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How to Manage Stress and Anxiety in Medical School

The pursuit of a healthy work/life balance in medical school can seem like an impossible goal. Many of us are torn between juggling heavy workloads, academic studies, managing relationship/family responsibilities, and squeezing in outside interests. More than one in four Americans describe themselves as “super stressed.” That’s not balanced—or healthy.

We might rush to “get it all done” and it’s easy to forget that as our stress levels spike, our productivity plummets and sense of empathy depletes. Stress can impede our concentration, make us irritable or depressed, and harm our personal and professional actions. To help others, we first have to help ourselves. As the old adage states, “The drowning man can save no one.”

Over time, stress weakens our immune systems, and makes us susceptible to a variety of ailments and disease. Reports indicate that over 400 physicians a year commit suicide. Why?

While we all need a certain amount of stress to help us perform at our best, the key to managing stress lies in balance. Achieving a healthy work/life balance is an attainable goal, but you have to make an effort and want it. When people are balanced and happy, they can be more productive, are sick less frequently, and are more efficient and effective.

Here are a few simple tips, strategies, and techniques that we can do to win back the balance in our lives by building resistance and resilience.

12 Tips for Managing Stress in Med School

1. Set manageable goals.

Being able to meet priorities helps us feel a sense of accomplishment and control. The latest research shows that the more control we have over our work, the less stressed we get. So be realistic about workloads and deadlines. Make a to-do list today, and take care of important tasks first and eliminate unessential ones. Ask for help when necessary.

2. Practice meditative breathing.

With your eyes closed, shift attention to the tip of your nose. As you breathe in, become aware of the air coming into your nostrils. As you breathe out, be aware of the sensation of the air passing back out. Notice that the air coming in tends to be cooler and the air breathed out tends to be warmer. Be aware of the cool air coming in and the warm air going out. Focusing on a physiological activity (air in and out) can help focus your mind and relax your body. If you lose focus, bring your index finger up and tap the tip of your nose. Breathe again.

3. Review your coursework daily. 

Take the time to integrate new material with what you already know.

4. Eat a banana!

A banana is a good source of tyrosine. Tyrosine is the amino acid that neurons turn into norepinephrine and dopamine. Norepinephrine and dopamine are excitatory neurotransmitters that are important in motivation, alertness, concentration, and memory.

5. Be efficient with your time.

When we procrastinate, the task often grows in our minds until it seems insurmountable. So when you face a big project at work or home, start by dividing it into smaller tasks. Complete the first one before moving on to the next.

Give yourself small rewards upon each completion, whether it’s a five minute break or a walk to the coffee shop. If you feel overwhelmed by routines that seem unnecessary, talk with work/study colleagues about it. The less time you spend doing busy work or procrastinating, the more time you can spend productively, or with friends or family.

6. Eat beets.

Betaine, an amino acid naturally present in certain vegetables, particularly beetroot, is an antidepressant of the first order. Betaine acts as a stimulant for the production of SAM-e (S-adenosylmethionine). The body cannot function appropriately without SAM-e, which it produces.

7. Use elaboration techniques to learn material.

Consciously relate new material to old. How does the medical school curriculum build upon the academic foundation already established? Know your science.

8. Work alone. 

Studying alone allows you to concentrate for long periods without interruption.

9. Develop a relaxation response.

The key to combating anxiety is recognizing when it has overtaken you and being prepared with simple available coping tools you can use on the spot. Notice what happens to you when you feel anxious. Does your heart pound, your mouth go dry, your palms sweat? Train yourself to become aware of your physiological symptoms. Keep a list of your symptoms and a list of your tools to counteract them. Have your list on hand. Be ready to take control when anxiety attempts to control you.

10. Perform a sitting body scan.

Place your feet flat on the floor and notice the feeling of your feet touching the floor. The weight and pressure, vibration, heat. Remove your shoes if desired. Notice your legs against the chair: pressure, pulsing, heaviness, lightness. Lean back. Notice the feeling of your back against the chair. Notice your abdomen. If your abdomen is tense or tight, let it soften. Take a breath. Notice your hands. Are your hands tense or tight? See if you can allow them to melt. Notice your arms. Feel any sensation in your arms. Let your shoulders be soft. Notice your neck and throat. Let the muscles soften. Relax. Soften your jaw. Let your face and facial muscles soften. Then notice your whole body presence. Where are you? What is your body doing? Take one more breath. Be present in your body. How does it feel?

11. Eat chicken.

Chicken, like eggs, contains complete protein that increases levels of the excitatory neurotransmitters norepinephrine and dopamine. Chicken is also a good source of coenzyme Q10 (Co Q10), which increases the energy-generating potential of neurons.

12. Make new material meaningful to you. 

Keep your end-goal in mind. Ask yourself or colleague: How will this information help me reach my goal?


With these tips, you’ll be well on your way to better stress management in medical school.