stress levels are higher among students with lower monthly earnings than among students with higher monthly earnings

 Some medical students are in educational debt and may be required to work part-time after school hours

 Working after school hours adds more stress to the already overwhelming situation in medical school 🏨

 Financial issues, like any other cause of stressful events, can have a significant impact on one's mental and physical wellbeing, relationships, and overall quality of life 

 Financial worries can have a negative effect on your sleep, self-esteem, and energy levels 😔

 It can make you feel furious, embarrassed, or scared, trigger stress and arguments with your close ones, intensify pain and mood swings, and even put you at risk for depression and anxiety 😔

 In the worst circumstances, it can lead to suicidal thoughts or self harm❗

 3) Extreme ambition

 The majority of parents wish for their children to be inspired and hardworking in school

 Young people who are competitive tend to push themselves too hard and do not spend enough time playing, relaxing, or pursuing personal interests❗

 It's likely that their time with their peers is more competitive than social

 They can become fixated on a goal, setting themselves up for a fall if they come up short of their own standards

 Medical students have extreme ambitions of education and professionalism

 They are ambition driven and in order to meet their academic goals, they place a lot of pressure on themselves 😔

 They tend to internalize stress and refuse to seek treatment if it begins to affect their mental health

 4) Family Issues

 Medical students may be affected by family issues such as major shifts in family dynamics, financial instability, and sibling bullying

 These issues may have a negative effect on them in a number of ways, including causing stress to the victim 😔

 Changes in family dynamic, say divorcing parents, can cause medical students to feel guilty, neglected, or unloved and as a result worry over the state of their family

 Financial problems and bullying by siblings can also place stress on students emotions 😔

 All this family issues combined with the complexity of medical school synergistically causes stress to medical student especially if they are victims of severe family problem

5) Personal relationship

 Relationship problems have a major impact on your physical health and mental well-being 😔

 This can be tough psychologically❗

 It can make you feel frazzled, exhausted, and unsure about how to handle other types of stress in your life 😔

Summary:

Major stresses suffered by medical students are caused by the complexity of medical school, financial constraint, family issues, extreme ambition and personal relationship.

Signs and symptoms of stress

 The most troubling part of stress is how quickly it can overwhelm you

 You get used to it, and it starts feeling normal

 You don't know how much it's affecting you until it's too late ❗

 As a result, it's important to understand the early signs and symptoms of stress overload 😔

 The signs and symptoms of stress are:

1) Physical symptoms

 Aches and pains 😖

 Diarrhea or constipation 💩

 Nausea 🤢

 Dizziness

 Chest pain 😖

 Rapid heart rate 💙

 Loss of sex drive ❌

 Frequent colds and infection

 Headache 😖

 Nervousness and shaking

 Ringing in the ear 👂

 Cold or sweaty hands and feet 👣

2) Cognitive symptoms

 Memory problems 🧠

 Inability to concentrate ❌

 Poor judgment

 Forgetfulness

 Seeing only the negative ❌

 Anxious or racing thoughts 😔

 Disorganization

 Constant worrying 😔

3) Behavioural symptoms

 Eating more or less

 Sleeping too much or too little 💤

 Withdrawing from others

 Procrastinating or neglecting responsibilities

 Using alcohol, cigarettes, or drugs to relax 🍷

 Nervous habits (e.g. nail biting, pacing) 😔

4) Emotional symptoms

 Depression or general unhappiness 😔

 Anxiety and agitation 😔

 Moodiness, irritability, or anger

 Feeling overwhelmed

 Low self-esteem 😔

 Loneliness and isolation

Summary:

The signs and symptoms of stress, affect the physical, emotional, cognitive and behavioural aspect of the person undergoing the stress.

Effects of stress

 Experiencing stress as a medical student is normal 🏨

 Although they are lot of ways in which students handle stress 😔

 These coping strategies can either be positive or negative

 Positive strategies include problem solving, belonging to a peer group, exercise, balancing academic life with social life and positive reinterpretation of criticism 😔

 Negative strategies are substance use, denial, self blame ❌

 The integrated effect of stress on the physical and mental health of medical students and also their academic performance emerge due to poor management strategies

 Consequences of poor stress management include:

1) Poor academic performance

 When students are stressed, it affects their ability to concentrate on their studies❗

 Poor concentration can limit students' ability to think critically or to perform at their best when writing papers or taking tests

 Poor judgment may lead to poor performance on exams and in class

 Students' academic achievement depends on their ability to recall details, and forgetfulness is one of the indicators of stress 😔

 Poor exam results and limited participation in class activities can result when students are unable to remember necessary information to answer questions

 Consistent worry and restlessness are signs of stress 😔

 When students are continually worried, it takes their attention away from essential schoolwork

 To meet the learning goals, students must collaborate with other students

 If they are stressed, they can become irritable and short-tempered, impacting the group's cohesiveness 😠

 As a result, the group will be unable to accomplish its objectives effectively ❌

 Students may become preoccupied and overwhelmed by stressful circumstances, paying little attention to relationships as a result of their reactions to stressors 😔

 Lack of supportive relationships can have an effect on their mental health, resulting in issues such as declining academic performance, as demonstrated by failed assignments and low test scores ❌

 Students who are under a lot of stress are more likely to procrastinate and neglect their responsibilities due to poor management skills

 Consequently, this will affect their academic productivity ✅

 Physical symptoms such as frequent headache, neck and back pain reduces the academic productivity of a student

2) Health problems

 Stress can cause and also aggravate health problems. This include:

 Depression and anxiety 😔

 Pain of any kind

 Sleep problems 💤

 Autoimmune diseases

 Digestive problems (gastritis, GERD and irritable colon) 💩

 Skin conditions, such as eczema

 Cardiovascular disease (Heart disease, high blood pressure, heart attacks and abnormal heart rhythm) 💙

 Weight problems (obesity and eating disorders)

 Reproductive issues (sexual dysfunction and menstrual problem) 🤰

 Thinking and memory problems 🧠

Summary:

Several health problems in all systems of the body and poor academic performances are the major effects of stress among medical students

Management of Stress in Medical students

 Stress in medical school is inevitable.

 It is important that medical students know several positive coping strategies in order to prevent frequent stress and progression of acute stress into the chronic phase 😔

 To increase academic performance and quality of life, stress has to be managed appropriately ✅

 Stress coping techniques among medical students could be positive or negative

 Negative strategies are only useful as a short-term coping mechanism because they decrease symptoms while simultaneously sustaining or escalating the stressor

 Negative coping technique eventually causes more harm❗

 Negative strategies include:

 Self distraction

 Substance abuse 💊

 Denial

 Use of alcohol 🍷

 Aggressive behaviour 😠

 Comfort eating 🍕

 Sleeping too much 💤

 Therefore, it is recommended that negative coping strategies should not be used as stress management because it causes more harm than good and makes the situation worse in the long run ❌

 Positive coping strategies are the appropriate techniques which are effective in stress management. They include:

1) Exercise

 This is a common recommendation in stress management and it is one that really works❗

 Exercise relieves stress and combats depression more effectively than most other methods 🚴

 It is beneficial to follow a healthy lifestyle(exercise) and once you have made it a habit, you can continue to do so

 Moderate exercise, like running or moderate weight lifting, is something that will always benefit you ✅

 Exercise can be use as a reset button for your life🚴

 Taking a break from study is really beneficial if you decide to get involved in an healthy lifestyle like exercise 🚴

2) Manage time

 One of the most effective stress-relieving strategies is good time management ✅

 Time must be wisely managed, whether it is for relaxation, work, or academic work

 Designing a time table that one will be compliant with helps in proper time management ⌛

 A good time table helps to organise one's academic life and keeps track of all deadlines

 Time management also helps to prevent procrastination ⌛

3) Take one step at a time

 Slow and steady wins the race❗

 It is really important to be consistent in medical school no matter how small you take your steps

 You must accept the fact that you have chosen a rather stressful profession, and the schooling required for it is equally stressful and challenging

 Try not to procrastinate and pace yourself ❌

 Going through your work slowly and studying in small increments in a consistent manner helps you to shape yourself throughout medical school 🏨

 Medical school is a journey, not a race 🏨

 Balancing academic life with other things you love doing is important in order to enjoy this journey 🎨

4) Spend time with friends

 Hanging out with friends is important in bringing your level of stress to normal

 If a person is lonely, stress can become even worse 😔

 You suddenly feel a lot better after telling a friend you trust all of your feelings

 Hanging out also help to create a break from studies, which is important in stress management 😔

5) Do something you love

 Anytime you feel too stressed, you can take a break and do something you love 💕

 Whether it is reading novels, seeing movie or listening to music 🎨

 They all help to lighten your mood and refresh you 😊

6) Be optimistic

 If you try keeping focus on the negative side of a situation or a mistake you've made already, you will be disturbed by mental stress 😔

 Try to stay optimistic at all time 😊

 Look at the positive sides of situations

 Always look at the glass half full even in tough times

 This helps to improve productivity and relief stress, especially mental stress 😔

7) Get a good mentor

 Everyone requires the guidance of an experienced individual

 A good mentor can show you the ropes and prepare you for bumps in medical school 🏨

 Having a good mentor will help alleviate tension because they have been in your shoes and made it to the other side

 It is beneficial to have a mentor who is in your age range, so they can become a friend who can encourage you and communicate with you on a personal level 😊

 It's also beneficial to shadow and develop a mentor relationship with an older, more experienced physician

 They will show you the professional ropes and help you to avoid making the same mistakes they did

 They can also help you on the long run, if you have any medical problems you want to talk to them about

 Some can even help you secure a job in future❗

8) Get enough sleep

 Having enough good sleep has a range of health benefits, including stress reduction and better mood 💤

 Students who sleep well are also have better memory recall, and enjoy a clearer mind 💤

9) Eat well

 Make sure to eat a balance diet 🍏

 Avoid junk food which lacks appropriate nutrional value 🍕

 Good food helps in one way or the other to combat the effect of stress

10) Seek professional advice

 Stress can become critical, to an extent of causing threats to your physical, mental and emotional health 😔

 If one regularly experiences suicidal thought, abnormal social isolation, violent outbursts, panic attacks, emotional outburst or constant poor academic performance due to stress, it is important to seek professional help to prevent any real or potential damage to one's life

Summary:

Stress management is a technique that must be practiced. People don't learn these things immediately, and they take time to master, much like medical school.

Conclusion

1. No one is immune to stress.
2. The structure and factors surrounding medical school have made stress inevitable among medical students.
3. It is therefore important to manage stress effectively with positive coping strategies.
4. Effective management of stress helps to enhance academic productivity and the quality of life.

By Innocent Chijioke