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Student Voices: What is it about the third year of medical school that creates so much stress?


They're expected to spend their lives taking care of patients but who's making sure they're ok? Brianna Lide is a third year medical student at Texas A&M who says med students are optimistic the first two years of school, but around the time year three hits, a few things happen that have a profound impact on shaping future attitudes. What is it about that third year and what can be done about it? Find out more. 

Interviewer: We're broadcasting live at the AAMC in Baltimore, 2015. And this year's conversation is about change. What needs to change in healthcare? And I know there's a ton of things, but we're asking each person what specific thing is on their mind right now.

Announcer: Asking questions, seeking solutions. Algorithms for Innovation. Live from Baltimore at the AAMC 2015.

Lide: Hi, my name is Brianna Lide. I'm a third year medical student from Texas A&M.

Interviewer: Brianna, we're talking about change. As a third year medical student, what is the thing right now that you think needs to change? I know there are a lot of things, but let's pick one and talk about it.

Lide: One of the biggest conversations that we have coming to these conferences, and I have with my medical students and physicians is the physician burnout rate, and the lack of emphasis on physician well-being and wellness and how that relates to empathy.

Lide: Are there any tools that they're giving you in medical school to help be a well physician?

Lide: Yeah, I would say probably the majority of medical schools have some type of wellness programming, teaching us how to eat well, exercise, and also deal with mental illness. I'd say the majority of schools have counseling resources, but it still is not something that is completely well addressed, and most students would not say that they feel like they are maintaining their well-being as they go through this really stressful process.

Interviewer: So what do you think the solution is? Have you heard of anybody doing anything? Is there anything that you think would work?

Lide: Well, there are a lot of different, awesome programs that are happening whether it be empathy training and teaching people about how to relate to their patients. I already mentioned the counseling programs. A lot of schools are making the effort to normalize mental illness because it is still very stigmatized in medical schools, especially as it relates to depression, and eventually, unfortunately, suicide. Yeah, I don't really know, I can't speak to a specific program right now but there are a lot going on right now.

Interviewer: What about the competitive nature of medical school? Do you think that contributes a lot or not so much?

Lide: Yes, absolutely. I actually think the competitiveness is kind of what drives the burnout. And we have a lack of residency positions right now which makes things even more competitive because there aren't enough spots for the medical students who are already committing four years of their lives to training.

Interviewer: It sounds like there are a lot of things that are stressing med students out and doctors out.

Lide: Yes, absolutely.

Interviewer: And some of them you can get rid of, some of them you can't. And some of them you just have to cope with.

Lide: Yes, absolutely. And a lot of studies have shown that in the first two years, students are relatively optimistic but during the third year, they start to lose their empathy. And that's where the trend starts to turn downward.

Interviewer: All right, so, this is a problem that you recognize, a change that you feel needs to happen. What's the barrier in our way to actually doing something about it, do you think?

Lide: The barrier is, well, I've already mentioned the residency funding and lack thereof.

Interviewer: So make a commitment to med students, if you're going to be in school, we're going to make sure that you have a residency program.

Lide: Exactly. Yes. And then also, financial burden is a huge contributor to this, and people graduating with hundreds of thousands of dollars of debt. And then, not to have a guaranteed spot at the end of that is terrifying.

Interviewer: Yeah.

Lide: And very stressful.

Interviewer: All right, you're in an elevator, I'm actually somebody that could help make a change, what would be your two cents elevator pitch to me, why this is an important issue and what I should do about it?

Lide: Physician wellness has a huge impact vastly, including on patients. And physicians who are not well lack the ability to really, truly be empathetic and provide optimal care to patients.

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