A guide to wellbeing for medical students

 

EXAMINATIONS

    

STRESS

 

RELATIONSHIPS

RAGGING

MENTAL WELLBEING

INDEPENDENCE SEXUALIT

SELF-CARE

TIME MANAGEMENT

    Disclaimer: Any technology platform, nutrition and exercise suggestions in this book should not be construed as medical advice or endorsements by White Swan Foundation.

We have provided additional reading material as hyperlinks. To access them, it is recommended that you view this book on a computer.

© 2019 White Swan Foundation, Indian Medical Association

Design: Applied Wonder

First Edition

Read more about mental health, visit http://www.whiteswanfoundation.org

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Index

Foreword 02 Message from IMA 04 Introduction 06

Common struggles 07 Transitioning to medical college
Time management
Planning your study schedule

Examinations
Bullying, discrimination and ragging Interpersonal relationships
Grief and loss

Mental wellbeing 31 Signs of emotional distress
Common psychological issues
How to be an ally

Seeking help

Growth and coping strategies 41 Self-care

Building resilience Staying motivated Mentoring

Editorial by senior members 49 Dealing with difficult people
Things you may not learn in college
Remember you’re not a doctor yet

Recommended reading 56 Acknowledgements 57

  

Dear student,

Congratulations on choosing to become a medical professional. The next four years of your life are crucial in fulfilling your dream. There’s no denying that it will require you to follow a demanding schedule.

During this time, it is important that you take care of your health. Good health is the first and most important requirement for you to perform well and enjoy your years as a student. And this includes taking care of your mental health too. It is not uncommon to feel the stress of a tough curriculum, frequent examinations, demanding study calendar, and the struggle to find time to unwind. Sometimes the strain can adversely impact your regular levels of functioning and lead to a mental health issue.

The biggest challenge in case of mental health problems is that they are difficult to detect at an early stage. When you do detect it, you often go into denial mode. You refuse to acknowledge the issue at hand, and others encourage you to deny that you might have a mental health issue. Accepting that the adverse situation you are facing could possibly be a mental health problem and that you need to seek professional help is half the battle won. Having the right knowledge about mental healthcare can help avoid the trap of denial you might get into, and lead you towards the path of recovery.

Like mental health professionals tell us – the earlier you seek help for mental health issues, the better the chances of recovery. It is crucial that you are able to detect the mental health problems that you might face at the earliest, and seek appropriate and timely professional help. This book aims to empower you with knowledge about mental health to help you take care of your mental wellness during your student years. We hope that the information curated for you will help you make the right decisions for your mental health.

 

– 02 –

– 03 –

As is true for other health issues, in mental healthcare too, your role as an ally to classmates and friends who may be struggling is important. Your timely intervention in providing a supportive environment will go a long way in the other person’s recovery. This book will also help you pick up a few crucial tips on how you could be a mental health ally in college.

Your decisions on mental health — be it your own or that of people around you — must be based on right knowledge. Give yourself the space and time to acquire this knowledge. We hope this book helps you begin this journey.

Wishing you the very best years ahead,

Manoj Chandran

CEO
White Swan Foundation

 

Dear student,

The purpose of this health and wellbeing guide is to provide medical students — especially the first year students adjusting to a new environment — information, strategies and resources for self-care as an essential part of their undergraduate life.

This guide has been developed by the psychiatrists’ sub-commit- tee of the Indian Medical Association’s (IMA) Doctors-4-Doctors initiative, in collaboration with White Swan Foundation (WSF). This booklet would not have been possible in its current form without the help and support of White Swan Foundation’s team, special thanks to Aditi, Pavitra, Shruti, Manoj and Ranjitha. The information provided is based on facts derived from research, an in-depth literature review into emotional and physical health of medical students, and other relevant student wellbeing resources from around the globe.

The suggestions are not meant to be prescriptive. They are intended as examples that have been drawn from research, training, and student support programs that other medical students have found useful. The topics discussed and the insights presented are not a panacea to all problems faced by a medical student; they only serve as possible solutions to the most common challenges encountered. Everyone will have their own unique approach to processing information from this guidebook. Some might prefer to read it all at once, some at different points through the course of a year, others might prefer to read it with friends and discuss the topics amongst each other, and there may be those who would like to make notes. Feel free to use this book in any way that suits you best.

 

– 04 –

– 05 –

We hope you find this information useful and relevant. If you feel like you are experiencing difficulties of any sort that are listed here, please ask for help – there are many people who can help you. There is no shame in asking for help – it is one of the most courageous things you can do. This guidebook is just one way of promoting a culture of self-care among medical students and will hopefully inspire institutions, policy makers for undergraduate courses, and teachers to broaden the scope of student wellbeing strategies. We welcome comments and suggestions to improve this guide, your inputs will make this a more relevant document for you.

Best of luck, and enjoy the process of learning ahead of you.

Dr Suhas Chandran and Dr Sandip Deshpande

On behalf of the psychiatrists’ sub-committee of the IMA Doctors-4-Doctors initiative

 

Your time at medical college can be fun and exciting despite the workload and pressure.

We interviewed several medical students and doctors just out of college to find out what kind of struggles you are likely to deal with and how you can cope with them. With some you can stay ahead by preventing their onset. With a few others you learn how to manage them. Things can get overwhelming and the right knowledge on mental health will come in handy in prepar- ing you for these struggles and overcome them.

While most content in this book is relevant for all medical students, in a few chapters we have particularly focused on the stressors that first year students face. As you begin your journey, the new environment can be challenging. Knowledge and a little discipline can enable you to stay ahead of the challenges. Senior doctors have also provided some cheat sheets to some of the more academically challenging subjects that you will encounter in your first year.

We wish you the very best and hope that your course goes smoothly.

 

– 06 –

Common struggles

– 07 –

The transition from school to college can bring with it a new set of challenges – being responsible for your own activities, managing your time, preparing for exams, dealing with seniors and forming new relationships. In this section, we cover the struggles you are likely to face on entering medical college and offer you some guidelines that could reduce the stress that they may lead to.

Transitioning to medical college

Dr Divya Nallur

Moving from the protected environment of a school to the vast world of medical university can be a daunting and anxiety provoking time for you. Always ensure that you ask for help when you feel overwhelmed with any of these issues.

Independence: Direct scrutiny from parents and teachers will be reduced, especially if you are living away from home. With this independence comes the responsibility to manage your education and life autonomously.

     

Waking up on time by yourself

Setting time Allotting time for to study hobbies/ interests/

Cleaning your space and doing laundry

Following hostel rules and regulations

social life

   

Relying on hostel food, eating at the right time

Interacting with new people

Adjusting to lack of space or time for yourself

Managing your finances (Planning expenditure to include food, hygiene products, emergency funds, stationery, etc.)

 

Academics: You are in charge of attending lectures, doing classwork, completing projects and self-study, all without direct supervision from others. Ensure that you balance your time for work and leisure appropriately.

Information Overload: Academics in university is different from school. The amount of work/ reading that may need to be done may seem endless. The subjects may have a broad syllabus. Having a planned reading habit will help cover it. Take suggestions and support from your mentors and teachers to ensure that you are studying the right things from the start. Also remember that you may never ‘know it all’ and that is okay.

Alternative activities: There may be multiple clubs and activities within the university that will interest you. Maintain a good balance of physical exercise and other activities.

Socializing: The time you spend socializing with friends increases dramatically when you are in university. Create a schedule that works for you to manage your responsibilities as well as your socializing. Use applications (apps) to help with routine setting and expenditure planning.

If you’re moving to a new town or city, you may be exposed to a whole new culture and way of life. The changes could vary – with everything from a different climate; new cuisine; a language you don’t speak; and different social customs.

Here are some ways that you can deal with these challenges:

• Read about the town or city that you’re moving to

• Get in touch with people you know or friends you already know in
your hostel or college

• Approach the student welfare division of your college if there is one

• Consider joining an activity club that interests you, such as arts,
sports, debating, quizzing etc
Dr Divya Nallur
is a consultant psychiatrist at People Tree Hospitals, Bengaluru, Karnataka

 

https://www.whiteswanfoundation.org/article/are-you-anxious-about-moving-away-from-your-parents/

Click here to read more about moving away from home

– 08 –

 

– 09 –

Time Management

Making the transition to college brings with it the responsibility of managing your own time, with no one to tell you when to do what. Managing to get all your tasks done can be accomplished by creating a time management plan.

Ideally, your plan should include all of the activities you perform in a day. These can be divided into commitments, personal time, essentials and housekeeping.

     

Classes

Extra-curricular college activities

Grooming/hygiene Hobbies

Commitments

Work
Calling family

Personal time

Socializing Browsing internet

Essentials

Housework

Cleaning the house

Exercise Commuting

Leisure Shopping

                  

Eating

Sleeping

   

Cooking Laundry

Washing dishes Paying bills

    

You can make a similar table for yourself according to what your activities are. Be sure to allot a realistic amount of time that you will need for each task. To do this, you can try logging the amount of time taken per task in a diary for a few weeks.

You can also divide some of the tasks according to how often you need to do them. For example, hygiene is an everyday activity, but laundry can be done once a week.

Tips to avoid procrastination

Procrastination is avoiding or postponing a task despite there being a deadline. You may be faced with the situation of being overwhelmed with large portions of syllabus in front of you. This could discourage you and lead you to procrastinate. Here are some tips that will help you tackle this:

• Starting off your study routine can pose as a major challenge. To avoid this, start with a smaller task even if it isn’t a priority.

• If there is a particular task that is daunting you, try to break it down into smaller, achievable tasks.

• Reward yourself after a few tasks by watching an episode of a show you like, reading a few pages of a novel, or stepping out for a walk. Be mindful that one episode does not become two, and a few pages do not become too many.

• Make sure you create an environment that will help you concentrate. This includes studying at a time of day that suits you depending on whether you are an early bird or a night owl.

• If you’re feeling more active, seize the opportunity and tackle a harder task.

– 10 –

 

Absolutely urgent

(high importance)

Better do it soon

(medium importance)

– 11 –

Planning your study schedule

Studying for medical college can be very different from studying for school or pre-university. You will need to make optimum use of your time to keep up with the change. One of the ways in which you can accomplish this is to make to-do lists and prioritize your tasks into the following groups:

Can wait

(low importance)

As and when the priority level of the task goes up, it can be moved to a group of higher importance.

Pomodoro technique

The Pomodoro technique helps you break your work into intervals using a timer. There are plenty of free apps available to employ this method:

• Make a list of tasks

• Choose one and set the timer to 25 minutes

• Work on the task until the timer rings

• Put a checkmark against the task

• Take a five-minute break

• After every four sets (where one set is 25 minutes) take a 20-minute break
Pomodoro apps: Pomodone
Pomodoro timer Pomodoro nTask

                      

Other tips for efficient study planning:

• Read the course curriculum: The curriculum will have essential information on what you need to study, why you need to study it, how to study it and how you will be tested at the end of the course.

• Organize your study resources: Identify the right resources. Talk to your teachers, seniors, and friends and choose the right resources. The number of books you study will not matter if they are not the right books.

• Read before class: You can benefit most from a lecture if you have surveyed the topic in your textbook before the class. Spend 15 minutes to scan the key concepts, look up unfamiliar terms, and identify what you need to learn from the class.

• Plan self-assessment: After studying, plan a small test to assess yourself to check what you studied and where and how it can be put to use. This will also allow you to recognize what you are having trouble recalling.

• Recall: Make it a habit to briefly recall whatever you’ve studied previously before you sit down to study the topic you were taught that day. The more you recall, the more you retain.

• Look for connections: All of your subjects are interconnected. Relate what you learn in physiology with what you have learned in anatomy and biochemistry.

• Use the internet: Videos, virtual classroom learning, guest lectures, flowcharts and 3D pictures are available for better understanding of the subject.

4R

Remember the four ‘R’s: Read

Recall
Revise
and
Repeat until the objectives are achieved

– 12 –

 

– 13 –

Introduction to the subjects

Studying biology in school or pre-university is very different from studying medicine in college. There are only three subjects that you will study in the first year and they will all be taught in great detail. Many students find this change in syllabus hard to adjust to and feel overwhelmed. Here’s a brief introduction to the subjects and some tips that will help make it more manageable.

Human anatomy in its broadest sense, is the study of the structure of an object; in this case, the human body. Human anatomy deals with the way different parts of human beings — from molecules to bones — interact to form a functional unit.

Here are some tips to help you study human anatomy:

• Categorize each bone by type, the joints formed by it, identifying the type of joint to describe and demonstrate the movement occurring at that joint.

• Practice surface marking on the cadaver; compare it with living anatomy by repeating this on yourself or your friends (after having taken their consent!).

• Never miss a dissection class, and chance to dissect. See the dissected speci- mens in all the dissection tables.

• Remember that in the first-year all you are expected to do is identify the normal anatomical structures in the X-ray, and none of the abnormalities present – so try and avoid being a radiologist this early in your MBBS course.
Dr Tejaswi HL
Associate Professor of Anatomy, Adichunchanagiri Institute of Medical Sciences, Nagamangala, Karnataka

 

Physiology is the scientific study of the functions and mechanisms that work within a living system. As a subdiscipline of biology, it focuses on how organisms, organ systems, organs, cells, and biomolecules carry out chemical and physical functions in a living system. Several basic skills relevant to becoming a physician are introduced in the course – clinical examination skills, understanding laboratory tests and problem-solving.

Here are some tips to help you study physiology:

• Practice skills and procedures during practical/laboratory classes. The more you do, the more you relate it to what you learn.

• Look for connections. Physiological systems are interconnected. Relate what you learn in one section of physiology with what you have learnt in other contexts.

• Learning how a healthy body functions provides the framework for understanding mechanisms and consequences of disease and the basis for managing them. Think of it largely as a systems-based approach to biology with a smattering of physics.
Dr Harsha Halahalli
Department of Physiology, KS Hegde Medical Academy, Nitte, Mangalore, Karnataka

– 14 –

 

– 15 –

Biochemistry is the application of chemistry to the study of biological processes at the cellular and molecular level.

Here are some tips to help you study biochemistry:

• Use colors and highlighters. For example, write all the substrates in red, all the products in blue, the energetics in black, enzymes in red and coenzymes in green. Follow the same set of colors for all the pathways that you’ll learn in the first year.

• Always start with writing the site of reaction – which organ or organelle is it happening in? Are there any exceptions? Highlight any anomalies and the key enzymes.

• The reactions in every step are pretty simple, usually involving oxidation, reduc- tion, dehydration and carboxylation. Use the knowledge that you’ve learnt before and mention the type of reaction next to each step.

• One can also make tables for various vitamins, minerals, storage disorders, metabolic pathway defects and draw simple figures for transport mechanism and acid-base balance.
Dr Kusuma S
Associate professor, department of biochemistry, JSS Medical College Hospital, Mysore, Karnataka

 

Examinations

Feeling stressed out or anxious is normal before and during exams. Normal levels of stress help you work, think faster, study more efficiently and improve your performance. That said, if you find that your anxiety is overwhelming, it could have an adverse effect on your performance. Exam related anxiety is very common and it is essential to be able to recognize its signs and manage it effectively. Becoming aware of what causes this anxiety will help reduce the stress.

Signs of exam anxiety

Patchy sleep and sleepless nights

Physical symptoms like headaches, body aches, feeling uneasy in the stomach

Irritability or short temper

Sudden increase in appetite/overeating, or a loss of appetite

          

If you recognize these signs of anxiety before exams and tests, it may be advisable to develop a routine before and during your exams.

Before the exam:

Weekly revision timetable: Plan a timetable and divide what needs to be studied over a course of time. This will help you avoid last-minute exam anxiety and will help you achieve better recall. Be realistic and add enough time to socialize and relax.

Prepare your own notes: Writing down your notes or recording them into a recorder allows you to engage directly with the material, and will also help you connect different concepts better.

Organize information: Make use of mind maps, diagrams, flowcharts, flashcards, mnemonics, and tables while studying. Find an online tool that allows you to do this.

Consult past question papers: Going through past question papers will give you an idea of where there are gaps in your understanding and where you can spend more time on revision.

– 16 –

 

https://www.whiteswanfoundation.org/search-result/?q=exam%20stress&tag=True

Click here to read more about exam stress

– 17 –

Ask for help: If you are struggling with a certain topic, do not hesitate to contact your teachers, a helpful classmate or seniors for assistance in understanding a concept.

Group study: Group study can be highly beneficial as it facilitates the sharing of ideas and perspectives. Choose a compatible group that gives you a good balance of learning and teaching concepts.

During the exam:

Even if you are prepared, you may to struggle with some anxiety while you’re giving the exam. Spend the first few minutes of your time planning how you are going to answer the question paper.

Read the instructions carefully so you can identify which questions are mandatory, and how many you need to answer. Being anxious can sometimes lead to misreading the simplest instructions.

Deep breathing:

Breathe in

Breathe in through your nose.

Hold your breath for three seconds…

Breathe out slowly

and let it out slowly through your mouth.

Repeat a few times.

          

Read through all the sections of the question paper and tick all the questions you intend to answer. Calculate the time you need to answer each question as well as the order in which you want to attempt them.

Once you’ve done this, begin writing and ensure that your answers are relevant and precise.

Carry a bottle of water and stay hydrated.

 

Bullying, discrimination and ragging

Bullying is any aggressive behavior that is intended to show power and control over another person. Through physical, verbal and non-verbal abusive behavior, a bully violates the space of the other person. They may also harass others using technology such as text messages, blogs, and social media.

A person may be more prone to being bullied than others due to a long-standing pattern of societal discrimination against various factors that single them out. This marginalization can be due to factors such as — but not limited to — caste, religion, mental health status, physical ability, socio-economic status, sexual orientation, sex, gender identity, weight, age, and race. Being treated as less than equal, or subjected to exclusionary treatment has a lasting impact on a person’s mental health. Marginalization can have the following effects:

• Vulnerability to stress

• Higher exposure to trauma

• Potential risk of being exploited or excluded

• Social withdrawal

• Paranoia about how they might be perceived or treated by others

• Self-doubt

• Risk of suicide and self-harm
Your college can be a safer environment to those who are marginalized. Every stakeholder in a student’s life must take on the responsibility of educating themselves to recognize and be sensitive to the fact that a person might be dealing with heightened vulnerabilities. Stakeholders here include college administration staff, teachers, parents and students like you. By developing empathy and paying heed to these social inequalities, you can help a person feel less isolated and alone.

– 18 –

 

– 19 –

Cyberbullying: Bullying in the virtual space

Cyberbullying is any form of bullying or harassment that occurs online. It could happen on any of these platforms:

   

Some examples of cyberbullying

    

Posting embarrassing/ vulgar content that harms the affected person

Sending obscene messages

Stalking

Hacking someone’s account

Posing as another person online

 

Threatening with violence

Sharing child pornography

   

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What can you do if you’re being cyberbullied

Do not retaliate: In most cases, perpetrators are just looking for a reaction. When you react, you give them the power to harm you further. Do not respond or retaliate. Block the person and inform those close to you of the harassment so they do not engage either. You can also report the harasser on whatever platform they are using to bully you.

Save the evidence: The advantage here is that you can actually save the evidence in order to prove the harasser’s act. Take screenshots, save messages, posts, and comments with timestamps.

Browse safely: Ensure your privacy settings are in order on social media platforms. Regularly change your password and do not share it with anyone. Do not click on suspicious links and be wary of your webcam when you are not using it.

In case you do want to reach out and get help, contact the anti-ragging committee in your institution. University Grants Commission (UGC – http://www.ugc.ac.in) has mandated that every institution have an anti-ragging squad and committee to ensure that ragging and bullying are prohibited.

If you want to file a legal complaint, contact any cyber cell, contact information for which is available online: http://www.cybercrime.gov.in

If reporting a harasser to the relevant authorities has not been successful, you could consider making use of different platforms such as social media, NGOs, online media collectives that can help bring this issue to a larger audience. In some instances, where the harassment has been perpetrated by a figure of authority, you may not always receive the help you need when you register a complaint. In such a case, having the support of your coursemates can help bring this matter the attention it needs.

The process of filing a complaint, managing what happens after is understandably difficult to handle. At such a time it is a good idea for you to use the available mental health resources at hand to make sure your health is not badly affected. No matter which way you choose to approach such a situation, remember that your wellbeing and good health come first and are most important. If the harassment is being perpetrated by a figure of authority, approach a students’ group on campus that can provide support.

– 20 –

 

– 21 –

Ragging – know your rights

In 2009, the University Grants Commission (UGC) passed a regulation to curb the menace of ragging in higher educational institutes. Let’s break this regulation down for you.

What is ragging?

The law defines ragging as:

Any act of physical or mental abuse targeted at another student is ragging. This includes bullying and practicing exclusionary tactics.

Any abuse on the grounds of;

              

Race

Region of origin

Gender

(Including transgender)

Place of birth

Nationality

Ethnicity

Sexual orientation

Place of residence

Color

Religion & caste

Linguistic identity

Appearance

Economic background

                             

 

Other offenses that fall under ragging

• Abetment to ragging

• Criminal conspiracy to rag

• Unlawful assembly and rioting while ragging

• Public nuisance created during ragging

• Violation of decency and morals through ragging

• Injury to the body, causing hurt or grievous hurt

• Wrongful restraint

• Wrongful confinement

• Use of criminal force

• Assault as well as sexual offenses

• Extortion

• Criminal trespass

• Offences against property

• Criminal intimidation

• Attempts to commit any or all of the above-mentioned
offenses against the victim(s)

• Physical or psychological humiliation

– 22 –

 

– 23 –

Preventive measures by institutions

UGC regulates that every institution include strict pre-emptive measures to control the prevalence of ragging. This includes lodging freshers in a separate hostel and surprise raids (especially at night) by the anti-ragging squad. Senior students and their parents are also required to submit affidavits taking an oath not to indulge in ragging. Every institution must have an anti-ragging committee and an anti-ragging squad.

The anti-ragging squad: Nominated by the head of the institution, the anti-ragging squad consists of members belonging to various sections of the campus community. They are to maintain vigil, oversee, patrol and be mobile, alert and active at all times. They must inspect potential ragging points and conduct surprise raids on hostels and other high-risk locations.

The anti-ragging committee: Headed by the head of the institution, the anti-ragging committee will consist of representatives of civil and police administration, local media, non-governmental organizations (NGOs) involved in youth welfare, faculty members, parents, students (both freshers and seniors) and non-teaching staff. Its purpose is to monitor the anti-ragging activities in the institution and consider the recommendations of the anti-ragging squad to make decisions.

What to do if you are ragged

Anonymously report to

• The anti-ragging committee

• The helpline (Toll-Free No.: 1800 – 180 – 5522)
The squad must investigate incidents of ragging and make recommendations to
the anti-ragging committee, and work under its overall guidance.
What happens to the perpetrator
A first information report (FIR) is mandatory following which the perpetrator(s) is penalized with a warning and counseling, suspension, expulsion, suspension from hostel, debarment from examination, rustication or debarment from other institutions depending on the severity of the crime.

 

A common justification offered by perpetrators is that it was a harmless way of seniors getting to know their juniors. In reality, ragging is a far more serious issue and can result in inducing fear, shame, and humiliation. Some students isolate themselves entirely, may drop out of college and in some instances, suicide is an unfortunate outcome.

How bullying and ragging affect your mental health

A victim of bullying or ragging can experience a number of mental health symp- toms that disrupt their daily lives. These include, but are not limited to:

• Irritability

• Heightened emotional state compared to their usual self

• Decline in academic performance

• Change in temperament

• Absenteeism/ frequently missing classes in college

• Low self-esteem

• Social withdrawal

• Sleep disturbance

• Change in appetite

• High risk of illness

• Anxiety
The long-term risk of bullying also includes chronic depression, risk of self-harm and suicide, anxiety disorders, post-traumatic stress disorder (PTSD), substance abuse, and difficulty with trust and relationships.

– 24 –

 

– 25 –

Interpersonal relationships

Importance of community

Community plays a large role in our wellbeing. It helps give us a sense of belonging and lays the foundation for a strong support system. Community can be anyone from your family to friends, classmates, teachers or mentors.

Building a healthy community will go a long way in buffering the emotional burden of medical college. Having a strong support group will help when things get overwhelming. It can help to reconnect with an old friend or confide in a new one at college.

Staying connected to home

• Stay connected to your parents; for example, you can schedule video calls at family mealtimes.

• Make a family group of your parents and siblings; tell them to keep posting pictures of home. If you have a pet, ask them to send pictures and videos of them.

• Stay in touch with friends from your hometown; this may take more effort as you will be busy building social relationships in college. Invest time and effort to stay connected to your old friends. Include phone conversations or text messages, whatever works for you.

   

What are healthy relationships?

Healthy relationships are where both parties — be it friends, family or romantic partners — maintain a connection based on mutual respect.

Signs of a healthy relationship

    

Quality time

Common interests

Listening

Honesty

Open communication

Personal space

Empathy

Mutual respect

Conflict resolution

Emotional support

Trust

Acceptance

        

– 26 –

 

https://www.whiteswanfoundation.org/article/emotional-abuse-when-its-deeper-than-a-bruise-or-a-physical-injury/

Click here to read more about emotional abuse

Click here to read more about sexual abuse

https://www.whiteswanfoundation.org/article/all-violence-sexual-and-otherwise-is-motivated-by-power/

– 27 –

Abuse

Sometimes, relationships can start out healthy but turn toxic and abusive. Abuse is when there is a lack of mutual respect and misuse of a power-dynamic/authoritative equation from one party over another. It is important to be able to recognize when a relationship is abusive, though it can be difficult to recognize this while you are facing abuse.

Physical abuse

Physical abuse is when someone does something on purpose to hurt you and it results in physical pain or suffering. For example, hitting, punching, kicking, burning, restraining, confinement, pulling your hair, etc.

Emotional abuse

Emotional abuse is when someone intentionally follows a pattern where they are hurting your feelings. It involves behavior such as bullying, humiliating, threatening, blackmailing, shouting, restricting social contact, not meeting your emotional needs and constantly making you doubt yourself by lying to you.

Sexual abuse

Sexual abuse is any sexual activity that occurs without your consent. This includes — but is not restricted to — sharing compromising pictures, videos, any media of you without your permission on any platform (such as a website, social media, instant messaging service); sharing vulgar photos or pornography; watching pornography in your near vicinity with the intention of causing you discomfort and without your consent; flashing, touching themselves, voyeurism using any medium; sexual advances; sexually colored remarks, and any other unwelcome physical, verbal and non-verbal conduct of a sexual nature.

An abuser can be anyone – a complete stranger or even a friend; a family member; a romantic partner; or someone in a position of authority. It is important to remember that nobody deserves to be abused and if you are a victim of abuse, it is not your fault. It is also crucial that you confide in someone you trust in the event that you face abuse, and report it to the authorities.

 

Impact of abuse on mental health

     

Low self-esteem

Feelings of helplessness

Sleep disturbance

Concentration difficulties

Loneliness

Hypervigilance

Confusion

Decision-making difficulties

   

Constant abuse can lead to depression, anxiety, substance abuse, eating disorders and a number of stress-related disorders.

Sexuality

Sexuality is essential to our identity, our interaction with community and our sense of belonging. Several people also identify on the asexual spectrum and this too is an important part of a person’s identity.

World Health Organization (WHO) defines sexuality as:

“…a central aspect of being human throughout life encompasses sex, gender identities, and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, legal, historical, religious and spiritual factors.” (WHO, 2006)

They are natural and guided by the body and mind; all sexualities must be treated equally and deserve a right to dignity in life.

 

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https://www.whiteswanfoundation.

https://www.whiteswanfoundation.org/ebook/LGBTQIA-Edition/

Click here to read more

g/ebook/LGBTQIA-Edition/

or

  

https://www.whiteswanfoundation.org/article/is-grief-more-than-a-negative-emotion/

Click here to read more about grief

– 29 –

Grief and loss

Grief is a common result of experiencing a loss in your life. This could be the loss of a friend, the break-up of a romantic relationship, a divorce in your family, a loss of a job, or the death of a loved one. Bereavement is the period of mourning that follows the loss.

Signs of bereavement

    

Emotional numbness

Helplessness

Change in sleep

Sadness

Tearfulness

Change in appetite

Frequent discussion of the loss or refusal to talk about it

   

Anxiety

Exhaustion

  

Social withdrawal

 

Difficulties of grief

Practical difficulties: You may find it difficult to perform tasks that are a by-product of your loss. These may be time-sensitive and crucial responsibilities that you may struggle to complete, such as sorting out a person’s possessions after their death.

Thoughts: Grief comes with a lot of unsettling thoughts – anger, shock, confusion, guilt, helplessness. These are normal reactions to loss but may feel out of the blue and very hard to manage. Thoughts like, “I don’t have anyone who loves me in my life,” might occur.

Behavior: You may start to avoid places that remind you of your recent loss. You may also avoid talking about it. A loss may impact a change in your behavior with people who remind you of the person you lost, the event that took place, or it might be hard to talk like you would before to people.

How to deal with grief

While it may be difficult to get out of bed following your loss, there are a few things that you can do to alleviate your experience.

• Get in touch with a friend

• Spend some time engaging in an interest you enjoy

• Exercise for twenty minutes

• Try and get the right amount of sleep

• Take some time out and relax

• Try meditation or yoga
Avoid substance use
It will help to accept and acknowledge that overcoming grief takes time, and healing is a difficult, messy process. If at first you are unable to get out of bed, socialize or exercise, it is a natural response. Give yourself a break and take things at a pace that you feel comfortable with.

https://www.whiteswanfoundation.org/article/coping-with-loss-or-death-of-a-loved-one/

How to cope with the loss of a loved one

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Mental wellbeing

– 31 –

Now that you have a fair idea of what to expect in medical college, let’s have a look at mental wellbeing. WHO says, “Mental health is defined as a state of wellbeing in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribu- tion to her or his community.” It is entirely normal to feel like your mental wellbeing is not in the best state. This does not mean you have a mental illness but only that your body and mind are reacting to stress. In this section we discuss the signs of emotional distress, and look at some common psychological issues that will help you be there for your own mental wellbeing and that of your friends.

Signs of emotional distress

We have elaborated on many stressors that you will encounter during your time in medical college. Stress is a part and parcel of life, but sometimes it can get overwhelming and cause emotional distress. Here are some signs of emotional distress that you can keep an eye out for.

     

Fatigue or dullness

Upset stomach or unexplainable aches and pains

Social withdrawal or isolation

Being emotional, tearing up easily

Drastic change in sleep, appetite or self-care

Being worried, anxious or stressed out

Loss of interest
in otherwise pleasurable activities

Being aggressive and irritated

     

    

Absence from college

Inability to perform daily activities

Thoughts of self-blame

Drop in functioning at college

Hopelessness or helplessness

Bouts of uncontrollable anger

Being worried, anxious or stressed out

Severe mood swings

   

Common psychological issues

Dr Sandip Deshpande

When you are faced with overwhelming stress and unable to care for yourself due to hectic schedules, you might start exhibiting signs of emotional distress. This can transform into psychological issues that may disrupt your life. This is a regular consequence of stressful lives and should be treated in the same way that we would treat symptoms of the flu.

Let us now highlight some common psychological issues so you can identify them and seek help for it if necessary.

Depression

Depressive disorder is a psychiatric illness which lasts for more than two weeks. It is different from sadness. Symptoms include impaired patterns of mood, thoughts and behavior which may last for a long period of time. It can cause a lot of distress and can affect the quality of life.

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Click here to read more about depression

https://www.whiteswanfoundation.org/search-result/?q=depression

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Most people with depression have five or six of the following symptoms which have lasted for more than two weeks:

Feeling sad most of the time (but may feel a little better in the evenings) Losing interest and enjoyment in life
Feel tired easily and have reduced energy levels
Reduced concentration in day-to-day tasks

Find it harder to make decisions
Can’t cope with things that they used to
Feel restless and agitated
Lose appetite and weight
Sleep an hour or two earlier than normal, and wake up earlier than usual
Lose interest in sex
Lose self-confidence
Feel useless, inadequate and hopeless
Avoid other people
Feel guilty about trivial issues
Feel irritable
Feel worse at a particular time each day, usually in the morning Have thoughts of self-harm, suicidal ideation, or act on these thoughts
Have a bleak and pessimistic view of the future

Anxiety and stress-related disorders

Anxiety is a normal feeling and we have all experienced it when faced with situations that we find difficult or threatening – like an exam or an interview. It is important to differentiate anxiety from worry and fear. When anxiety is a result of a continuing problem like a financial issue we call it worry. A sudden response to an immediate threat like looking over a cliff is fear. Both fear and anxiety can be helpful to avoid dangerous situations, keep us alert, and motivate us to deal with a difficult situation. But if it becomes too strong or goes on for too long, it can interfere with our daily activities and make our lives miserable.

Anxiety can cause numerous physiological (in the body) and cognitive symptoms (in the mind), shown in two separate boxes below.

Physiological symptoms of anxiety

       

Irregular heart beats

(palpitations)

Tightness in the chest

Sweating

Muscle tension and pain

Dizziness

Shakes and tremors

Faintness

Butterflies in the stomach

Diarrhea

    

Breathing heavily

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Click here to read more about anxiety

https://www.whiteswanfoundation.org/search-result/?q=anxiety

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Cognitive symptoms of anxiety

    

Fear of ‘going mad’

Fear of a serious physical health problem

Inability to concentrate

Fear of ‘passing out’ or ‘imminent death’

Feeling worried all the time

Feeling irritable

Fear of having a ‘heart attack’

Feeling excessively tired

Sleep problems

      

If the above symptoms have persisted for over a few weeks or have been disabling or disrupting in nature for you, seek help from a medical professional.

Dr Sandip Deshpande is consultant psychiatrist, sexual & relationship therapist at People Tree Maarga, Bengaluru, Karnataka

 

Here’s a helpful exercise to cope with anxious feelings. 5-4-3-2-1 grounding exercise

Identify and pa5y attention to the following using your senses:

4things that you can see 3things that you can feel 2things that you can hear 1things that you can smell

thing that you can taste

Using all of your senses, this exercise allows you to observe the present environ- ment around you, which in turn leads to the alleviation of the unpleasant symptoms of anxiety.

     

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https://www.whiteswanfoundation.org/search-result/?q=suicide

Click here to read more about suicidality

– 37 –

Suicidality

Suicidality refers to and includes – suicidal ideation, suicidal thoughts, or attempt- ing suicide.

Symptoms that indicate you or someone you know might be suicidal:
Mood swings or excessive sadness:
These are symptoms of depression, which

may result in suicidal ideation.

Sudden calmness following a depressive episode: Feeling calm may be the result of a decision to take one’s own life.

Social withdrawal: Not making social contact or not taking interest in activities that they found pleasurable.

Changes in personality or appearance: There may be a significant change in their attitude and behavior. They may also start to pay less attention to their appearance.

Indulging in risky behavior: This could include reckless driving, substance abuse, unsafe sex.

Making preparations for death for no reason: The person may put their affairs in order, make a will, visit friends and family, or even prepare for the actual suicide itself.

Threatening to kill oneself or talking about death: They may talk about death or violence often. They may also talk about wanting to kill themselves. While many threats don’t turn into attempts, they must never be taken lightly.

Feeling worthless, helpless or trapped: They may feel there is no way out, feel like they are a burden to others, and complain about feeling worthless and helpless.

If you are having thoughts of suicide, it is very important that you reach out to someone. Try talking to a friend, a family member or even reach out to a medical professional. If you know someone who might be having thoughts of suicide, reach out to them and get them to seek help.

 

How to be an ally

If you notice any signs of distress (see page 33) among your friends, there are many things that you can do to be there for them. People with emotional distress can benefit greatly from a support system that understands them and offers them empathy.

To begin with, you can ask your friend how they are feeling and let them know that they can share their thoughts and emotions with you. They may not want to share, in which case you can let them know that you will always be there to listen. This is vital too as it will make your friend aware that support is just around the corner when they need it.

If your friend does decide to share, be careful of the following:

• Listen. Do not judge or blame them for their thoughts.

• Validate their emotions. Tell them it is okay to feel what they’re feeling and encourage them to talk openly.

• Do not offer advice or suggestions unless they specifically ask you for help.

• Find out if they have a support system – other friends, family, mentors, etc.

• Do not pressurize them to open up about something they don’t want to. Respect their boundaries.
If you believe that your friend is having thoughts of suicide, is unable to cope with their emotions, is unable to function because of the emotional distress, or is resorting to substance use, refer them to a mental health professional. It could save your friend’s life.

https://www.whiteswanfoundation.org/video/9290ef63389444a7847e7038a11dd0d9/

Click here to find out more about being an ally

– 38 –

 

  

https://www.whiteswanfoundation.org/article/asking-for-help-is-not-a-sign-of-weakness/

Asking for help is not a sign of weakness

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Seeking help

Asking for help can take a lot of courage, but it can relieve the emotional distress you may be facing.

When you should seek help

Unable to submit Difficulty in maintaining assignments on time interpersonal relationships

Decline in academic Decline in personal Unable to manage

            

performance

care

day-to-day activities

Changes in appetite and sleep pattern

 

Noticable difference in personal hygiene

Taking the decision to seek help is not easy for many people. You can take the first step by sharing your concerns with family or friends whom you trust and who have been there for you before.

 

How to seek help

Help can be sought from a mental health professional. This could be a counselor, psychologist, psychiatric social worker, or a psychiatrist.

Counselors and psychologists offer therapy and a psychiatrist will provide you with medication, if necessary. Medication and therapy go hand-in-hand. Whoever you consult must inform you of the nature of your issue, illness, prognosis, medication and side effects, as the case may be. Do not hesitate to ask any questions.

Make sure you are comfortable with whichever professional you meet. They must listen to you non-judgmentally and with patience. You may not find the right professional immediately. Do seek a second opinion in this situation.

Helplines

iCALL 022-25521111 8 am – 10 pm, Monday to Saturday

Parivarthan Sneha India Sahai

7676602602 4 pm – 10 pm, Monday to Friday 044-24640050 24/7
080-25497777

  

Use mental health apps:

You can also use other mental health apps which have mood trackers, breathing techniques, and guided meditation exercises.

Calm Headspace Wysa
Daylio
Virtual Hope Box 7 cups

                              

– 40 –

 

Growth and coping strategies

– 41 –

Self-care

Diet

Nutrition impacts both your mental and physical wellness, and the path to becoming a doctor is a long one. Your schedule will be demanding, rigorous, and you may find it hard to focus on your nutritional intake. Here are some ways in which you can maintain a healthy lifestyle:

• Create a mini-pantry in your room/ hostel/ dormitory — it can be a collective one among six to eight friends — that stores tea, coffee, sugar, salt, pepper, ketchup, jam, mustard, etc.

• Stock up on fresh fruits, eggs, bread, energy bars, nuts, milk, juice, buttermilk tetra packs, whole-grain biscuits, ready-to-eat foods like poha, upma, soup, and noodles.

• Never skip breakfast – if short on time, at least have a fruit!

• Never go to bed hungry; have a cup of warm milk or soup.

• Always keep some peanut chikki and nuts in your backpack.

• Always have a bottle of water on you, and remember to hydrate through- out the day.

• Avoid too many cups of coffee/ tea especially in the late evening as it might affect your sleep.

• Order healthier food on apps like Swiggy/ Zomato.

• Explore the possibility of getting home-cooked food by subscribing to a tiffin service.

  

Exercise

Exercise is linked with the release of important brain chemicals such as serotonin, dopamine, and endorphins. An increase in the levels of these chemicals can lift your mood, can reduce hostility, and make you more socially active. In short, it helps you feel happy and healthy.

Improvements in

Appetite Immunity Memory Concentration Energy levels

Sexual function Sleep quality Self-esteem Ability to cope with stress

Making time for exercise in your routine can pose as a challenge. But it is possible to find ways to be physically active.

                           

Join a sports club that you like

Join a gym

Practice yoga

Join a dance class

Walk to college instead of using public transportation

Schedule a walk or jog with a friend

Take the stairs instead of the elevator

Walk around while you’re on the phone

   

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Practice yoga:

Yoga has many benefits including bringing focus and attention to your body and mind which can help reduce anxiety. These are some apps you can use:

Daily Yoga Simply Yoga Yoga Studio Yoga Cure Yoga.com

Sleep

Sleep is essential for your physical and mental wellbeing. It is necessary for efficient brain functioning and it has an impact on your mental health, physical health, quality of life and overall safety as you go about your day. Sleep deficiency can have hazardous results – whether it is the impairing of judgment in the moment (like when you are on the road), or over a period of time where it can manifest in the form of health risks. Sleep deficiency can:

                  

Impair judgment

Impact ability to make and store new memories

Create hormonal balance

Affect concentration

Reduce immunity

Increase risk of heart disease

     

Maintaining a healthy sleep schedule

     

Wake up and go to bed at the same time every day while aiming to get eight hours of sleep

Do not use any electronic devices with backlights an hour before bedtime

Do not do any activity that requires high levels of focus an hour before bedtime

 

Avoid heavy meals within two hours of bedtime

Remember, alcohol, nicotine and caffeine can interfere with sleep

Here are some apps that you could use to track your sleep habits and improve them:

Sleep Cycle Insight Timer Noisl

With inputs from Dr Nilima Kadambi, founder director, Belle Sante Institute of Wellbeing, Bengaluru, Karnataka

                  

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Building resilience

Medical college is a long ride and somewhere along the way, you are likely to get overwhelmed and stressed. Resilience is riding through these times without it affecting your mental health, functioning, and interpersonal relationships. It is about how you cope, manage your emotions and seek support during a stressful period.

It is a misconception that resilience is something you are born with; when in fact it can be cultivated. Some of the ways in which you can improve your resilience are:

• Setting realistic goals

• Being aware of your feelings, thoughts, and behavior

• Expressing yourself and your needs to those around you

• Finding solutions and working towards them

• Having a support system you can rely on – friends and family

• Having relationships that are based on love, trust, are encouraging and
reassuring in nature
Levels of resilience can change over time – some episodes of stress may affect you more than others. It is important to have a positive view, and to believe in your strengths and abilities.

 

Staying motivated

There will be times when you feel you lack the motivation to stick it out for the entire journey in becoming a doctor; it is natural for this to happen. These are some ways in which you can stay motivated:

One of the advantages of medical school is the variety of subjects you learn over the course of your journey. While your first year may be very theoretical in nature, your practical experience begins shortly in the year after. With so many branches in medicine, know that there will always be a new subject just around the corner keeping you on your toes.

Picture yourself as a doctor. Be aware that what you are learning is adding to your skill as a doctor. The information might be boring but its value translates to the fact that someday a patient will rely on you to know this.

Remember why you wanted to become a doctor – think of the values, goals, and missions that brought you to this point. You worked hard to find a spot in a medical college and that is strong proof of your ability to put in the required amount of work and achieve results.

With inputs from Dr Edward Hoffman, adjunct associate psychology professor at Yeshiva University in New York City.

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Mentoring

Prof Sanju George

It is the process by which one person (mentor) guides the development of another (mentee), in this case, you. In the field of medicine, the mentor is generally a senior doctor who is experienced and knowledgeable. This process can benefit the mentor, you, and the organization itself. For a successful mentorship, you and your mentor need to actively participate in the process. Remember that your relationship will be dynamic and roles will constantly need to be redefined. You can decide the more specific aspects of your mentorship – whether you prefer a structured or flexible program, and the duration of it. The goal of mentorship is to learn, so don’t make it competitive.

The mentoring contract checklist

At the very first meeting, it is helpful to jointly come up with a mentoring contract and make it official.

   

Preferred means of communication

What areas will you focus on?

How long will the mentorship last?

What are your long-term goals?

How often will you meet?

How often will you review?

What are your short-term goals?

      

Make sure to ask as many questions as you can about what your expectations are, and what responsibilities you will have to take up. Also maintain a log of your mentoring sessions.

What should you look for in a mentor?

A good mentor should be supportive, knowledgeable, reliable and not judgemental. Exchanges should be kept confidential, and the mentor should be committed to the professional development of the mentee. A mentor should

Motivate
Empower and Encourage Nurture self-confidence Teach by example
Offer wise counsel
Raise the performance bar

Souba W: Mentoring young academic surgeons, our most precious asset (1999). Benefits of a mentorship program

Most mentorship program evaluations point to its numerous benefits. It can enhance your future in medicine by giving you a broader educational experience, outside of your textbooks. It can act as an aide for when you need to make decisions about your internships and choice of speciality. A mentor can also be a part of your social support system and enable you to network effectively in the field.

Very few medical colleges have a formal mentorship program. It is up to you — ideally in the first year of college — to take the lead in identifying a mentor and in taking the mentor-mentee relationship forward. One-to-one and face-to-face mentoring is preferable, but where this is not possible group mentoring and e-mentoring can be considered. You can also choose a mentor from outside your medical college, but make sure they are from your medical field.

Prof Sanju George is a professor of psychiatry and psychology at Rajagiri College of Social Sciences, Kochi, Kerala

– 48 –

 

Editorial by senior members

The underlying

motivation for the

interaction

(getting something done)

Your own value

or self-worth

(sticking true to your values and standing up for yourself)

The relationship

with the person

(be willing to compromise)

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Dealing with difficult people

Dr Ashlesha Bagadia

As you enter the vast and bewildering world of medical studies you will meet many people along the way; some of them may become memorable for all the wrong reasons. Here are some tips to help cope with difficult interactions with friends, seniors, juniors, teachers and professors.

American psychologist Marsha Linehan outlines suggestions for turning a negative interpersonal interaction into an effective one.

While interacting with someone, try to think of what you would like to salvage:

Depending on what is more important to you, you should be able to let go of the other two.

If you are asking a store owner to refund your money for a faulty stethoscope, the main thing to focus on is getting the refund. If he makes insulting remarks, don’t take them personally. Your self-worth is not of primary importance here, neither is your immediate relationship with him. If you value the relationship more than getting your refund, then you should be willing to compromise on the refund and that’s okay.

            

 

In the hostel, you may have to share a room with a difficult senior whom you rely on for borrowing notes. If that senior starts bullying you or harassing you, it may perhaps become important to let go of the focus on the task at hand (getting notes for exams) or your relationship with the senior, and shift the focus on your self-worth. You may choose to stand up for yourself and not let the senior bully you, find a different means of getting notes, and learn to walk away from the toxic relationship.

   

While interacting with friends you may often find yourself balancing between the three with a healthy dose of compromise to ensure that you build a lasting relationship.

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– 51 –

One of the most troubling areas of interaction may be with teachers or professors – especially if there is an unwritten understanding that criticizing students is like a rite of passage, that doing so builds resilience and prepares them better for the future. The same rules apply when interacting with difficult professors – try to turn their criticism to your advantage. Just as every failure provides a learning opportunity, every rude remark or criticism can work as an opportunity to improve yourself.

All of this seems easier said than done and it may be so, especially in your early years when you’re still trying to find your feet. An important asset to develop is an understanding of yourself and your own set of values. Find activities that are meaningful to you and develop your skills in them. You will then gravitate towards like-minded people whom you can turn to when you encounter difficult people.

As you become more aware of yourself and learn to manage your emotions better, you will be more prepared in situations where you have to deal with difficult people.

Dr Ashlesha Bagadia is a perinatal psychiatrist and psychotherapist at The Green Oak Initiative, Annaswamy Mudaliar General Hospital, Bengaluru, Karnataka

 

Things you may not learn in college

Dr Suhas Chandran

The extensive voyage through medical school teaches you the technical requirements for future practice, but lacks in addressing many crucial dos and don’ts for a successful medical career.

Things won’t always go as planned. That’s okay.

Most students start medical college with this grand idea that everything will go perfectly. But, there are bumps along the road – being able to adjust to new situations is an incredibly important trait to have as a student. You need to expect the unexpected and accept that you can’t prepare for every potential scenario. The ability to perform under pressure and think on your feet are qualities that will serve you well.

You are never really told how to manage your own health

Medical training is hard on its students, and quite frequently even inconsiderate about students’ physical and mental health. The long running classes and equally long study sessions do take their toll. You need to learn to help yourself before you effectively learn to help others. So take a step back, take some time off for yourself every once in a while.

Everyone you meet will know something that you don’t

Knowledge can be gained from the most unlikely places. The lab assistant in your physiology or biochemistry labs will often know more about your experiments than you and be willing to teach you most of the time. It’s also not just factual information that gets picked up; the five-minute coffee break discussions with faculty, peers and seniors can be a prospective wellsprings of ideas.

Your marks are important but not everything

Exams do not define you, they are simply checks on academic competence. Your self-worth should not be defined by your marks; don’t compare your marks with

– 52 –

 

– 53 –

those of your peers. Everyone’s journey leads to the same destination – graduating as a doctor. You came to medical school not to become excellent medical students, but to become excellent doctors. Many of you have entered this field with a desire to help people, and your marks can’t stop you from doing that.

You can achieve a lot by moving forward together with your peers

In the stressful milieu of a medical college, ensuring strong relationships with peers takes effort when you are fatigued, honesty when it’s an uncomfortable situation, and integrity when it’s difficult. You need to be able to include your peers and help them refocus when they are looking only at the obstacles – identify when this can’t be achieved and understand when to move past such a situation. Confrontations are frequent; understanding and effective communication are crucial to resolve conflict.

Untold parameters of student evaluation

In medicine, student evaluations are often hinged on long-term observation, on how students can reflect on their errors and correct themselves. This means that you need to be mindful about how you speak and be prepared to communicate effectively to benefit optimally from faculty interactions. Asking questions and participating in discussions will be appreciated as it shows your inquisitiveness and willingness to learn.

Take criticism constructively

Feedback should be received in its entirety, no matter how upsetting it might be. The attitude that criticism is always constructive helps deal effectively with any kind of feedback. It helps to have a discussion with the person giving feedback so that you can identify weaknesses and work on rectifying them. Following up and improving your work in line with the feedback is important as it shows that you’re willing to improve.

Never lose touch with your creative side

Music, art, poetry, literature are all essential to being a well-rounded human. They keep you in touch with the intangible, show you what the material world can’t; and teach you what can’t be taught. Keep in touch with your creative side.

Dr Suhas Chandran is an assistant professor at St. John’s Medical College Hospital, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka

 

Remember you’re not a doctor yet

Dr Kishor M

Twenty years ago, when I was returning home after being selected for the MBBS course, my hometown was in a festive spirit I felt as if the entire town was celebrating my entry into the medical profession! As I rushed home and bragged about becoming a doctor, my parents gently reminded me “You are not a doctor yet.”

A few months into medical college you will soon realize that the place in which you feel most like a doctor is not in class or in the dissection lab but when you are at home. You will be subjected to a torrent of medical questions and requests for advice from friends and relatives. This is especially common if you are the first medico in the family. There will invariably be an aunt with high blood pressure, an uncle with constant headaches and a friend with abdominal pain. It is important that you offer these individuals some comfort but not necessarily academic medical advice. When you are in the medical profession, your words matter. People have a special propensity for recalling anything that can be interpreted as a prognosis. The same holds true for those just perceived to be in the medical profession. And, like it or not, a first-year medical student does fall into this category. Choose your words wisely, do not surmise on which medication is better, which clinical investigation is sound or what the prognosis is.

It is imperative to remind individuals that you are far from being a physician, and that you are not involved in their care as a professional and as a result don’t know the details of their situation. You need to be conscious of the fact that whatever you say can be taken out of context, and people will read between the lines and make their own assumptions. By indulging in giving such advice, you bring unwarranted pressure on yourself. It may even inadvertently lead to you getting into trouble, in case your advice leads to negative outcomes for their health.

‘Doctor’ literally means ‘to teach’. Hundred of years worth of wisdom have ascertained the fact that to teach, you have to learn continuously. Often medical students assume every change in their body or mind as something they know of. It is true that you know more about clinical conditions like the common cold than the lay man. However, a practicing doctor or an ENT specialist would know far better.

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– 55 –

So when a friend or a family member asks you for advice, be mindful of the consequences of your words, and that it is better to admit that you do not know rather than say something which may lead to complications. It is also prudent to refer them to professionals and experts. Be humble and always keep in mind that you are not a doctor yet.

Dr Kishor M is an associate professor at the Department of Psychiatry, JSS Medical College Hospital, Mysore, Karnataka

 

Recommended reading

(Click here to read)

(https://jssuni.edu.in/JSSWeb/UDData/Docs/Ebook%20for%20MBBS%20Freshers.pdf)

(Click here to read)

(https://www.bmj.com/content/365/bmj.k663)

(Click here to read)

(https://www.ncbi.nlm.nih.gov/pubmed/23496121)

(Click here to read)

(https://jamanetwork.com/journals/jama/article-abstract/2696615)

– 56 –

Books

• This Won’t Hurt a Bit (And Other White Lies) by Michelle Au

• William Osler: A Life in Medicine by Michael Bliss

• Everything I Learned in Medical School by Sujay Kansagra

• White Coat by Ellen L Rothman, MD

• The One Thing I Would Like to Tell You by Suhas Chandran, Kishor M

• How to Succeed at Medical School by Dason Evans and Jo Brown
Papers

• Study tips for medical students BMJ 2019;365:k663

• Enhancing learning approaches: Practical tips for students and teachers
Samy A. Azer, Anthony

• P. S. Guerrero & Allyn Walsh (2013) , Medical Teacher, 35:6, 433-443

• Advice for a Student Starting Medical School. Cifu AS JAMA. 2018;320(8):759–760

  

RAecckonmowmledngdemd erenatsding

– 57 –

White Swan Foundation’s mission is to ensure that everyone has access to right knowledge of mental healthcare so that they make informed decisions. We had reached out to Dr Sandip Deshpande to seek his advice on developing knowledge and at one of our meetings, Dr Deshpande mentioned IMA’s Doctors-4-Doctors initiative and asked us if we could develop a knowledge repository for medical college students. Having developed India’s largest knowledge pool on mental health for the people, we were excited to be serving them.

Under the guidance of Dr Sandip Deshpande, Dr Nilima Kadambi and Dr Suhas Chandran, White Swan Foundation has put together this guide for the students. We would like to express our gratitude to the members of the IMA, particularly the Doctors-4-Doctors Committee, for giving us this opportunity. We would like to thank several practitioners who have taken time out to contribute for this book. We are also thankful to those numerous current and past students of medical colleges who have so readily shared their personal experiences with us that have significantly enriched the knowledge provided in the book.

 

Recommended reading

Recommended reading

Recommended reading

http://www.whiteswanfoundation.org

http://www.doctors4doctors.in

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