Medical Students, Leave College Coping Strategies Behind

How did you handle stress in college? Are you ready for the additional stresses of professional medical education? A medical student can bring poor stress management skills from college to their medical training. That’s risky since stress starts in college. Alongside excitement and opportunity, stresses and challenges await the approximately 20 million students in 4-year colleges¹. Transitioning to college often yields increasing stress^2,3, binge drinking^4,5, substance misuse^5,6, depression, and anxiety^7,8.

Medical school amplifies these challenges by demanding attention to a complicated topic and adding the unique challenges of clinical training in medical school.

Medical schools impart clinical encounter and decision-making skills. These skills are unfamiliar challenges that impact future provider and patient care. The difficulty follows the student as they progress through residency and into practice, potentially leading to physician burnout and other complicating effects.

Physician burnout impacts self-care. Excessive alcohol use is a significant problem, both for the individuals and for the patients under their care. US physicians report higher than normal burnout rates⁹ and burnout correlates with alcohol use problems^10,11. Specifically, AUDIT-C scores in 15.3% of physicians were consistent with diagnoses of alcohol abuse or dependence, especially for women (21.4% vs. 12.9%). Burnout also correlates with higher body mass index (BMI)^12,13, poor sleep¹⁴, less exercise¹⁵, and low career satisfaction¹⁶. Medical students also show high rates of burnout (up to 50%) and suicidal ideation (estimated at 10%)¹⁷. For medical students, 32.4% met the diagnostic criteria for alcohol abuse/dependence¹¹.

Each of these topics is discussed in more detail in other blogs including the facts that

1. Medical students are not Leaving College Coping Strategies Behind
2. Burnout & Decreased Personal Accomplishment are probably happening but the scales aren’t measuring it.
3. The answer to the question Does Burnout Get Better During Medical
   School is No. Burnout persists into later years of training.
4. Physician burnout has downstream negative effects on patient care (coming soon)
5. Burnout is related to Risky Alcohol Use & SI. Addressing burnout decreases the risk of alcohol use in professionals

Preparation for a career in medicine must then include:

• understanding factors leading to burnout,
• preventing burnout, recognizing burnout, and
• intervening when burnout is a personal issue or noted in a colleague.

Existing efforts at building physician resilience while still in medical school show promise^15,18–22. However, medicine needs a scalable, comprehensive, standardized solution.

In Lift, a medical student entering clinical training experiences a series of interactive scenarios including study, clinical duties, professional development, diet, and exercise, and social activities. The player encounters problems of hunger, stress, preparedness, and hygiene and makes choices that achieve health and resiliency.

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