The Medical Student in Pursuit of Sanity
– By Semiloore Atere, ABH PRESS
If you could see me vulnerable, weak-willed and susceptible to my emotions, who am I to heal you of your diseases? Admitting to mental illness many times is seen like admitting to a catastrophic failure. It feels like a strange plague that should never infest one despite obvious risk factors. We do not like to talk about it, thus addressing mental issues and proffering solution is a challenge.
As humans, the kind of goals we set for ourselves determines a lot about what we do and how we do them. There are certain pleasures and satisfaction when a specific goal is attained, so also does unhappiness creeps in when we lose. In most medical schools, a typical class is a competitive academic atmosphere. Medical students are generally intelligent, the best of the best from various backgrounds, focused and smart folks, and to be goal oriented is a natural habit to imbibe. Howbeit, medical school is a training ground to break and make you in terms of goals achievements, which is quite challenging for many students.
Regardless, it is quite dangerous to generalize the medical school journey for all students, but of course there are some common pertinent and familiar situations. The vision and mission of the Ibadan College of medicine for example, is to produce medical graduate that are worthy in character and in learning, excellent, knowledgeable, highly skilled, professional and champion in research (paraphrased). To achieve these goals, our curriculum is designed to be student driven; one must study smart and very hard.
Just like every other medical school, our curriculum has didactic lectures, practical, modeling, supervised practice, mentoring, hands-on experience to augment individual study. And in clinical school, in a full year you are entitled to only two weeks of vacation. These aspects of training process unfortunately have had unintended negative consequences on some student’s personal health. There are instances of depression, suicide attempts, emotional exhaustion, depersonalization, distress, social withdrawal, unwarranted social behaviors, burnouts, lack of sleep, alcohol drinking, substance related disorders, declined academic performance and stress.
Adjusting to the medical school environment is a big quest to conquer for many. The expectations to master a large volume of information in such a short time, the need to join groups for learning and interactions can be surreal and intimidating for young teens and adults used to instant mastery of materials and academic honors. This is further amplified for students who eventually get to have challenges academically for the very first time.
Human cadaver for learning could be very discomforting for some students, accommodation challenges can be very herculean especially for pre-clinical students and in clinical years there is a separation from peers, the adjustment to the frequent rotations from one posting to another, each requiring an idiosyncratic medical knowledge base and expectations also tend to focus attention on student’s deficiencies rather than their progress, the duty assignments, exposure to human suffering and so on
Interpersonal interactions between students and teachers- the consultants and residents, other medical students, health workers especially nurses, patients and their relatives could be arduous for some. There can be situations of verbal abuses, institutional abuses, running inappropriate errands, transfer of aggression and ethical conflicts. There could be inability to report due to fear of reprisal or potential negative repercussions.
Often times, student confidence and self-esteem are questioned in these circumstances. Personal life stressors such as losing a family member, an accident, a personal illness or injury, lack of maintenance of regular life style, change of health in a relative etc. Although, some degree of stress is a normal part of medical training and can also be a source of motivation for some individuals, however, not all students find these constructive.
Sadly, many medical students including me have felt awkward, overwhelmed, apprehensive, vulnerable, angry, anxious, victims of perpetual wishful thinking and negative self-criticism, incompetent and useless, filled with guilt, and experienced psychological and physical morbidity. In our pursuit to become health care givers we become victims of emotional stressors. Unfortunately, only few students are willing to use mental health services but will rather rely on the support of family and friends.
Despite all, my pursuit of sanity is a pursuit of happiness, joy and a sound mind. It is realizing that smooth seas don’t make good sailors and whatever comes my way is to make me better. It is a will to focus on the journey and not the destination, and my joy is not only from big tasks achieved but also appreciation of little accomplishments. It is not losing touch with humanity. My pursuit it is not building a life around a single thing because I am a person so multifaceted, it is participating in other areas asides medicine. It is taking control and thus avoids comparing myself with A or B or C but loving who I am and who I am becoming. Casting down every imagination and also realities that serves as a threat to my originality. This pursuit is a culture of love, hard work, obedience, sincerity, a culture of acceptance and openness regarding my physical and mental health and issues around it. For, if I must guide others about their health, it is only reasonable I guide my first and very jealously at doing so.
“We are fragile creatures and it is from this weakness, not despite it, that we discover true joy.” Desmond Tutu