How to Keep Yourself From Getting Too Overwhelmed

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PMY 523: How to Keep Yourself From Getting Too Overwhelmed

Session 523

Today, we have Khevna Joshi to talk about how to stop stress from overcoming you as a premed. We all deal with stress in our own ways. Khevna is a med student who has worked on her mindfulness, meditation, and stress relief. Hopefully, you will get some good tips today to help you with your stress relief.

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Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[01:05] The MCAT Minute

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[02:28] Becoming A Doctor

Khevna realized that she wanted to be a doctor when she was taking science classes in high school. What is happening inside our human body was something she found to be really interesting.

In college, she majored in neuroscience where she started exploring the science side of things.

It was also her personal experiences in her family, having family members go through some diseases, working with them, and learning about it like the classic shadowing experiences. These were factors that influenced her. But it was in her middle college when wanting to be a doctor really got solidified.

[03:25] Most Stressful Part of the Premed Journey

Just as COVID had hit, Khevna was in the middle of her MCAT prep. She was scheduled to take the MCAT in March 2020. But COVID happened in late Feb to early March. At that time, her MCAT got rescheduled and postponed about four times.

She constantly had to stay on top of her material while also taking classes remotely. She did not want to take a gap year and so at the same time, she started thinking about applying to med schools.

During this whole time, COVID was still going on.

For her, it was like the combined stress of having this pandemic and also reading about twice as many people who are now applying to med school because they just have more free time.

[05:05] Coping and Managing Stress

COVID was obviously stressful for everyone, especially for premed students. Some data have shown that premeds are more depressed and anxious than their fellow undergrad counterparts. During that time, Khevna was not handling her stress very well. She was not eating properly and her sleep cycle also got messed up. Somewhere in the middle of all of that, she realized that this is not going to be a long-term sustainable way to handle stress. Especially if she was planning on pursuing a career in medicine.

“Medicine itself is a stressful career, and you need healthy ways to manage and cope with that stress.” Click To Tweet

She started to realize that she would need a combination of physical and mental strategies to combat the stress. Physically, she started exercising more. She would go on walks outside, whether that was by herself or with her family. She was also eating healthier. It was nice being at home because even though she was quarantined, she did get good food from her family.

Mentally and spiritually, she started to get into meditation a little more. The brain, when you are stressed, makes it very easy to let your mind race around with thoughts. It can get very hard to control your thoughts even if 80 to 85% of the time, the things you worry about never actually happen.

Trying to find a way to control those things is the healthiest way to deal with that stress and keep yourself at an all-time low. It does not mean that you are not going to be stressed. Some level of stress is healthy and that is going to help you get your work done. But pathological levels are going to push you to this level where you’re not going to be productive. For Khevna, meditation and being and staying physically active, were both good for her during that time.

[07:25] Exercise and Meditation

Khevna never used to go to the gym. But now, she regularly workout and goes to the gym three to four days a week. And if she is not at the gym, she would go outside on walks just to keep her mind fresh, especially right now while she is studying for step one. She says it is like a full-time job of 24/7.

Basically, you wake up, you’re studying, and then you go back to sleep. You need something to keep you active in different ways so that you are not always in the books. 

Meditation has also been consistent. Every evening for just 10 minutes, she would close her eyes, take some deep breaths and look back on the day thinking about what went well and what she could have done differently. She would look at the points where she was stressed and didn’t handle well and what she can do to change it tomorrow.

The daily contemplation and change in outlook has helped her be a little better at handling her stress every day. Even if there are some days where it does not go well, overall, she can still track that she is making progress.

[09:10] Taking Breaks and Striking the Right Balance

There could be students out there listening and saying that they don’t have time because they need to study for the MCAT or as step one, work on their personal statement for applications. Their concern might be the 30 to 45 minutes going and playing at the gym could be a long distraction from what they should be doing.

Khevna says that taking seven to eight hours out of your day to sleep and eating your food also takes time out of your day. 

At first, when you do it, it feels like a drag. You are taking time out of your day to go to the gym and it’s going to suck at first.

“Once you build in that consistency and once you realize that taking that break is actually good for your brain and gives you a fresh perspective, it will be built into your routine.”Click To Tweet

For Khevna, the first one or two months were very difficult and the consistency was super hard. But once she realized that doing this was actually freeing her body and her mental energy and made it easier for her to accomplish what she needed, it became a lot easier for her to get out of her seat.

She adds that if you are just sitting at your desk for eight hours a day, your brain is going to be dead after. You are not going to be able to think properly so you need something to keep your mind fresh.

It’s simple math if you want to try to equate it. 70% effectiveness for eight hours is worse than 90% effectiveness for six hours. Students really need to understand that the breaks help. It’s about the balance and striking the right balance.

[12:38] Transition from Premed to Med School

The transition from premed to becoming a medical student took a while for Khevna. She felt it was so much information when she went into the first block and it was going to get thrown at her from every angle. But you cannot use everything.

'There's not enough time in the day to do everything, and you're never going to know everything.'Click To Tweet

Khevna thinks that was the hardest thing to transition because she feels that as a premed, she needs to know everything and she needs to score in the top 10% and be on their A game.

For Khevna, studying or learning how to study smarter, is better as opposed to working harder. She adds that it’s okay to find what works for you, what resources work for you, and use that trial and error to figure out what is best for you. 

Do not get influenced by other people because a lot of people will tell you what is working for them and what is good for them. That might be good for you but it might not be the best study strategy for you.

Khevna says, you also need to take a step back and see what is going to be the best way for you to do well on exams. Figure out the best way to maintain your mental sanity because it is different for everybody. For her, it took the whole first semester to figure out what that balance was.

[15:10] Wellness Programs in Med Schools

Khevna says she is lucky to go to a medical school that has a robust wellness program. Not a lot of medical schools have that but it is becoming more and more popular.

They have a great wellness director and a wellness chair. They frequently have events set up throughout school where you can learn more about wellness like sleep habits and how to eat better. Most of their exams have also been pass/fail which has eased the stress.

For Khevna, having those programs built into the school has made it easier for her to focus on being able to meditate and exercise from an early point. It gives the understanding that school cannot be all about just working all the time. There is a need for some balance between that and your personal wellness and that has been really important for her.

[16:51] Different Groups of Students in Med School

Khevna has different groups of friends. There is one group that frequently enjoys going out to the bars on Friday nights and decompressing over the weekend. But by the time Monday comes, they have not watched any of the lectures and then they are behind for the rest of the week.

There is another group of friends that still decompresses but in a healthier way. They do board game night or just chill out with friends but not in a way that stops them from doing any work over the weekend.

Over time, you will see the group of friends that don’t do anything over the weekend are perpetually behind on lectures for the rest of the block, and that hurts them in the end.

Whereas the other group of people that still take time to decompress, but in a healthier way, end up doing better.

On the other end of the spectrum, there is a group of people that don’t decompress at all and are constantly studying even after an exam. You can see them having puffy eyes, never sleeping, never going home to spend time with their significant others. That also takes a different type of toll.

There are two sides of the extreme that Khevna would not want to be on. Realizing how to toggle her way between those two has been a journey for her. She says it is also going to be a forever-ongoing journey for all of us.

It is important to realize that at every step of this journey, you can find what works for you. During your pre-clinical years and as you enter your clinical years after you take step one, that’s all going to change. You are going to have to find a new balance, find a new schedule, and a new rhythm and balance to everything.

It is about understanding that you are in another transition period. You may not be perfect right away and that’s okay. You are going to find out where that balance is for you based on the priorities you have in my life.

[20:04] Burnout

Burnout is definitely a big issue starting from being a premed going all the way up to residency and even when you are already a practicing physician.

Khevna is currently serving as a Well-being Champion as part of the AFP (Academy of Family Physicians). They work on educating people about burnout, talking to them about how to possibly recognize what some of the signs and symptoms are, and preemptively tackle those. Some of the signs could be physical like the puffy eyes from not getting enough sleep.

There is also that constant feeling that you need to be in a place where you are always working. You can’t leave your desk because you might not be able to read those last two pages or do those last 10 questions. It is constantly having the feeling of guilt that you didn’t do those or you are not going to do well and will not get into med school.

Impostor syndrome can be a common feeling for many people, and Khevna was no exception. She often felt like she didn’t know enough and didn’t deserve to be where she was. This feeling caused her to overcompensate and do more, which ultimately led to burnout. It’s important to acknowledge and address these feelings instead of letting them consume us. Remember, you are worthy and capable of success.

Impostor syndrome can be a combination of mental and physical symptoms. Mentally, it often manifests as a feeling that you need to make up for something that you might be lacking. However, these feelings are often unfounded and simply a product of our own thoughts.

Physically, the stress of impostor syndrome can lead to symptoms such as anxiety, sleeplessness, and even physical health issues. This, in turn, can create a vicious cycle, where the physical symptoms make you feel even more like an impostor. It’s important to recognize these symptoms and seek help if needed. Remember, you are capable and deserving of success.

[22:13] Developing the Wellness Toolkit

For students who are going through burnout and want to get into the path of better self-care, Khevna says, it’s not going to happen in one day. It did not happen for her and it did not happen for anybody.

The biggest thing to remember is to start off with small steps. Progressively, as you are able to do these small things and take these small steps, eventually, they will get to a place where you can take bigger steps that will evolve into a longer well-being journey for yourself.

Khevna says they are working on making a toolkit of different strategies. These are tools that you can pull out any time that you need.

One example of a tool that she helped develop was this meditation where you can do some small practices for yourself like doing just 10 deep breaths. If you take a step back and take 10 deep breaths for yourself, you realize how much you can decompress and how much you can calm yourself.

And there is the body scan where you close your eyes and realize where all of your body parts are in space. That helps you separate yourself from your body and make it so that you can relax.

To help distance yourself from burnout, you can pick just one thing that you want to do. Take 10 deep breaths. Write three things in your gratitude journal that you’re thankful for and be able to forgive yourself for not being able to do everything.

You should not have to punish yourself for not being able to do that. It should be a journey of wellness and forgiveness while also being able to help others. Because if you’re not well yourself and you’re not able to help yourself, then how are you going to be able to help others?

There are many aspects of wellness. There is mental wellness and there is also physical wellness. And then there is also financial wellness. Finances are also having a huge impact because med school costs a lot of money. It is also learning how to balance that aspect of it so that it does not add a new layer of stress.

[24:57] Finding Time and Making Time

“You will never find time, you have to make it.”Click To Tweet

Parkinson’s principle states that the amount of time that it takes to do the work will expand to fill the amount of time that you have to do the work. If you set aside three hours to study and you set aside an hour to exercise you will and can accomplish four hours of studying in those three hours that you blocked off.

It is important that what is important to each person is scheduled on a calendar. If you put it on your schedule and your calendar, it is like holding you accountable because it is on your schedule and it needs to be done. It is making it a priority by putting it on the calendar.

It might also help to find like-minded premed students who are in a similar boat but there should be a balance there because every premed is different. Some premeds might be more uptight than others. But if you find somebody who is in a very similar study habit, that could be really helpful.

[30:28] Final Words of Wisdom

Be authentic. Be genuine.

There are a lot of steps in the med school application process and there are a lot of moving parts in the process.

Your job is to do what you can. Take the MCAT, write your personal statement and be as authentic and genuine as you possibly can because you want to go to a school that is going to be a good fit for you.

Trust the process.

“Put in all the work that you need to, for everything and then, literally, just trust the process.” Click To Tweet

Most people do end up getting into med school provided they do all the work. So if you do all the work, trust that what is meant to happen is going to happen in the end.


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