Burnout is a serious issue for medical students. The extensive periods of studying for exam after exam, the looming stack of write-ups and patient notes awaiting completion, and the ever-growing landscape of the medical curriculum can cumulatively generate an overwhelming burden that compounds over the four years of medical school.
Empirical studies have found that approximately half of all medical students exhibit signs and symptoms indicative of burnout, and that it’s become more common over the past few decades.
The phenomenon negatively affects both medical schools and their students, and its impacts can persist well into residency and attending-hood. Unfortunately, students are often encouraged to persevere in the face of burnout, as if it’s just a normal part of medical training. This is not a good approach for the students who suffer from it, or the medical schools that must deal with the attrition it causes.
In this blog, we’ll dive into the issue of burnout in medical school, exploring its multifaceted signs, dissecting its underlying contributors, and offering various strategies both students and medical schools alike can employ to alleviate its effects.
3 Signs of Med School Burnout
Let’s begin by examining some of the key indicators of burnout. Do any of the following signs sound familiar to you?
1. Emotional Exhaustion
Beyond the exhaustion that comes from long hours of study and clinical work, emotional burnout in medical school often presents as a profound sense of depletion.
This is more than physical fatigue—it’s a soul-deep weariness that makes it challenging to summon the emotional strength required not only for patient care, but also self-care. A student experiencing burnout may even find it difficult to cook, grocery shop, or complete other necessary tasks for self-care.
2. Depersonalization
Depersonalization, another classic symptom of burnout, entails a growing sense of detachment from patients and colleagues. You might notice yourself becoming cynical or indifferent, and starting to view patients more as cases than individuals, which erodes the empathy that drew you to medicine in the first place.
3. Reduced Sense of Accomplishment
As burnout progresses, your inner critic can become louder, whispering doubts about your abilities and the impact you’re having.
For example, a student experiencing this may start to question whether their tireless efforts are bearing any fruit, leading to a diminished sense of accomplishment. Furthermore, this student might feel that their life has amounted to less than expected, and overly compare themselves to more successful peers.
6 Common Contributors of Med School Burnout
Now that we’ve covered some of the common signs of med school burnout, let’s examine some of the underlying causes of the phenomenon:
1. Demanding Workload & Tight Schedules
The intense curriculum of medical school can feel like an insurmountable mountain. Constant exams, clinical rotations, and the pressure to excel academically amplify the mental strain. The difficulty is compounded with strict time demands, particularly during clinical years, during which you must study for shelf exams and complete surveys and evaluations, all while putting in 10+ hours a day at the hospital.
School consumes most of your time during med school, and for the most part, your schedule only becomes more demanding during residency. Having such an unyielding schedule for most of your 20s can result in medical students missing out on important life events from birthdays to weddings. As a result, relationships can become strained, decreasing the student’s support system and intensifying the debilitating effects of burnout.
2. High Expectations
Many medical students set exceptionally high standards for themselves. The pressure to not only succeed but excel in all aspects of their medical journey can be overwhelming, especially when peers and professors also have lofty expectations.
3. Lack of Work-Life Balance
The elusive concept of work-life balance is often unattainable for medical students. The sacrifice of personal time, hobbies, and relationships can lead to isolation and intensify burnout.
4. Public Expectations
I’ve often heard (and I’m sure you have too) that “doctors shouldn’t have health issues.”
The belief that doctors and healthcare professionals don’t succumb to burnout or other mental health issues like depression is not only incorrect, this stigma contributes to the problem of burnout during medical school. Additionally, many believe that if residents and fully-minted attendings are not having issues with burnout, then what business do medical students have complaining about it?
Of course, this is a damaging mindset—medical students should communicate their concerns and struggles, especially because it will help them manage and prevent burnout before becoming residents and attendings. Meanwhile, it’s pivotal for schools to provide a safe environment in which students can feel at ease asking for help and discussing their concerns.
5. Difficult Patient Encounters
While patient care is the core of medical education, it can also be emotionally taxing. Witnessing suffering and making life-altering decisions can lead to compassion fatigue and vicarious trauma. Having adverse outcomes such as death, misdiagnosis, mistreatment, or dealing with patient harassment, are all things that can take a toll on a student’s mental well-being.
It’s important, after such events, to take a time-out and reflect on the experience. This can be done as a simple debrief and discussion after a tough case, or a full-blown M&M conference for an adverse event.
6. Financial Stress
The sheer cost of medical education adds an extra layer of stress. The burden of student loans and the fear of financial instability can weigh heavily on medical students’ minds. Students can often feel trapped by their loans and incorrectly believe that the only way to pay off the staggering student debt is with a high attending salary.
8 Things Medical Students Can Do to Alleviate Burnout
Let’s explore some things you can do to alleviate burnout during medical school. These include:
1. Communicate.
If you find yourself struggling with the overwhelming emotional weight of burnout, don’t hesitate to seek the guidance of a mental health professional or counselor. They can provide invaluable support and coping strategies. Your school likely offers various avenues of support, including the student affairs office, wellness programs, and deans that are willing to listen to you. Whichever direction you choose, make sure to communicate your concerns fully so you can be directed to the appropriate help.
2. Manage your time and prioritize.
Develop effective time management skills, prioritize tasks, and set boundaries. Allocate time for self-care, allowing it to become an integral part of your daily or weekly routine. This is nothing new, but it needs to be mentioned and should be done to the best of your ability.
3. Make self-care a priority
To build on this point, treat self-care as non-negotiable. Exercise regularly, engage in hobbies, spend quality time with loved ones, and at the very least, make sure you buy groceries. You have to take care of yourself in order to care for others.
4. Engage in stress mitigation.
Learn skills and techniques to decrease your stress. Embrace mindfulness techniques such as deep breathing, meditation, and progressive relaxation to manage stress and improve your overall mental well-being. Or…play basketball, take up archery or boxing, whatever feels good to you! Everyone has to have something to destress after a tough day at school.
And remember to reward yourself when you put in hard work. To illustrate this point, I want to share some wisdom from my mentor about the struggles of medical school—after decades of teaching clinical courses, he noticed that after the initial allure of a clinical rotation wears off, they become a slog. For students planning to go into solely a medical field, many will wonder, why do I have to spend months at the hospital for a surgical rotation? The rotation becomes a chore—trust me, when you’re in the hospital 12 hours a day, 6 days a week for months, it begins to wear you down.
My mentor said one of the best ways to deal with this is to treat yourself with trips or a nice and fancy meal after a tough rotation. Basically, reward yourself with something big upon finishing a medical school milestone.
In my experience, and for the many students I have worked with as a tutor, having something to look forward to is hugely helpful as it provides a light at the end of the tunnel.
5. Set realistic goals.
Re-evaluate your expectations and set realistic, achievable goals. Recognize that no one is perfect, and it’s perfectly acceptable to ask for help when needed. As more and more medical schools, particularly on the preclinical curriculum side of things, are transitioning to pass/fail, there is little need to strive for perfect scores on every test. As they say, P = MD (pass equals medical degree). I’m not saying do the bare minimum, I am simply saying you don’t need to be perfect.
6. Take advantage of available resources.
Many schools offer guidance and advice from the student affairs office. Be sure to seek help when you need it. Whether that’s an extra day for an exam, or a month off of rotations for your personal health, make use of what your school has to offer.
7. Talk with your peers.
Share your experiences with your peers, as they are going through it just like you. Create a support network with fellow students and upperclassmen who can understand your journey and provide advice and support.
8. Advocate for change.
If systemic issues within your medical school are contributing to burnout, be proactive in addressing them. Advocate for changes that promote a healthier work-life balance and overall safer and better learning environment for all students.
For example, one positive change you can make at your institution is to educate faculty and staff about the dangers of burnout. Having understanding and supportive faculty who are familiar with the rigors of the school and know how and when to help their students is valuable.
When the faculty and staff understand the symptoms of burnout, they can work with students to combat issues contributing to it. Deans and faculty alike can help mitigate student burnout by working with students and LCME to standardize better preclinical and clinical schedules that allow for self- care, friends, family, and personal time.
Further Reading
Burnout in medical school is a complex and often overlooked challenge. To combat it effectively, you must recognize its subtle signs, understand various contributors, and implement strategies for mitigation. Doing so means that healthier, happier, and more successful medical students will go on to graduate and become physicians!
For more (free!) mental health content for med students, you can find these other posts from Blueprint tutors on the Med School blog:
