“There’s not a student going through medical school—osteopathic or allopathic—who won't experience burnout during their tenure as a medical student,” said Jason Walker, PhD, associate professor of physiology at PCOM South Georgia. He has seen first-hand the effect of burnout in medical students during his time as a professor and as a researcher on the topic.
Coined by American psychologist Herbert Freudenberg in the 1970s, burnout—a psychopathological syndrome—is used to describe the consequences of severe stress and high ideals in “helping” careers. Then, in 2019, the World Health Organization officially classified burnout as a medical diagnosis.
Why is medical student burnout so high?Medical professionals fall under that “helping” category with 60-70% of medical students saying they experience burnout during their education. Dr. Walker likens the educational experience to drinking water from a firehose.
He said, “During medical school, students are actually drinking water from three fire hoses at once: the curriculum, their personal life and unexpected life circumstances.”
It's because of those factors that Dr. Walker said burnout reaches its peak at the end of the second year of medical education when students are preparing for board exams, then again during the third and fourth years of clerkship rotations.
“The peaks come when students are facing stress, accountability and responsibility from their preceptors while preparing for upcoming boards and exams,” Dr. Walker said.
Medical students, especially those from underrepresented communities, face an overwhelming amount of pressure and expectations from themselves, their families and their communities who want to see them succeed. An additional pressure point comes from the student debt, which averages around $300,000 for medical education.
He also said that COVID-19 exponentially increased burnout due to the lack of group settings and in-person socialization.
Dr. Walker said that there is a difference between stress and burnout. Oftentimes, stress and normal fatigue can be solved with self-care—taking a walk outdoors, relaxing with friends and taking time away from studying to re-energize.
Burnout comes when the fatigue simply extends and cannot be fixed with self-care.
“Burnout is not fixed through self-care because it's not caused by that person,” he said. “It's caused by outside stressors and extenuating circumstances.”
Symptoms of burnout include lack of motivation, emotional detachment, withdrawal, feelings of hopelessness along with mental and physical exhaustion. Dr. Walker said he's personally seen an increase in burnout in medical students, which can easily lead to depression.
“When someone says, ‘I just don’t want to do this anymore. I dread going to school. I have insomnia. I can’t study,’ that's when they need to see a mental health counselor. Truthfully, they need to see one before you even get to this point,” said Dr. Walker.
Dr. Walker said the number one thing to do is see a counselor. Then, take time to meditate, get some physical activity and get away from studying.
Jay S. Feldstein, DO '81, President and CEO of PCOM, said he faced burnout as an emergency room physician. After nearly 10 years, he knew he had to make a change for his mental health.
“Part of the reason I'm here at PCOM is that I burned out as an emergency room physician,” he said. “I got to the point where I dreaded going to work. I dreaded seeing patients, and I didn't want to go to the ER. It's because of that, that I sought out a different career path. Between shift work, loss of control and pressure, it just became too much. I am a living example of experiencing a career burnout in emergency medicine.”
Dr. Feldstein is a testament to seeking help for burnout. He said, “Get help early. Don't be embarrassed. We're all here to support our students and we have a vested interest in seeing our students succeed. Burnout is reversible and treatable. It's difficult to get through medical school alone so having a supportive peer group is crucial.”
In 2019, Philadelphia College of Osteopathic Medicine (PCOM), a premier osteopathic medical school with a storied 125-year history, extended its commitment to the Southeast by establishing PCOM South Georgia. An additional teaching location in Moultrie, Georgia, PCOM South Georgia offers both a full, four-year medical program leading to the Doctor of Osteopathic Medicine (DO) degree and a Master of Science in Biomedical Sciences. PCOM is a private, not-for-profit institution that trains professionals in the health and behavioral sciences fields. Joining PCOM Georgia in Suwanee in helping to meet the healthcare needs of the state, PCOM South Georgia focuses on educating physicians for the region. For more information, visit pcom.edu or call 229-668-3110.
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