REST and reduce Stress

Medical education and the academic and professional journeys from UME to GME, to board certification, can be stressful. Remember, REST. 

1. Read your medical school and residency handbooks. Like the preface of a book, which often unlocks the author’s intention and approach, a handbook is often a guide to what to expect in school and residency. If you skip it, you may miss key information, particularly when students and residents are the main contributors to the handbook.  
2. Embrace the notion that medical education requires self-directed learning. Unlike undergrad, there’s simply too much information to learn during medical school to wait for lectures and labs. You need to prioritize what to learn and how to learn it. Develop a workflow, because a lot of your time will be spent watching, listening, reading, practicing, and doing flashcards outside of school. During residency, it’s similar, but with even less time available for study, learning, and practicing, for annual ITEs and board certifying exams is often a competition for time spent preparing for cases, pre-rounding, attending grand rounds, and more. 
3. Stress management and wellness are essential to maintaining overall well-being, including physical, psychological, spiritual, and emotional health. Personal wellness is a foundation for learning, studying, and providing healthcare. Depending on your preferences, it is important to make time for yourself, to connect with family and friends, and to preserve time for sleep, fitness, nutrition, self-reflection, and spirituality. Prepare and share your schedule with family and friends, and communicate, so others can understand when you are available and when you are not.
4. Time management is integral to medical education. This means designating personal time to create a schedule and prioritize your fixed commitments, variable tasks, and responsibilities to learn, achieve, and succeed. Develop a realistic workflow for daily and weekly goals that incorporates time to self-reflect. The best schedules are not very good if we can’t stick to them. Sometimes, we expect too much, particularly if our proposed workflow requires changing or modifying habits of mind. 

Considerations

For many of us, when we’re in the throes of the day, it is nearly impossible to designate time for personal wellness, let alone imagine how to use that time. Yet, this should be a priority, not a luxury, and not an afterthought. Prioritize personal wellness first; it is necessary and invaluable, and without it, taking care of others is unsustainable.  

Annually – Remind yourself of your academic and professional goals. Why did you decide to go to medical school? Residency? Fellowship? It may help to take a look at your personal statements from your medical school and/or residency applications. Think about all you’ve completed, revisit your annual goals, and set new ones for the upcoming year. 

Quarterly – Reflect on what is working and what is not. What do you need to maintain, and what do you need to modify or change? This isn’t easy. Be honest with yourself. If something isn’t working, it doesn’t mean it can’t work, but it may indicate that it’s time to pivot or ask for support, and if you don’t ask, you may not realize what’s possible.

Weekly – Pause and consider whether your weekly goals and workflow are working. Make time to take stock. This is an important consideration and probably requires designated time to self-reflect. Prompt yourself, “Did I complete the tasks for this week? Did I cram them into one or two days, or did I stick to a schedule? Did I allow time for personal care and wellbeing?” Work-life balance isn’t about managing two different variables; it’s about harmonizing and integrating all the moving parts. Be realistic.  

Daily – Review your goals before you start your day. Consider whether they are realistic. Which professional responsibilities must be completed and which are works in progress? What about your personal goals? Prioritize both and, when possible, designate one or two for the next day to ensure you have some time for personal wellness. 

Personal wellness – This topic is so important, I included it twice in this post. Even when we’re in the throes of the day and it is nearly impossible to imagine taking personal time, let alone figuring out how to use it, personal wellness should still be a priority. Philosophers and researchers alike explain that those who take time to rest and replenish, and implement wellness routines, not only live longer, but they also live better (and healthier). In reductive examples of well-lived lives explained during ancient times, Aristippus (435–356 BCE) taught that the goal of life was personal happiness (hedonic), while Aristotle (384–322 BCE) believed that life’s highest virtue was personal excellence, representing the best within us (eudaimonia).

References

Lobo, F. (2006). The Work-Leisure Paradigm: The Stresses and Strains of Maintaining a Balanced Lifestyle. World Leisure Journal, 48(3), 22–32. https://doi.org/10.1080/04419057.2006.9674451. 

Ryff, Carol D., Boylan, Jennifer Morozink, and Kirsch, Julie A., Eudaimonic and Hedonic Well-Being In: Measuring Well-Being. Edited by Matthew T. Lee, Laura D. Kubzansky, and Tyler J. VanderWeele, Oxford University Press (2021). © Oxford University Press. https://DOI.org/10.1093/oso/9780197512531.003.0005.  

Veal, A. J. (2019). Is there enough leisure time? Leisure studies, work-life balance, the realm of necessity, and the realm of freedom. World Leisure Journal, 62(2), 89–113. https://doi.org/10.1080/16078055.2019.1667423. 

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