Medical students and health professional know the importance of teaching others to stay healthy, especially when it comes to the prevention of many chronic conditions like heart disease or obesity. But knowledge is not always enough and doesn’t always result in self-care. The long hours, massive amounts of studying and high levels of stress that are the norm for medical school can make it difficult to start or maintain the good habits that will keep you healthy during your med school years. However, there are important reasons for doing this–and many simple habits that can make it happen.
Part One: Why is This Important?
Apart from the obvious importance of staying healthy–e.g., reducing the risk of cardiac disease or certain forms of cancer–there are many reasons to take care of yourself that are specific to medical students and others working in the healthcare field:
● Medical students, doctors and other professionals can be more effective at their job if their stress levels are low and they are getting adequate rest.
● It is important that health care providers set a good example for their patients when it comes to living a healthy lifestyle: patient education is not as effective if it is coming from a doctor who is overweight or who obviously smokes. It can quickly become a case of “do as I say and not as I do”.
● Staying healthy can help avoid problems with medical student burnout and help to keep student doctors emotionally engaged with and empathetic to their patients.
Let’s look at healthy lifestyle habits that medical students can get into to keep fit during the course of their training.
Part Two: How to Stay Healthy as a Med Student
So if the “why” of staying healthy is obvious, the “how” can be a bit more difficult to tackle. The nature of medical school itself simply leaves little for anything outside out. However, there are simple, effective ways to maintain a healthy life even with the demands placed on you at this point in your life.
Eat Healthy
Let’s face it, it is really tempting to live entirely off the hospital/school cafeteria, fast food and snacks from the vending machine. Convenience food is, well, convenient. But it is also loaded with the saturated and trans fats, sodium, and simple carbohydrates that we spend so much time warning our patients against. In one enlightening study of students attending a medical school in Poland, it was found that the majority of those students had a variety of bad eating habits: they ate most of their calories later in the day, ate too much fat (especially animal fat) and did not get enough fruits, vegetables and fish in their diets. It was also found that alternative diets like vegetarian diets were not generally popular.
However, it has been found that self-analysis can help change these bad eating habits. In another study published in the journal Medicina, medical students who attended a long-term nutrition course where part of the work was a nutrient analysis of their own diet, showed favorable changes in their diet as the study progressed, including a decrease in saturated fat and an increase in fiber and vitamin C.
Once self-analysis has taken place and students have a better idea of what improvements they can make in their diet, they can take matters into their own hands. Many students, for instance, bring several packed meals with them (to cover long shifts) as well as healthy, convenient snacks like fresh fruits, fresh vegetables or protein bars. Apart from being a better choice as far as nutrition is concerned, this can also save a lot of money. A great booklet has been put out by the East Carolina University Brody School of Medicine entitled “Good Eats: Quick and Healthy Meals for Med Students” which is loaded with detailed ideas for simple, mindful eating even with a busy schedule.
Hydrate
As med students, interns and residents, we spend a lot of time lecturing our patients about how important it is to stay hydrated, especially for patients who have a history of kidney disease or similar conditions. But during a long and busy shift at the hospital, it is easy to go for hours without feeling like you have time to get a drink.
Actually, though, this is one of the easier ways to stay healthy. Bring a water bottle with you and take a slug on it in between patients. Know where all the water fountains are–and use them! Make sure that you drink on all your breaks and before and after your shift. If you want to keep track of how much you are drinking, there are plenty of bottles out there that mark the ounces so you can make sure you are truly getting enough.
The Good Eats booklet from the Brody School of Medicine has an entire section dedicated to healthy drinking tips for med students. This includes using water as the main beverage of the day and skipping on caffeinated drinks or energy drinks, sugary sodas or fruit juices and opting for low-calorie beverages over high-calorie ones.
Stay Active
Exercise helps to manage weight, is good for nearly every bodily system, and also helps to combat stress. It is also something that students can struggle with due to hectic schedules and little time. In the Polish study mentioned above, exercise levels were also analysed: it was found that nearly one half of the medical students studied got no exercise at all and that around 10% of females and 15% of males in this group were overweight.
However, even medical students can manage a healthy activity level during the course of their studies. The key here is to multi-task, combine exercise with other activities that you have to do already. When you are on a shift, take the stairs–every time–and you might be surprised about how much extra activity this gives you! When you are shopping or running errands, park at the far end of the parking lot so that you have to walk in. And if you have a ton of studying to do, bring your book with you to the gym or fitness center, prop it up against the front of your treadmill and start walking. See if you can bring some friends to make this a regular habit. If it is possible, walk or bike to class instead of taking the car. All of these tips can help to fit activity into even a very busy schedule.
Also, remember that you don’t have to have huge chunks of time carved out of your day in order to stay active. Mini-workouts throughout the day can be incredibly beneficial. So do some situps or pushups at home to start your day or a short, 10-minute yoga routine of just a few poses to keep your muscles supple. If you have a break in your time during the day, take a spin around the parking lot of the hospital or school. It might not seem like a lot, but in the long run, it can really add up.
Manage Stress
Stress is a killer, for medical students as well as the general population and can lead to sleep problems, irritability, weight gain and put you at a higher risk for burnout. This is a common problem. In one study of medical students, it was found that students reported multiple stressors in their lives (many of them related to academics) and that furthermore, the study linked these stressors to suicidal ideation and other negative impacts on mental health.
But the nature of medical school in and of itself is stressful: how can this be combatted?
There are many stress management techniques that are effective without taking up a lot your precious time. Yoga and tai chi are two important disciplines whose slow, controlled movements and breathing can help to lower blood pressure and stress levels; even breathing exercises alone have been shown to help reduce anxiety levels. Many universities offer classes in these disciplines or you might find it easier simply to start with a beginner-level video. Either way, these are two stress-busting activities to consider. In a review of studies done on the benefits of tai chi for students in higher education, it was found that this exercise was positively correlated with a decrease in depression and anxiety, better quality of sleep and lowered levels of aggression/hostility.
Another simple way to help beat stress is to simply get out into nature. Most hospitals and universities have at least some green space available in the vicinity, and even if you are attending school in a major metropolitan area, cities are putting more resources into parks and walking trails. Take advantage of them. If you have to study, bring your books and go outside to do it or take a short walk in the morning or evening at the start or close of your day. In a study of adults at high risk for job-related stress, it was found that participating in a nature-based stress management program for 12 weeks significantly reduced stress-related symptoms, symptoms of burnout and long-term sick leaves, while at the same time increasing work ability and healthy methods of coping with stressors.
Former medical students also note that pacing yourself is also important. Med school is a long haul and there is no getting around that. But keeping in mind your medical education is a marathon and not a sprint is important so that you do not overdo it and wear yourself out at the beginning.
In the study mentioned above, it was noted that the medical students suffering from stress and suicidal ideation, that combination of listening to music, reaching out to family and friends and keeping active helped to combat this issue. In other words, good stress management often requires a multi-pronged approach.
Get Enough Sleep
Sleep is as much a necessity for the body as oxygen, and yet most medical students–indeed, most Americans in general–do not get enough sleep, which is estimated to be between 6 and 8 hours a night. Long shifts, a ton of studying and stress-induced insomnia are big culprits here. A study published in the Saudi Medical Journal analyzed the sleep habits of a group of medical students and found that they averaged around 5.8 hours of sleep a night; 30% of these students were found to have poor quality of sleep, 40% reported daytime drowsiness and 33% reported insomnia, often brought on by stress related to school.
The question of sleep not only affects the health of doctors but the safety of patients. Authors of a study published in the International Journal of Medical Education note that past studies have shown that sleep deprivation from night shifts or extended shifts can have a negative impact on cognition, performance, patient care and overall quality of life. These studies prompted the United States Council of Graduate Medical Education to establish new parameters for medical school rotations, including a limit of 80 hours of work per week, no more than 24 hours of continuous work and shifts no more often than every 3 days. Still, some feel that even these changes are not enough to combat the problem of sleep deprivation during medical school.
General tips for good sleep habits that med school students can follow include napping when the opportunity presents itself, not working in bed, maintaining a sleep schedule (i.e. waking and going to sleep at the same time each day) whenever possible and, again whenever possible, aiming for 7-9 hours of sleep a night.
In short, staying healthy during medical school is no easy task–and it is tempting to take the easy way out and ignore your health in favor of convenience. But in the long run, this strategy simply does not pay off and it is better to start out, from day one as a medical student, with an attitude of health promotion to keep you fit throughout your medical training. This will not only help you make it through the rigors of med school, it can ultimately make you a better doctor, one who sets a good example for his/her patients and has the energy it takes to give patients the care that they deserve.
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Brian Wu, MD, Ph.D., MNM, graduated from the University of Maryland with a Bachelor’s of Science in Physiology and Neurobiology, and graduated from the Keck School of Medicine (University of Southern California) with an MD with a focus on holistic care and treatment. He currently holds a Ph.D. in integrative biology and disease for his research in exercise physiology and rehabilitation.