Wednesday, 2 October 2013

One month on

It's been a long time since I felt this pissed off, overwhelmed and really tired all at the same time. I have to apologise in advance, this is not going to be a happy post, but it's something I need to get off my chest because for the past few hours I have been feeling a level of anger and frustration which I haven't felt in ages. Unlike the majority of my posts on this blog, I don't even need to think about what I'm typing here, it's just flowing from my fingers effortlessly, which I assume is a big sign that I really need to vent.

To put things into context, I've been back at medical school for exactly a month, and am now halfway through the fifth week of a 12 week term which will be followed by a very important exam which, if I pass it, will allow me to progress to the clinical phase of the course. I'm glad to be back and to see my friends, but my god, there are certain aspects of this course which sometimes feel like I'm being pushed beyond belief and am totally powerless to push back. I'll try to break it down into a number of categories:

The pointlessness of small group work

How a typical morning/afternoon is structured on my course is as follows: lecture, small group work, lecture OR lecture, lecture, small group work. Then there's a lunch break or the day ends. The purpose of the small group work is to consolidate the concepts which have been taught in the immediately preceding lectures and I suppose, in some way, to encourage team work between group members i.e. by answering questions and completing exercises together.

This is an admirable aim, but it fails to take into account that different people learn in different ways. I find group work to be TOTALLY useless because it immediately follows the lecture and gives me no time to properly absorb the content, to go and look things up in a textbook, or to arrange my own notes - before throwing a load of questions at me.

Now, normally, I don't particularly mind having my time wasted because of someone's misguided notion of what learning "should" be like (er, as if I don't study in my own time anyway). However, when I have the most important exam of my life coming up in 8 weeks, this really throws into sharp relief just exactly how much of my limited time is being squandered each week to this rubbish. I could be spending the time working through things at my own pace and in a way which I understand, or you know, catching up on sleep (I'm not saying this to be lazy, see below).

Unfortunately attendance is monitored and compulsory, meaning that I have to sit through this utter pointlessness for up to 2 hours or more each day.

Lack of sleep

Once again, I'm finding myself becoming increasingly sleep deprived as the term drags on. In part, this is because, yes, deep down I'm nervous about these upcoming exams and the revision which I will need to recommence in two weeks or so (including year 1 content!) and this keeps me up at night.

HOWEVER a greater part is because a large amount of my day is wasted on pointless lectures or, even worse, group work - which means that I have to work much later into the night than I otherwise would. I would estimate that on a good night, I actually get into bed at 2 AM. When I fall asleep is anybody's guess, but I'd assume 3ish? I have to get up at 7:30 incidentally, so most nights I consider myself lucky if I get 5 hours sleep. I have had to go into uni on 3 hours sleep (or less) on more than one occasion this term, once again because group work is monitored.

Ordinarily, I wouldn't give a toss about losing sleep for a mere couple of weeks - the human body can withstand far sterner stuff than this, however, what I have noticed is that my lack of sleep isn't exactly doing me any favours as a human being. On a bad day, imagine my usual grumpy self, multiplied by about, I don't know...20? Don't misunderstand - I don't act like a dickhead and take things out on my classmates, but on many occasions I think it's very obvious that I'm really not all there and I'm not really being as friendly or sociable as I should be. Usually when my eyes are sliding out of focus for the fifth time in 20 minutes or so.

Lack of effective stress relief

Clearly the above aren't unique complaints. All students feel tired (though admittedly I don't know anyone else who's keeping my sleep hours - one of my friends tells me I'm pretty alone in this regard), all students feel stressed out about exams, and all students eventually feel fucked off at their university's assumption that the university's way of doing things is the "best" way.

However, I think I've unfortunately also become deprived of effective means of stress relief. When I lived in London and was feeling the strain, I would take my iPod along on one of my favourite walking routes, enjoy the scenery and fresh air and spend a good 3 or 4 hours simply walking the stress out of my system. Or you know, I'd just get smashed a couple of times a week.

No such luck here: the town my med school is in is rather small and if you tried walking anywhere for more than an hour or so, you'd either end up in the middle of nowhere, or walking around in circles. What's more I don't even FEEL like I have 3 or 4 hours to sacrifice for this anyway. But yeah, okay, I feel homesick for London a lot. There's no point denying it: I am so happy to be training to be a doctor, but I also really miss what I've left behind too.

As for getting smashed a couple of times a week, well that's even more off limits - I don't have the time and my hangovers have become something awful since I entered this latest stage of my life i.e. my mid-20s. But my god, everytime I see or hear drunken freshers on campus or around town, I literally want to break down in front of them and plead with them most earnestly to PLEASE, PLEASE, PLEASE appreciate what you have right now i.e. the simply pleasure of being able to go out whenever you like, act like a fool, and not have to care about the consequences the next day. It will NOT last forever unfortunately - and that really, really makes me want to weep.

Being me

Of course...these problems are only problems because I am me. There are people on my course who deal with all of this crap and don't feel stressed out to the point of skipping sleep and getting grumpy. There are people who get much better grades than me, run long distant races for charity, have stable long term relationships and are just, well, let's face it, much more well rounded as people than me anyway, however much they do or do not sleep. I am not one of those people - I am me. All I know is that I want to be a doctor more than I've wanted to do anything in my life...and I am willing to make all the necessary sacrifices for this to happen...but sometimes I feel like I've abandoned so many other aspects of my personality in the pursuit of this one desire. And I do regret that somewhat.

No doubt, some people out there will be shaking their heads and will be saying "mate, you need to just give less of a toss" - yes, this is very true, but unfortunately I am not used to not giving a toss. After twentysomething years I'm not sure I'm really in a position to change this attitude either. I am - by my nature - intense, driven and determined. It's gotten me results, as my end of first year results showed. Unfortunately, it also leads to stress, personal neglect and mood swings. This is obviously something I need to work on as a person, and I hope very soon I can have the time to do that.

Do I feel better after this rant?

If you've gotten this far, then congrats and thank you. Yeah I feel a bit better but the fact that I'll probably be up until 2 AM tonight trying to figure out exactly what the bastard Loop of Henle does means that this isn't going to be an effective source of long term stress relief.

All I can do, I suppose, is plug away in the only way I know how to and hope that when I (hopefully, PLEASE) progress to clinical medicine, things will be less pressurised and I'll have more time to be return to being me. I can only hope it won't be too late by then and I won't have become irreversibly accustomed to feeling under pressure. Or maybe I'm just screwed for the forseeable future!


  1. Writing as a junior doctor I know how stressful med school (and work) can be! But, if you don't look after yourself it makes everything a lot worse. We're told that the most important thing when we're on call is to eat, drink and pee- even if we don't feel we have time. There's no way you can perform your best when you feel rubbish.

    Try to take one evening off this week and have some 'me' time (cheesy I know!) Do something non medicine related, and get some sleep- you'll feel so much better the next day.

    When I was revising for finals I always used to take Friday nights off from revision- as I felt that without a break I was just really unproductive. Maybe try this and see if it helps- after all revision is quality not quantity.

    Hope things get better


  2. Believe me, I know how you feel. I feel so tired (although I'm not doing anywhere near the hours you are), like there's just not enough time to even keep up, and guilty if I use any of my time to do anything non uni-related (even if it's just to do some housework or earn some money). I don't really have anything useful to say, but hopefully it'll get better after exams. Just try not to burn out before then, your health is more important! Good luck with it all :)

  3. Oh gosh I can empathise with the pointlessness of small group-work sometimes too - why do they want to mash everyone together when we all learn at different rates and some are more prepared than others? As for the stress and lack of sleep, it sounds as if you're working really really hard - I know you have exams coming up but you also want to be in the best possible shape for them mentally and physically wise.

    Last year I was feeling similarly homesick too but I think you just have to find some space in your town and explore a little. I run in the mornings (when I've got the time...) and it really gives me a chance to just get my mind of anything studying-related and relax.

    I wish you all the best in trying to overcome these hurdles - and I'm partial to a rant now and then so at least it made you feel a little better.

  4. Thanks for the advice and kind words guys - I will try my best to achieve a more happy medium (amazing that this time a month ago I was so confident that by taking things "one day at a time" I could avert stress), but I'm not sure there will be any significant change over such a short period of time.

    I hope that the pre-exam adrenaline kick will override the stress and feelings of being overwhelmed so I can get through these exams and hopefully pass to the (apparently) less pressurised clinical phase of the course. If that happens, I'll hopefully have more time to achieve a better balance in my life. Cheers.

  5. Yeah, that whole not sleeping thing feels like it is catching up with me as well... That just kinda compounds what I like to refer to as non-belonging-ness (NBN) syndome!

  6. I feel your pain! We also had to do a lot of exercises we thought were questionable in the pre-clinical years and which eat up so much valuable time.

    When I started clinical medicine I thought those days were over. They are in a way, but when you start clinical medicine (and you will!) you'll come up against a whole new set of problems.

    Getting into medical school means hopping through a whole bunch of hoops and there are another set of even higher hoops to jump through to remain in medical school. We just have to jump them and try to keep positive.

    There were times when I felt at a loss and that the workload was crazy. How was I going to learn all that? My classmates and I have all felt like that. But one thing that I realised was that everyone is in the same situation and the majority get through, the sooner I stopped stressing, then the sooner I could get things done. Good luck, you'll do it!

  7. I also think you should give yourself an evening off. You might feel less burnt out that way, and it looks like you deserve it! Not much to add, just hope you feel better very soon :)

  8. Ahhh man. You are really working yourself super hard it seems. Yeah, the stress can get really unbearable at times, medicine is hard enough in 5 years let alone being squeezed into 4! Do you feel the pressure to be top of the class? Or is this just you being naturally very driven?
    I know the first two semesters I was gutted that I was around middle in our cohort. But for me personally it was important to have a life and take care of health issues, and there will always be someone better than you.
    Stay positive! And maybe get a couple of sneaky nap times in the week, being sleep deprived is the root of all evil! :)