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Mental health tips for NOSM medical students

Posted on December 11, 2019
If you’re feeling overwhelmed, please reach out. NOSM is here to help. Nick Alderton is a Senior Learner Affairs Officer at NOSM who also holds a Masters in Applied Sports Psychology from the University of Ottawa. His forte is counseling high calibre athletes, and he draws parallels between them and the high achieving medical students he sees at his day job. Both thrive on competition and pressure to perform and sometimes it can be overwhelming.

Here are a few of his tips for helping manage mental health:

1.    Be self-aware and recognize the signs of high anxiety and stress.

“There’s a variety of different reasons why people might feel more pressure at different times, but often with high achieving students and athletes it’s easy to catastrophize—to think about the worst possible outcome of what might happen if you don’t do well at something or to exaggerate the negative outcomes of what might happen,” says Alderton. He suggests that you need to be aware of when you’re feeling this happen as it often manifests through negative self-talk.

Being aware that you may be “catastrophizing” is a signal to seek advice or reach out for support. Recognize that catastrophizing is “a way of thinking called a ‘cognitive distortion.’ A person who catastrophizes usually sees an unfavorable outcome to an event and then decides that if this outcome does happen, the results will be a disaster.”[1]

This can sometimes be triggered during particular times of increased perceived stress or pressure during a student’s academic year, for example, thoughts might include: “If I fail this exam, I’m a failure in life” or “if I don’t find a CaRMS match, my career is over and I’m going to have to quit.”

2.    Focus on the present moment and the very small steps forward.

“When a student is catastrophizing, it’s helpful to bring them back to the present moment. They can also think about some of the much smaller steps that they can take right now to move forward,” says Alderton.

A good technique is to have a clear idea of what you’re trying to accomplish each day and break it down. “If you focus on the small, small steps, that helps you manage that catastrophic thinking and instead, and regain focus on the desired outcome,” he says.

Mandatory check-ins with first-year students to find out how they’re managing and dealing with the new learning environment, is one strategy Alderton says Learner Affairs uses to support students.

3.    Remember that you only have control over certain actions and outcomes.

“Sometimes it’s recognizing what you have control over versus what you don’t have control over. Reminding yourself that you’re doing the best you possibly can in each of your classes, in each of your rotations, and in your clinical experiences. Ultimately, you don’t have control over where you end up matching. You can only present yourself in your best possible way and that’s all you can really control,” he adds.

4.    Don’t get fixated on being the best.

In high achieving athletes, Alderton says people become used to having a high self-esteem and often times naturally evaluate themselves in comparison to others. The same can be said of medical students who thrive and are used to being in the top of the class.  They come to medical school and are joining a group of other students who are also used to excelling. It’s something I’ve seen a lot in sports and it’s a transition for everyone when you no longer have that standing.  Everyone is top of the class so it can be hard to adjust.”

He says he reminds medical students of what they’ve already accomplished. They have made it into medical school for a reason. “The main thing is realizing that you belong here, and that you don’t have to be the best. You don’t have to always feel like you’re smarter than everyone else or that you have to prove anything. You know, just being here is really an accomplishment in itself. And the competition is over at this point, it’s about you finding the best fit for you and not trying to be the best,” Says Alderton.

5.    Consider participating in unique mental health training that may come in handy both on and off the job.

Alderton encourages students to seek resources that help teach them about their own mental health. For example, a student-led committee is offering Applied Suicide Intervention Skills Training called ASIST to increase awareness. If you are interested in ASIST training or mental health first aid or community courses, please contact Learner Affairs.

6.    Try reflective journaling to gain deeper insight.

Another strategy that Learner Affairs encourages is reflective journaling. Students are taught the value of private journaling throughout their degree to process their experiences. Alderton says journaling helps gain deeper insight into what has happened. “It’s also really good way to identify what sort of doctor you would like to become and what you might want to pursue.”

“It can also help you develop your identity as a physician and think about what kinds of environments are best for you, and help you process difficult experiences, so it’s a good tool for learning and for mental health,” he adds.

7.    Stay connected to your support system of family and friends outside of medical school.

Alderton encourages medical students to stay in touch and connected to their hobbies, interests and friends.

“I think it’s important to maintain a life outside of school and keep the friends you have outside of medicine as well. If all your friends are in medical school and dealing with the same challenges, it can emphasize your own challenges.”

He says keeping up hobbies and getting mental breaks, as well as reminders of the other things in life that bring you joy, renewal or a sense of wellbeing will help you maintain perspective. A change of environment can be healthy.

“In sports, we talk about the analogy of the plant that isn’t thriving; sometimes you need to change the soil and its environment. The same goes for people,” says Alderton.

8.    Book an appointment with Learner Affairs to check-in.

If you need student counselling advice or help with day-to-day student life, contact the NOSM Learner Affairs office to book an appointment. NOSM medical students and learners also have access to Morneau Shepell Assistance Program and to mental health counsellors at Lakehead University and Laurentian University.



[1] How to stop catastrophizing, Medical News Today