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The perception of stress is, to some degree, subjective. What is successful for some may not be stressful in the same way for others.
However, without question, medical students face a variety of stresses daily.
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Definition of Stress
Stress is an internal process that occurs when a person is faced with a demand that is perceived to exceed the resources available to effectively respond to it, and where failure to effectively deal with the demand has important and undesirable consequences.
Each of us deals with stress in our own unique way. Stress is not always problematic.
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Stress is very subjective. Stress is our unique reaction to events.
Stress is defined as "our reaction to events, environmental or internal, that challenge or exceed our adaptive resources." Each of us has a certain number of coping resources, and when those coping resources are challenged or exceeded, stress usually results. Stress reactions consist of both physical and emotional responses.
Each of us deals with stress in our own unique way. Stress is not always negative or problematic. Stress can be a motivator toward change and growth or a cause of impairment.
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What are Stressors?
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Physical
Psychological
Familial
Financial
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Spiritual
Social
Academic
Clinical Training
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Physical Stressors result from internal physical symptoms, such as headaches, stomach problems, etc.; and external physical stressors, such as heat, cold, excessive noise, etc.
Psychological Stressors arise from time pressures or the unrealistic expectations we place on ourselves or allow to be placed on us by others, such as, “you must be perfect,” “you must know everything,” or “you must suppress your feelings at all costs.” An irrational belief, for example is “doctors don’t get sick with illnesses such as: anxiety, depression, psychiatric disorders.” Fatigue and time demands can lead to anxiety, depression, and substance abuse.
Familial Stressors can arise from relationship problems with parents, spouses and children. Medical students face completing time demands for family and education. Family problems can tax important resources like time and money, and often require immediate attention.
Financial Stressors are common for medical students. Often medical students do not have the time to have jobs. Students loans are a burden shared by most medical students. Medical students face challenges in whether they can make by with their current funds or must they acquire another student loan.
Spiritual Stressors arise when basic spiritual values or beliefs are reformulated, called into question, disregarded, or when time constraints impede on spiritual growth or attendance at services. Neglect of spiritual needs contributes to higher levels of stress and impairment.
Social Stressors are abundant and can arise in any context where interpersonal relationships exist, like school, work, church, and community. The loss of contact with friends and family contributes to feelings of loneliness among busy students. Stress can arise from continued forced contact with individuals with whom you may not share the same values or beliefs.
Academic Stressors change as the student progresses through school. The first two years, the student faces competition and fear of failure. As the student proceeds into the later years of education, stressors are experienced by the student, such as fears of increasing responsibility, death of patients, fear of infection or bodily harm, and discomfort with discussing sexual issues.
Clinical Stressors include difficulties in dealing with the chain of command/pecking order common for students. Coping with hierarchy and the authoritative environment is of troubling for students.
“One student compares medical training to military training. She says they both recruit young people full of leadership potential and essentially break their autonomous will through a rigorous hierarchy. The first two years are boot camp, the last two, during which students are thrown into the hospital wards, are definitely front-line duty.”
[Coombs, Robert. Surviving Medical School. Sage Publishing: Thousand Oaks, 1998. pg.22.]
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Possible Stressors in Medical School
- Heavy academic workload/clinical caseload
- Perceived need to excel at all cost
- Lack of timeouts for a temporary emotional breather
- Exposure to and responsibility for direct contact with patients
- Concern of exposure to infectious diseases; i.e., AIDS, Hepatitis C, Tuberculosis, and MRSA
- Limited access to a social-professional support system
- Inadequate training for working with patients and families
- Frenetic, intense pace of training
- Repetitive single tasks/scut-work
- Problems without solutions; i.e., “you can’t fix everything”
- Time pressures and demands
- Tendency to self-diagnose
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For instance, there is generally a heavy academic workload/clinical caseload. Students have a perceived need to excel at all cost; i.e., always try and maintain a 4.0 GPA. Students often transition from being “top dog” in undergraduate school to an equal among their peers. Medical students who receive C grades still become doctors, C=MD.
Busy schedules and excessive, continuous, direct contact with patients do not allow for even short breaks for emotional recharge.
Students sometimes have concern of exposure to infectious diseases, such as AIDS, Hepatitis C, Tuberculosis, and Methicillin Resistant Stephococcus Aureus (MRSA). Medical students sometimes have limited access to a social-professional support system and no time and place to share personal feelings with colleagues. Medical students often receive little or no training for working with patients and their families. Stress develops for some students from the frenetic, intense pace of training/scut-work.
Time pressures and demands may also stressors for students. As students become more knowledable about disease processes, there may be a tendency to self-diagnose. This is sometimes referred to as the second year syndrome. Suffice it to say, stressors may adversely affect a medical student’s level of functioning.
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Last Published: 3/23/2009 Print this page
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