Medical students, especially those at Erasmus MC, are prone to burnouts. As a result, Professor Myriam Hunink has been researching the matter. “If they are to provide effective care later on, it’s important that they have resilience.”
TEXT: Sjoerd Wielenga
PHOTOGRAPHY: Erik Smits
Lack of energy, a detached and cynical attitude, feelings of personal inadequacy, insomnia and emotional exhaustion — these are the main symptoms of stress and burnout. And medical students at Erasmus University are found to be the most prone to burnouts and related symptoms of all Dutch undergraduates. This came to light in a 2017 survey by De Geneeskundestudent (The Medical Student), the national advocacy body for medical students. In response, Erasmus MC launched the DESTRESS study (destress.info) at the beginning of 2019 under the supervision of Professor Dr Myriam Hunink. The professor and her researchers are studying and tracking the severity of symptoms, risk factors and the progression of symptoms among students. They also monitor what the students are doing on their own to combat stress. In addition, some students are offered the chance to participate in stress-reduction interventions, such as mindfulness training, yoga, running, aikido (a Japanese contact sport that teaches self-defence) and music-making or -listening sessions. Hunink herself runs some of the aikido classes. “It’s about gaining awareness: why do I respond the way I do? A physical response is a reflection of what happens in the mind. If you mentally flee or strike out when you feel under attack, you will do the same on the mat. I teach the students to harmonise and, as it were, dance with their attacker."
What do you hope to achieve with this study?
“Erasmus MC produces future healthcare professionals. If they are to provide effective healthcare when they go into practice, it’s important that they have resilience. Thus we’re running this study not just for the well-being of current students, but for the healthcare sector as a whole. If the stress-reduction interventions prove effective, we’d like to implement them in the curriculum.”
What are the students stressed about?
“Medical students tend to have high expectations of themselves, which is exacerbated by their studies. They, like other students, suffer exam- and deadline-related stress. And they often have a lot on besides their studies. Medical students in particular have side jobs and research to do, both of which they do in the hope of increasing the likelihood of securing a training position in their preferred specialisation. In addition, students these days are very active on social media. The constant checking of smartphones taxes the brain, which causes yet more stress.”
“Yoga and mindfulness have been scientifically proven effective in reducing stress”
Is medical training itself stressful?
“Yes, it is. Medical students are confronted with illness and death at a younger age than most people, and that’s not easy. And working in a hospital can be very stressful by the very nature of its demands. Moreover, night and weekend shifts can be gruelling. Add to that the uncertainty surrounding every decision: did I do okay? Did I do something wrong? Because, don’t forget, the work is about the well-being of your fellow man, and deals with matters of life and death. What's more, I know from experience — having worked as a radiologist myself — how easy it is for doctors to get burned out. The electronic patient system and administrative burdens cause doctors a great deal of stress. “Too many clicks”, as the Americans say.”
Mindfulness, yoga, relaxing music and Japanese martial arts. Magazines like Happinez cover things like these. So what’s the academic value of this research?
“We use lifestyle interventions that have been scientifically proven effective against stress: yoga, mindfulness, running and music are good for relaxation. We don’t yet have empirical proof for aikido, but the sport includes elements of yoga and mindfulness and is a vigorous form of exercise.” The researchers have noted that many students find it hard to remain in the study for long; lots drop out. Is that part of the problem? That participating in a study like this makes an already busy life even more stressful? Hunink: “Some students have indeed said they don’t have time for aikido class, for instance, because of the demands of their side job or upcoming exams.” Nevertheless, she hopes the study runs its course. And in the meantime, she is also preparing to expand the research to cover newly qualified doctors. “We need to ensure that new entrants to the field have the resilience necessary to do their work happily and healthily.”
