Medical School and Mental Health

written by Tajwar Taher, MD Candidate OHSU Class of 2021

A couple of years ago, if anyone had directed the words “mental health” towards me, I probably would have rolled my eyes, scoffed, and moonwalked away. Okay, I probably wouldn’t have done that because I’m neither rude nor rhythmically coordinated, but it gives you an idea of the lack of importance I attributed to mental health at the time. After all, I’m not crazy. I don’t have any of the neurological disorders I’d learned about in Psych classes. I was normal.

Yet normal is what we so desperately need in society, by which I mean we need to normalize discussing “mental health”; we should understand it not as a binary between “normal” and “crazy”, but a dynamic spectrum upon which all humans travel because the basis for being human resides in the mind. It’s as important to monitor our mental health as it is our physical health since the former can have such profound implications on the latter. If this wasn’t the case, we wouldn’t see the expanding emphasis in physician training on mental health services given that 50-60% of what we’ll be treating (for Primary Care anyway) will be mental health.

I hope I’ve hooked you now. I know that you’re an aspiring pre-medical student, so even if mental health wasn’t a personal priority for you before, it should be now. One day as a doctor you’ll have to engage with mental health in some form, so the more you can develop a competency to do so now, the better a provider you’ll be in the future. The best way to develop such competence is to reflect upon your own mental health since it rests upon your ability to empathize with others.

That’s probably why Oregon Health and Science University placed such an emphasis upon mental health during my orientation as a first-year medical student. They acknowledged that the coming four years would be the most mentally challenging experience of our lives, but that the university had many resources to help us through them. This was extremely comforting to hear, because it meant I had left behind the toxic “survival of the fittest” culture that unfortunately pervades the pre-medical community. No, OHSU doesn’t see struggling mentally as a sign of weakness; it sees it as a sign of being human.

Humans thrive in communities of supportive individuals, and I’m blessed to be in a medical school where my peers and I do whatever we can to make sure we succeed together: we share resources, we invite people to form study groups, and we even babysit each other’s kids so that we have the alone time we need to study. If you’re currently disenchanted with the dog-eat-dog culture within pre-med, I want you to know I’m sorry you have to bear such negativity in your life but that it’ll all be worth it once you matriculate. The culture of medical school and the health care profession is much more collaborative and supportive. If it weren’t, we wouldn’t be able to form effective teams to provide the best care for our patients.

However, accepting the pre-medical culture as an opportunity to develop your own mental health will make medical school a wonderful experience for you. No medical student exaggerates when they complain about how mentally draining the experience is. At the end of a typical day (which includes 4 hours of lecture, 4 hours of clinical lab work, and then an additional 2 hours of studying at home to pre-view the next day’s material and review the current day’s material), I sometimes stare blankly at a wall and do my best not to drool. It’s not that the content of the material is significantly more difficult than what I learned in undergrad, but the sheer amount of material we’re expected to learn in such a short amount of time is staggering. Medical school has been described as a marathon run at a sprint, and I get such tunnel vision from the pace that sometimes on the weekends I emerge feeling like I’ve just surfaced after swimming the entire length of an Olympic level swimming pool without taking a breath.

Just as swimmers must remember to breathe periodically, so too must the medical student. In order for me to be my best self, I know I have to invest in “wellness” to make sure I complete each lap. Yet, I’m not the kind of person who feels fulfilled by just “getting through a week”: rather than a half assed doggy paddle, I want to swim the entirety with a majestic butterfly. Wellness for me means that during my one-hour lunch break in the afternoon, I don’t go study like some of my peers. Instead, I meditate for 10 minutes, chat with friends, or read a pleasure book. When I return for afternoon classes, I find I can tackle the material with fervor and genuine interest. In the evenings, I have a cutoff time after which I don’t study anymore because I know my brain has reached its capacity to learn effectively. It’s a better use of time every night to get through my Netflix cue than it is trying to hammer material into my skull. I work out regularly, play IM sports, I make full use of the jacuzzi free to OHSU students, I sleep 8 hours every night, and on the weekends I go out to hike or eat with friends and I visit my parents. I invest in the people and things that make me happy, and in return I consistently receive solid scores.

As you prepare your application for medical school, please don’t forget that your mental health is a critical component of that application. Medical schools want to see that your brain does more than just store information; they want to see your ability to persevere when presented with demanding situations, your ability to adapt in an ever-changing environment, and the ability to reflect and redirect when critiqued. By finding your support system, by investing in personal wellness, and by recognizing that being a human means it’s okay to feel vulnerable, I have no doubt that when you face the MCAT for the first or second or third time, when you file away your first rejection, and when you find out whether you’ll be matriculating or re-applying, that you’ll have the mental fortitude to overcome these obstacles.

It might seem crazy to carry on when you feel overwhelmed or frustrated along the way, but just know that even med students, residents, and practicing physicians feel the same. Yes, we’re all a little crazy. It’s a reflection of the characteristic that makes us the best healthcare providers. It also portrays the most significant asset that you can have as a medical school candidate: being human.