Medical school can be very challenging and affect many aspects of life. Sure, the schoolwork is difficult (both in quality and quantity), but often it is more than just the work—it is the extracurricular activities that consume you, the distance from family and friends, the constant comparison of yourself to your peers, and the time constraints preventing you from doing the things that make you who you are. We are focused on getting into medical school and spending significant amounts of time on academics and volunteer activities, but we fail to see the bigger picture. What is it like to be in medical school? How will it affect my personal life? What are some strategies to maintain my life outside of medicine? I hope to provide some insight into the challenges of medical school and offer some suggestions about surviving that I learned along the way.
I am a third-year medical student at the Northern Ontario School of Medicine (NOSM) in Thunder Bay, Ontario, Canada. NOSM has a distributive model of learning in which students experience clinical placements throughout small northern and rural communities while simultaneously keeping up with academics. In first year, we have a 1-month cultural placement where we live in Indigenous communities throughout the region. I was placed in Biigtigong Nishnaabeg, a First Nations community just outside of Marathon, Ontario. In second year, I had two 1-month clinical placements in small, rural towns in northern Ontario—Emo and Marathon. Depending on the assigned site, students will have a variety of clinical experiences ranging from family medicine and walk-in clinics to hospital-based medicine. In third year, students spend 7 months in small northern and rural communities throughout Ontario. I am placed in Sioux Lookout, a community approximately 5 hours from Winnipeg. The Sioux Lookout hospital serves many Indigenous communities throughout northwestern Ontario, including remote First Nations communities accessible only via plane or seasonal ice roads. During this year, I will be flying to some of these communities to practice medicine. Patients in Sioux Lookout are often very complex, giving me ample exposure to internal medicine.
Loneliness and isolation have been challenging for me throughout medical school because we are frequently away for long periods, sometimes in placements great distances from home. These communities are small, further escalating feelings of isolation. I am still working on combating loneliness, but I have developed some helpful strategies. I prioritize frequent phone and video calls with friends and family. I try to travel to Thunder Bay to visit friends and family as often as I can. Yes, travel can take time away from studying, but your mental health should take precedence. Besides, you can always listen to medical podcasts on the drive! I find that participating in hobbies can help distract from the feelings of isolation. It is also important to maintain physical fitness and nutrition. Even after long days at the hospital or lengthy study sessions, prioritizing health is ultimately most important. Exercise promotes strong mental health and can help with better sleep and the ability to learn.
Comparing myself to others is an ever-present struggle, one that has plagued my mind both before and during medical school. It is easy to get caught up in how amazing and accomplished everyone is. With the fears of not matching to a residency program always looming overhead, thoughts of “Have I done enough?” or “Am I good enough?” continue to amplify. Everyone in your class will be brilliant, and everyone's medical journey will be different. It is important to remember that you have also accomplished great things and not to discount yourself. Just because you are not spending every waking moment working or studying does not mean you will not become a competent physician. In fact, working at your own pace and doing things you enjoy will likely give you a higher burnout threshold and maintain your compassion in comparison to your peers. Matching to a residency program is more than just what you did or how much you did. It is about your personality, your willingness to learn, and your ability to get along with others. Bottom line: Don't compare yourself to others. It will only lead to stress.
Being overwhelmed is common in medical school. It is easy to say “yes” to all opportunities that come your way. I have fallen into this trap—especially in first year. However, I still make this mistake. Attending all of the talks hosted by different interest groups, being involved in several interest groups, participating in extracurricular activities, planning class events, all the while trying to find time for your studies and hobbies is certainly a challenge. I have learned when to say “no” and remain involved in interest groups and events that I am truly passionate about. I no longer attend all of the talks offered by the school; instead, I attend the events I think are useful to my future career. Being involved in too many activities can lead to feelings of loneliness and isolation as they distract from hobbies and main supports, and also leave less time for maintaining a healthy lifestyle.
While I am still working on achieving work–life balance in the medical field, I am glad to have discovered some tricks that have helped me tackle the challenges of medical school. In sum: maintain relationships with close friends and family; keep up with your hobbies; maintain a healthy lifestyle; don't compare yourself to others; and remain involved in extracurriculars that you are passionate about. I am hopeful that I can continue to employ these strategies and find new methods of promoting work–life balance. Upon graduating from medical school, I hope to match to a residency program that aligns with my personality and career goals. I hope never to lose sight of who I am in the context of medicine.
Chelsea Kubinec, M.Sc.
Northern Ontario School of Medicine
Medical student – Class of 2021
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Back to the January 2020 issue of ACP IMpact