stressed medical student residency

The transition between medical school and residency is quite possibly one of the most difficult things you will ever have to do. We all start off with the knowledge that residency training is going to be extremely challenging and we mentally prepare ourselves for the endeavor. Unfortunately, actually going through residency training is a lot different than the mental anticipation of it.

Depending on your specialty, there is a high probability that you will be sleep deprived, underfed, and overworked. After you add in the stress of high expectations and real patient lives at stake, the experience has the potential to be extremely overwhelming.

In order to meet the demands of work life, you have to carefully pick and choose the hobbies/activities you will participate in. Unless health and fitness are a major priority in your life, they will likely be neglected. Unfortunately, residency isn’t the ideal time to ignore these things.

Here’s why…

 

Residency is destroying your fitness

The emotional stressors caused by a demanding residency schedule can have a lasting impact on your mental health. According to a meta-analysis done in 2015, approximately 29% of resident physicians are depressed or experience depressive symptoms.1 It is well documented that depression could lead to cognitive decline, which could have serious consequences in acute medical settings.2

Suicidality is also a major concern in the medical field. Sadly, approximately 300-400 physicians die by suicide every year. Fortunately, hospitals have begun to take the matter seriously, as residents are being provided with free mental health services and other wellness initiatives.

Residency can also impact your physical body in many ways. One small study done in a cohort of 375 residents at Yale University found that on average, residents were more likely to be overweight at the beginning of PGY3 as compared to PGY1.3 Additionally, other smaller studies have seen statistically significant increases in resident weight gain throughout the course of their training.4

While it may not sound like much, 1 in every 3 adults is either overweight or obese. Any increase in body fat will decrease your lean muscle mass percentage, lower your, quality of life and increase your risk of all-cause mortality.

Becoming overweight/obese during your late 20s and early 30s can have major consequences that could be prevented. These include the development of chronic conditions such as diabetes mellitus, hypertension, and dyslipidemia.

 

Simple strategies to maintain your health & fitness in residency

While these negative effects sound grim, all hope is not lost. Even as a resident physician, there are ways to take care of your health and improve your fitness.

Exercise has been shown to have tremendous benefits on both the body and the mind. A study done by Duke University found that exercise was just as effective as antidepressants (SSRIs) in decreasing major depressive symptoms in individuals with a clinical diagnosis of Major Depressive Disorder.5 In addition, a subsequent follow-up study found that those individuals who continued to exercise at the 4-month mark were less likely to relapse into depression.6

Most residents say that they do not have time to exercise. Unfortunately, having that mindset will create a procrastination habit and keep your health and fitness spiraling downhill. After residency, you may be starting a family, or trying to establish your own practice. If you don’t develop the mindset and the habit of making time for yourself now, it will only get more difficult to do so later in life.

It is absolutely possible to carve out 30 minutes a day, three times a week to exercise. One of these sessions could even be on your day off.

Make sure to find a fitness center that is near your hospital so that you can go straight to your workout after your shift. Additionally, bring your gym clothes with you to work so that you don’t have to waste time going home to change. Expecting to go home and then go back out to the gym is a set-up for failure.

You could also get a fellow resident to join your fitness journey so that you could hold each other accountable.

 

But what if I hate going to the gym/exercising?

There are some people who truly dislike physical activity. If you really hate exercising, you could still benefit from exercise by increasing the amount of walking that you do.

Related story: 12 common exercise excuses debunked

Walking is by far the most underrated exercise of all time. It increases your body’s circulation, decreases the risk of chronic metabolic conditions, and helps to keep your weight in check.

Studies have demonstrated that 10,000 steps a day is a great goal to aim for, as this threshold has been associated with increased levels of fitness and decreased rates of chronic conditions in young adults.7,8

Fortunately, it is very easy to keep track of your steps. Many devices of various price ranges have entered the market that could be used as fitness trackers.

If you want to be a superstar, you can do both. Begin exercising and walking more!

 

Simple ways to improve your diet in residency

As a resident physician, it is difficult to make good food choices. Being on a 24-hour call or on the night shift increases the chances of consuming low-quality foods. Making the matter worse, vending machines at every corner provide a constant supply of soda, potato chips, and candy bars.

One simple way to circumvent many of the problems caused by poor food choices is to add high-quality food choices into your current diet. Instead of having to find good substitutions, just try eating healthy foods with whatever meal you’re already having.

One of the best food groups you could consume is green vegetables. Aim to consume some type of leafy green with each of your major meals. They are loaded with calcium, magnesium and many other micronutrients that your body probably doesn’t get enough of.

Another great food group to add is nuts. Try consuming a packet of nuts as a quick snack whenever there is minimal time to eat. They are loaded with healthy fats that can help satiate your appetite and decrease the risk of splurging later.

One of the best things you could do is to limit the amount of non-water drinks that you consume. Soda and juice are the major players and contain very high levels of sugar and calories. Do your best to drink plain water. Don’t say that you don’t like water. You are water. Try drinking water and nothing else for one week and see how you feel.

 

Final words

Once you begin to prioritize your health and fitness, you will notice significant improvements in your mood, your energy levels, and your overall quality of life.

Take action and don’t delay any longer. Residency is the time where you will obtain the vast majority of your medical training and also probably a lot of unhealthy habits. Don’t become a statistic. Don’t let residency destroy your fitness.


References
1. Mata, D. A., Ramos, M. A., Bansal, N., Khan, R., Guille, C., Di Angelantonio, E., & Sen, S. (2015). Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. Jama314(22), 2373-2383.
2. Lam, R. W., Kennedy, S. H., McIntyre, R. S., & Khullar, A. (2014). Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment. The Canadian Journal of Psychiatry59(12), 649-654.
3. Leventer-Roberts, M., Zonfrillo, M. R., Yu, S., Dziura, J. D., & Spiro, D. M. (2013). Overweight physicians during residency: a cross-sectional and longitudinal study. Journal of graduate medical education5(3), 405-411.
4. Battles, S. M., Williams, C. J., & Duldner, J. E. (2004). Body composition change during the intern year of emergency medicine residency. Annals of Emergency Medicine44(4), S76-S77.
5. Blumenthal, J. A., Babyak, M. A., Moore, K. A., Craighead, W. E., Herman, S., Khatri, P., … & Doraiswamy, P. M. (1999). Effects of exercise training on older patients with major depression. Archives of internal medicine159(19), 2349-2356.
6. Blumenthal, J. A., Babyak, M. A., Doraiswamy, P. M., Watkins, L., Hoffman, B. M., Barbour, K. A., … & Hinderliter, A. (2007). Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Medicine69(7), 587.
7. Tudor-Locke, C., & Bassett, D. R. (2004). How many steps/day are enough?. Sports medicine34(1), 1-8.
8. Murtagh, E. M., Murphy, M. H., & Boone-Heinonen, J. (2010). Walking–the first steps in cardiovascular disease prevention. Current opinion in cardiology25(5), 490.

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