Beyond the White Coat: Balance, Burnout and Being Human in Med School

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In this episode of UMich Med Mosaic, host Mohika Nagpal engages M3 Krupa Patel in a year-by-year conversation about navigating medical school. They unpack M1 imposter syndrome and study strategies, the unique pressures of M2 clinical year, and the autonomy and stressors of M3 and M4 years, including Step studying and specialty decisions. They share coping tips like “brain, body, heart” check-ins and how to prioritize rituals and rest. The episode also highlights U-M support options such as peer support advocates, mental health counseling, CAPS and student wellness representatives.

Transcript

Mohika Nagpal:

Hi everyone, and welcome to UMich Med Mosaic, a medical student run podcast we've created to shine a light on the diverse backgrounds and experiences of our students here in Ann Arbor. I'm Mohika Nagpal. As one of the social media interns, I'm on this podcast team to help highlight the stories and experiences of my peers to life. I hope this podcast helps bring our voices together as a student body so that wherever our journeys take us, we're still connected. So, whether you've got us on your walk home from clinic or while you're catching up on the weekend, we're delighted you're here.

Hi everyone, and welcome to episode three of UMich Med Mosaic. Look, medical school is hard and not that much like Grey's Anatomy. It takes discipline, grit, and sacrifice, but also it's four unforgettable years where you learn the art of medicine, have a lot of firsts, and build relationships that last a lifetime. Here at Michigan, our medical students do a lot in and outside the classroom. They find ways to make the most of their time here. Today's episode talks about building balance, battling burnout, and being human. And I'm joined today by M3 Krupa Patel. Krupa, how are you today?

Krupa Patel:

I'm doing well. How are you?

Mohika Nagpal:

I'm doing really well. Thank you. I'm so excited to do this episode with you today because we're both in the branches years. We've had a couple of years here at Michigan. I know you do a lot of different things. I've had some experiences over these last few years as well. And I think it's nice to kind of think about how we've maintained it and how we're able to kind of move forward from this juggling act that has been med school, the good, the bad, the ugly. So, I want to ask you first, what has medical school looked like for you so far in and outside of the hospital? What's been your highlight reel of medical school?

Krupa Patel:

Oh, man. Medical school, I feel like often on social media it's really glamorized. So, I feel like I had this idea of what it was going to be like. And then I got here and it was really hard. It was really hard. And I think there's a lot of things to think about. Isn't just the school that you're juggling, you're juggling a new place, a new apartment, right? Being on your own for the first time, making new friends. And those are things that also kind of go into that really big change. Highlight would honestly be the people. I think I've been very pleasantly surprised by the people that I've met and that have really kind of been my support system.

The unexpected friendships, but also the ones that I was able to maintain. Luckily I went here for undergrad, so that was really nice to kind of build upon those friendships and have those while I was a medical student now.

Mohika Nagpal:

That's awesome. So, for our listeners, our M1 year is our predominant didactic year. We're in the classroom, we're watching lectures, we're studying the textbooks of what we need to be learning. And then our M2 year is our primary clinical year. That's when we're on the wards, we're doing our required rotations. We're working real hard and we're studying for our shelf exams. And then we get into the branch years, which is what you and I are in now. M3, you're focusing mostly on taking your step one, your step two, doing some research time if that's something you want to do, starting to think about sub-eyes.

And then M4 is a continuation of those sub-eyes, away rotations, more research time and residency interviews. Those are kind of the stages that you and I are in right now, respectively. What were some of the things that you've been able to stay involved in throughout these four years?

Krupa Patel:

I've been very involved in the orthopedics group here. I also happened to build an organ burnout, so medicine in motion. That was really exciting. That's a really important organization for me. Research is also very important. And then also sports. Playing those when the weather gets a little bit better, pickleball, volleyball, picking those up has been a really, really good time as well.

Mohika Nagpal:

Yeah. Some of the orgs that I've been involved in include the OBGYN interest group. I'm a part of the American Medical Women's Association chapter here. I do a lot of stuff with admissions. I love to be a communications intern. That's been really fun for me. Research, of course, as well. And just finding things to say yes to has been really fun. So, let's kind of take our listeners down memory lane and I'd love to kind of go through year by year what things have looked like. What were some of the challenges of M1 year for you?

Krupa Patel:

M1 year, you're getting your feet kind of settled in, but you're also learning how to study. And that was half the battle. You find out what works for you, what doesn't work for you. And at the same time, you're trying to fit in and make friends. Because sometimes you feel like this pressure too, like that is your year to really make those friendships. That's the beginning. Those are your roots. So, M1 year, I think for me at least was a lot of learning the how to and also being very comfortable being uncomfortable.

Mohika Nagpal:

Yeah, I agree. It's so funny. Even just like the nuts and bolts of how to study change. I took a couple of gap years between undergrad and med school, and I was initially a little bit nervous about what it would be like to be in the classroom again. And I remember all through college, I was very gung-ho about just taking notes with a pen in a notebook and just taking handwritten notes. And I tried so hard the first two weeks of M1 year to continue that. And I had like a binder with the slide decks that I was printing out. Bad idea. I had to learn how to use an iPad to take my notes because that's not something I had to do in undergrad.

And I remember that being really challenging, but also to your point of learning what study strategies work for you because M1 learning is so different as compared to undergraduate learning. So, I think that was definitely hard. Other than just trial and error and time, do you remember thinking back to strategies that you used to handle those challenges of being comfortably uncomfortable?

Krupa Patel:

Yeah. I think for M1 year was really important to talk about it. You're starting out. Imposter syndrome is huge no matter what, but M1 year, when you just have gotten in, you're getting started, it's really real because you're questioning, "Man, was it just a mistake or am I supposed to be here? Am I doing anything right?" So, I think leaning on people and talking about it was huge. I'm going to also give a shout-out to the upperclassmen. I think as an M1, I like to say you're the baby med student. It was so important to find people older than you that had been through what you had gone through and then kind of offer that mentorship and that advice.

Mohika Nagpal:

Yeah. I think for me, the biggest takeaway I have from M1 year is it helped to have people around me all the time. I think there was a strategy that I implemented M1 year that continued throughout medical school, and this is something I swear by to this day. Med school is hard every single day, but I have three rules for what I say counts as a win of a day. Every single day, I need to do something for my brain, which we're doing every day here anyway. So, if I meet my study goals for the day, great. If I tried out a new study tool for the day, great. Something from my brain. I need to do something for my body.

So, being able to get to the gym, which was a lot easier in one year, again, when you do have more of that autonomy, but sometimes it was getting to go walk down the B2B trail here in Ann Arbor, right? Or getting to go on a bike ride with a friend, something for your body or even dance practice with biorhythms, which is another org that I loved to be a part of all through med school. And then finally, something for your heart, which has the loosest definition. That could be getting coffee with a new friend you've made in med school or getting to set up a shadowing opportunity that you've always really wanted to do, or eating Chipotle for the third time that week. No judgments.

So, M2 a year, the heat turns up a little bit. What was hard for you about clinical year?

Krupa Patel:

I think for me, it was for the first time, seeing what sacrifice looked like. I wasn't used to that M1 year. I wasn't used to that as an undergrad, as a pre-med. But clinical year, there were days, there were birthday parties, there were bachelorette parties I missed, and I had to. And it was really kind of a shock. I knew that was coming, and I knew that was a big part of signing up to be in this field, but I hadn't expected to kind of face it as a student and say no. And I think setting those boundaries with friends and families was really, really difficult. Also, because they weren't used to kind of me being so unavailable for an entire year.

They might have gotten used to that during MCAT studying right or during application season for medical school, those small bursts of those times. But for an entire year, it was really hard on I think my support system. Yeah.

Mohika Nagpal:

How did you handle setting those boundaries? Because that's really uncomfortable to do.

Krupa Patel:

A lot of it was having those conversations as soon as possible. And I was really intentional. Before clinical year started, I really did sit down and I went, "Hey, here's what it's going to look like." What can we do to kind of maintain this relationship, still keep it healthy, but also in a way that protects my wellbeing and my health? Because like you said, you're working all day and then coming home to study. Sometimes I can't do those phone calls to you, mom. I'm sorry. Or I can't go get that coffee for you with you every Thursday like we used to. So, I think setting those boundaries is really important, having those conversations, but also leaving space to kind of plan what you can do.

And for me, that was, "Hey, look, I can't be there September to November, sorry." But December break, why don't we do a trip? Why don't we catch up or why don't we make a plan post clinical year, we can do a girls trip. So, it was kind of like that, setting things to look forward to so that way they still felt very involved, but also setting those boundaries so it was healthy for you.

Mohika Nagpal:

It's interesting that you bring that up. I feel like for me, I had two challenges, M2 year. One was no one really warned me about what it would feel like to be on all the time. M2 year, you're always under some kind of evaluative pressure, I call it, right? When you're there in the hospital or in clinic, you are on. You are engaging with your patients because you want to do your best by them. You are on in front of your residents and your attendings and your team, because you want to learn from them and they are literally evaluating you. And so, there is this kind of pressure to be on your best behavior all the time.

But that pressure doesn't really go away even when you get home because you still have to be on to study for your exams that you have to take at the end of the rotation. You may need to be on to prep for clinic the next day or read up on the case that you're going to be a part of the following day. And so, there really isn't an off button. You're always being evaluated and that was really draining. M2 year is a marathon within the overall marathon of medical school. And I think that I struggled with that. It was really hard, which leads to the other struggle that I had, which was I'm someone who is very fulfilled by the activities that I get to do. I love getting to be outdoors. I like to see the sun, like you said.

I like to be able to see my friends and be a part of all these different orgs and go do all of these fun things around town, but literally not having the time to do those, I think it would have been very easy to fall into feeling like you were living a very one dimensional life for an entire year. But we're talking about balance today. So, I want to now turn the question on its head and ask you, how did you still maximize your experience as an M2? And while those things were challenging, what worked during your M2 year?

Krupa Patel:

Yeah. Well, I always started each day with a little mantra, it's cheesy as it sounds, which is you're a student. Oh my gosh, you're a learner. Give yourself some grace, girl. And that was so important. And tell yourself that as many times as you needed to, but I needed to hear that out loud. It's okay. You're going to make mistakes, but that's part of what's going to make you such a good doctor. And it's so important. And I tried to really, really reel in on that mantra, especially because when things did go well, yeah, it's a win, but also sometimes you would get on that high and then you'd crash when you would make a mistake. It would really, really hurt and you'd be really disappointed in yourself.

So, I think like starting off with that kind of healthy mindset was very important for me every single day of rotations. Evaluations are also, they're a double-edged sword, I like to say, because yes, like you said, you're on all the time, you're being evaled all the time. But at the same time, there can be really positive ones and those can really keep you going. They can give you the affirmations that you weren't even sure you were looking for, but when you hear those and you hear like, "Hey, you're actually doing a really great job," or, "Hey, I can see how hard you're working," sometimes, those things are really important and those do keep you going.

And so, I think a big part of it was the positive side of it. Also seeking feedback when it wasn't under pressure. So, when it wasn't being graded, but you would just pull someone aside, "How am I doing? Am I doing this okay?" And hearing that validation from residents, from attendings, that kept you going. And then I think another part of it was, yes, clinical year is hard, but you're doing incredible work. And I think those relationships that you had with patients, that isn't I think spoken about enough. I think it can be really daunting like, "Oh man, you're part of a team, you're taking care of people, you're going to see some really tough stuff on the job."

But also it was the best moment ever when patients would tell you how thankful they are or hold your hand and be like, "Hey, I really appreciated the time you spent with me to talk to me." And then you kind of felt important in that moment. I think as a medical student, sometimes you feel at the bottom of the totem pole on the care team, but you have those small, small moments I think with patients that remind you that you are valuable, you are essential and you don't necessarily need that validation from an evaluation form. You'll get it when you have those relationships with patients.

Mohika Nagpal:

I think you hit the nail right on its head. There were certain mindsets that I adopted M2 year, which I also felt helped me make the most of my experience. And the first one was, yes, it's hard. It's supposed to be, right? Everything is hard. Film school is hard. Law school is hard. Med school is hard. You just have to choose your hard. Clinical year is also the meat and potatoes of medical school. It's when we were all signing up to do this thing, that's what we had envisioned, right? We'd envisioned being on the wards and going to clinic and like being in the OR for the first time. That's what we were hoping to have in the first place and now we're actually getting to do it, right?

So, yes, it is hard, but it's supposed to be. And it's also worth it, to your point, because we're finally getting to do the patient care stuff. We're finally getting to learn and have all those firsts that I was talking about that are going to help set us up for the job that we want. And then the final thing that helped me really maximize clinical year is my two best friends and I sat down and we actually synced up our clinical year schedule. We were on the same rotation track. I think that worked for us because we also worked well together in the clinical space if we were ever on shift together, but it just helped us feel a lot more connected.

You end up spending so much time with the classmates that you're rotating with. And so, the fact that we got to at least have similar schedules, we were able to study for some things together, we knew what the other person was going through. It just helped kind of build in those little pockets of joy throughout the day. It was so exciting to be able to run into one of my friends in the cafeteria, or like sync up our breaks somehow. That just helped give you a little bit of fuel to get through the day.

Krupa Patel:

Yeah, that is so interesting you bring that up. I did something similar, but the exact opposite in a way. I found a friend and we planned it so all of our rotations were the exact opposite of the show that I was on, which sounds odd. Why would you want that? This was my best friend. Why would we do it that way? Because at the end of each rotation, we had donut dates. So, after every one of our shelf exam ended, the next Saturday, we wake up early in the morning, 6:00, 7:00 AM, and go get donuts. We've tried every donut place in Ann Arbor.

Mohika Nagpal:

Incredible.

Krupa Patel:

So, that was our big accomplishment.

Mohika Nagpal:

Wait, what's the best one?

Krupa Patel:

Oh my gosh.

Mohika Nagpal:

The listeners need to know.

Krupa Patel:

DJ's bakery.

Mohika Nagpal:

Okay.

Krupa Patel:

That's the winner.

Mohika Nagpal:

I'm going to put that on my list.

Krupa Patel:

And we tried lots of donuts the past year. You have no idea. But we would catch up and we would actually share advice from our rotation. And it was so healthy. It was such a good exchange of advice giving, but also catching up, complaining, venting, but also sharing the really good moments. But it was nice because he was on a completely different rotation than me and so was I. So, getting to hear that and then also share that. And then at the very end, we kind of would come back and be like, "Oh man, I'm so grateful for that piece of advice you gave or you were so right about that." That was a really good moment. So, yeah, donut dates, clinical year if you can find-

Mohika Nagpal:

Love that.

Krupa Patel:

... a friend who might not have the same schedule as you, but you can still make time.

Mohika Nagpal:

As mentioned, you're in your third year, you're kind of navigating the step one, step two, what's next. I'm in the residency process right now. What's been hard about this time in your life?

Krupa Patel:

Oh, I think the hard part was thinking clinical years over. I'm free again. And you were for a 2-week vacation and then you weren't. And then you got back and you're studying again and it's stressful because it's like, man, this entire year just ended and I just really thought I made it and you did in a way, but you didn't. So, I think the discipline that it takes to keep going, the self motivation, that is really, really hard because you look just so forward to being done in the sense that you got to get your time and autonomy back, right? But at the same time, you're studying for board exams. These are really important.

Or you're exploring specialty, you're trying to make a decision on what am I going to commit to at the end of these four years, like what am I going to go into for residency? And that's a lot of pressure too. So, in a way, there's a lot going on, but there's also a lot of the autonomy that you got back, the flexibility of making your own schedule, but at the same time, the difficult part is again, maintaining those boundaries because you're not fully in the clear yet. These are still important milestones that you have to finish.

Mohika Nagpal:

Yeah. What are you doing to make this time worth it? How are you checking all your boxes and getting your studying done?

Krupa Patel:

Yes. Well, wellness and rest to me, it's not a reward for surviving. At least it used to be, I think, in clinical year more, but for branches and M3 or especially, it's not. It's more of a prerequisite for my sustainability, and that's how I like to frame it. Rest is what I need to do well and study for these board exams. So, it is fully integrated into my schedule, which is so nice. It's not like clinical year where I tried to fit in where I could. Now it's very intentional. Now it's I take a lunch because I can. And it sounds goofy, but that's important. I take snack breaks because I can.

Catching up with friends and family has been really, really beautiful at this time in my life because I haven't been able to do that. So, getting back to that, getting back to my hobbies that I feel like I was neglecting during clinical year, or didn't have enough time for, hobbies that might be just bringing back joy. I'm a magician. I do magic tricks and I haven't done them in a really long time and I got back into it this year. So, that's been like a really fun little break in between studying is learning a card trick to fool somebody.

Mohika Nagpal:

There you go. And with that group, it's going to make your stress disappear.

Krupa Patel:

There we go.

Mohika Nagpal:

I think for me, the harder part about the branches years is, like you said, now you have all this autonomy. And the way it's organized for us here at Michigan is you kind of get a list of requirements that you need to fulfill at some point between years three and four. They include a certain number of clinical electives, a couple of sub-Is, which are more intense clinical electives, an emergency medicine rotation, an ICU rotation. At some point you need to take step one and step two. At some point you need to apply for residency. It's a lot of like, at some point, do this.

And I remember about a year ago when I was in your shoes, I think it was really hard for me to decide on one particular order in which to do things because I was maybe convinced that there has to be a most optimal combination in order to kind of like tackle these next two years to make the most out of them and to set myself up for success for residency. But as I started to go through it's not that there is one right answer. My branches years look completely different from those of my friends and that's okay.

But the exciting part about it is now you're done with all your required clinical rotations and you actually get to take the electives that you want to take and hone in on parts of medicine that you either haven't gotten to see before or would really like to see more of. And that's been so exciting to take electives that are going to help inform me as a resident, hopefully in the next year. So, I've loved that, but I think it's like that pressure you feel like when you're at a grocery store and there's like too many options sometimes for something. I think that was a little bit challenging, but I'm here to tell you all that there is no one correct answer.

There's a correct answer for you and then there's a correct answer for someone else. Things that I've found have been really helpful branches years, of course, continuing the principles from M1 and M2 to do something for my brain, body and heart and my friends and I, we have officially entered our season of yes, where we try to say yes to as many things as possible now that we have the time to do that. And that's just helping us truly make those memories and make sure that we're having fun and capitalizing on the friendships, the relationships and the experiences and everything that Michigan and Ann Arbor have to offer. We made a real life bucket list and we have been slowly checking items off of that.

Most recently, we just went to a jazz show here at the Blue Lama in Ann Arbor because one of our classmates performs there. Alon, he is one of the players on the band and it was so good to go see him. I went skiing the other day. We're going to go to the Detroit Museum of Art again. It's just a great season. So, I think saying yes and acknowledging that this is kind of like you only do med school once and now is the time to get to do all those things. That has been really, really fun.

Krupa Patel:

Now being in branches, I feel like I'm also in the position now to be a mentor and that's been a really big bucket filler as well, like kind of giving back, talking to an M1 who was in my shoes, not to kind of where I was and not too long ago. And being able to tell them what worked for me and what didn't work for me and kind of ease those stress and concerns, I think is a really good full circle kind of way of thinking about it. And also just saying, oh man, I guess I'm not the only one that kind of felt like this. This is a very valid feeling and this can be universal and hey, I got through it and you will too, and this is what worked for me. And it's so nice to be able to do that for them.

Mohika Nagpal:

Oh, 100%. I'm a tutor for the med school right now and I absolutely love it. It's also helping me make so many friends across all of the four years and I'm secretly studying for step three as a result of it. So, it's a win-win for everyone involved. I'm curious, what surprised you about going through medical school? You're in the second half now. Was it what you thought it was going to be when you first came in? Was it as hard and scary as you thought it was going to be?

Krupa Patel:

It is, but I am so surprised by how much we have done and that is what I like say and I stand by it. I look back and I go, "I cannot believe I did that." And that is the best feeling ever. I knew it was going to be hard. I knew it was going to be challenging. I knew there were going to be bad days and I knew that there was going to be a lot of time lost, a lot of sacrifices. These are things that you know when you're signing up or when you're shadowing and getting ready to pursue medicine. And you get asked this in the interview trail, "Are you ready? Why do you want to be a doctor? Do you know what this field entails?"

And I think when you're prepping for these interviews or when you're shadowing or kind of getting ready to make this big life decision to go and study and be here for four years, you kind of know those things I think in the back of your head. I think when you're here though and actually going through it, you're so surprised by how much you accomplish in such a small amount of time.

Mohika Nagpal:

Totally. I think I maybe was on the other side of the spectrum. I thought med school was going to be way harder and way scarier and way busier than it was. I'm not saying that it wasn't, but I had definitely overestimated it when I was coming in. And I think going back to what I said, I don't think there's anything in life that is not hard. And I'm really glad that this is the hard that I picked for myself because it reaffirms who I've always wanted to be. I'm really surprised that not only did medical school help set me up to become a doctor, but it has also given me experiences that I did not expect to be able to have clinical and nonclinical.

It has given me relationships and friendships that are deeper than any relationships that I've had before. It's given me a chosen family. It's also really just helped my personal and professional development in ways that I can imagine are only going to help me for the rest of my life. So, I'm incredibly grateful, getting a little sentimental as we're approaching the end here. I want to just touch on one more thing, which is a really real part of today's episode. Can you talk about any particular time that you felt burnt out or pushed past your limits and how did you make it through that?

Krupa Patel:

Yeah, absolutely. Unfortunately, it does go back to clinical year. I feel like a lot of the struggle does. And I know I touched on a little bit earlier, but sacrifices was something I wasn't used to, saying no to really important moments in your friends and family's life. And unfortunately, when I was on my surgery clerkship, my grandpa passed away. It was really unexpected. I guess I'll start by saying I didn't say a thing to anyone when I was going through this. And so, I think not talking about it was really probably the hardest part of it. Showing up the next day, keeping it going, sorting up the day after that, really not coping or healing with the death of my grandpa was, I think, a big challenge.

What I did, and I don't advise it, but I did bottle it up for the majority of that rotation. And then when winter break came, I fully crashed and needed that recovery. And I know we talked about that. Sometimes, rest can look like doing something and sometimes, it can be doing nothing. For me, at that time, rest was doing nothing. It was mourning, it was grieving, there was no preparation. It was more like lock in, get this rotation and shelf exam over with, and then we're going to handle it.

Mohika Nagpal:

Thanks so much for sharing. I know that that's hard to talk about, but like you said, I think this is the space to have those conversations and some variation of this happens to most people at some point in medical school. Can you talk a little bit more about the support structures that exist at Michigan for people who might be going through a hard time at any time?

Krupa Patel:

Yeah, absolutely. Peer support advocates is like one of my favorite. I did utilize that. That's really great. They're composed of kind of M1s through M4s that kind of volunteer to kind of be available and chat with you about anything. Literally can be a bad grade to a bad day, to a bad eval, to a death in the family. And I did utilize that and I connected with someone that actually unfortunately experienced the almost exact same thing I did during the clinical year, but I felt very seen in having that conversation. So, that's one resource. I know that we have wonderful mental health counselors that people utilize.

We also just have our general guidance counselors who also are very available to kind of just listen to you or at least connect you if there is a resource that might be a good fit. We have CAPS, which is our psychological services area as well, the undergrads utilized, but lots of good resources and things that we could do. I think I've been really proud of our student council who have been incorporating wellness representatives.

That's been kind of a new addition over the years that I've been at Michigan and that's been really good to have like a student in each class advocate and really present things and concerns that I think people are going through, usually related to burnout and balance and wellness. So, I think that's been a really good resource of ours.

Mohika Nagpal:

A little story that I have when I experienced burnout was also in my clinical year, it was towards the end. And to be honest, I was getting tired. It is again, a marathon. And so, towards the end, it was just like a series of unfortunate events had unfolded for me one fine May, literally May 1st, I got into a terrible car act Accident followed by in the next couple of days, I'd been seeing someone and that basically fizzled out, which was really sad. And then a couple days later I got an ear infection and then a couple days later it moved to the other ear. And then a couple days later, I think I gave myself the stomach bug because of just how stressed out I was.

All of this was happening while I was on internal medicine inpatient month, which is six days a week. It was just the month where I got all my negative juju out there, I guess you could say. I'm laughing about it now, not to be insensitive about it, but rather because I was able to process it, I was able to make it through. But in the time it was really, really hard and it just felt like that month would never end. I think one of my coping strategies when the water starts to get above my head, again, not a super healthy one, but this is what I find myself doing.

I find myself overcommitting myself and overinvolving myself and overworking myself maybe as a compensation mechanism to avoid processing what has actually happened. So, suddenly, I was offering to take late call for my peers who couldn't take late call that day. I was actively finding opportunities to stay in the hospital longer. I was actively finding the club meetings that I hadn't been to in months. Suddenly I'm going to them now. I don't know what it was. That was just the compensation mechanism that I launched into. And would you expect that I ran out of fuel really quickly because I realized that I was spreading myself really thin. Thankfully, the way I got through that is first my body made me.

When I got sick later that month, I realized that I had been pushing myself too hard. And what I was just really doing was avoiding processing my accident, the fallout, the demands of being on internal medicine. So, I was kind of forced to pause. I fortunately felt very empowered to talk to my team about it. I had a resident on my team who I had developed a friendship with and I kind of just talked to them about what was going on. Immediately they were like, "You need to go get your car taken care of, girl." They were so kind about it. They gave me a lot of grace and a lot of patience, and I really appreciated that. And that is one thing that I'm going to carry forward when I'm a resident.

I really can't wait to bring that attitude to a team as well, because it means the world to someone, especially when you're navigating that dynamic of being the student who, like you said, you internalize somewhere that you can't take a day off. But the grace and love with which my team treated me, I really, really appreciate. So, that was thing one. Thing two was, again, my friends. I cannot appreciate from the emotional support that I got to the logistical support that I got. I didn't have a car for a few weeks. And so, my friends were taking turns, taking me around, helping me get to where I needed to go.

I very quickly emailed the coordinator of the rotation because for some of our outpatient clinics, we may have to travel to the different outpatient sites across Michigan. And I told her that unfortunately I'd been in an accident. And so, they reshuffled my schedule so that I could stay in Ann Arbor for the majority of my outpatient clinics. My friends helped cover for the rest. One of my other friends, he was the one who was taking me to the maintenance shop for the car and to check in on the car and make sure that things were progressing correctly in that way. So, I felt, even though it was a really hard month, I felt extremely supported. I felt extremely loved and cared for. Things happen.

And I think because I was so well taken care of during that month, I'm able to laugh about it now. And in fact, my friends and I laugh about it too. So, it all works out.

Krupa Patel:

I think overall strategies for wellness and burnout prevention. I've echoed it kind of throughout this podcast, but it starts with the mindset. It starts with how you define those words, how you look at it. Don't look at it negatively. I know it's really hard to kind of shift that. And sometimes those words can be really connotated with laziness, trying to find a way out, trying to secure rest and not do work. That's not what those words mean. And really kind of incorporating that into your schedule and treating it with the same respect and value that you would give to things that require energy. Brain, studying, think about those things that you dedicate a lot of time and value to.

Treat rest with that same sort of value because that is important. And I guess along those lines, when I think of a mindset, again, echo throughout the podcast, wellness and balance won't look the same every day. They won't look the same person to person. And some rotations, some seasons of your life will require more events, some will require less of it. But try to think of it as something that doesn't need to be a dedicated walk outside or a dedicated time to sleep. It can be simple things, and that's okay. It can mean just drinking your three water bottles a day as you should. It can be spending a little bit of time in the morning, getting ready, just so you have that time to yourself.

Those are still wellness and those are still balanced. And I guess if I had to leave our listeners with something today, it would be, if you're going to pursue medicine, you're going to take care of so many people. You're going to be so important, you're going to take care of a diverse array of patients, but you need to take care of yourself to be able to do that. And it's easier said than done. But if you want to kind of promote wellness and taking care of yourself to these patients, you got to make sure you're doing that too. And a lot of it starts by the simple things, sleeping, eating enough, drinking water.

These are things that sound very basic to the average human, but for medical students, especially being really difficult, these are things that you will start to neglect and you'll notice a pattern. Whether you're on rotations or you're step setting, suddenly you don't have time to exercise. You don't have time to cook those meals. And so, when you start to feel those patterns or see that kind of coming through, take a step back. Take a couple of minutes, just reflect on what you could do better, figure out your essentials, lean into your support system, and asking for help isn't a weakness.

And I think put all those things together, put it in a cooking pot, and there you go. You have something to work with. And it's also perfectly okay if you don't have it figured out. You will not. I certainly didn't know what wellness and balance was as an M1. I have learned it throughout medical school, and that definition has changed in every single year. I'm sure it'll look different for me. M4 year when you're doing interviews, I'm sure and presumably might burn out answering the same question again and again, but it'll change. That definition will grow with you. So, be open, be flexible, talk to people. You're not alone.

Don't feel any shame in feeling like you're struggling or feeling like you don't belong or you are fizzling out. That doesn't mean that you're not worthy of staying in this field. It doesn't make you any less of a doctor. It makes you human and it is so important to remember that.

Mohika Nagpal:

Yeah. I think those are beautiful words. Thank you for sharing. I think to close out my comments, I think a lot of it is having faith in your own growth and own capacity. We've been through a lot of experiences. Going back to the muscle metaphor, maybe you can think of your brain as a muscle for just a second where we have been building it up. We have been building up our capacity to handle more to take on more over the years. And I think it's important to have faith in our growth and in our increased capacity as the years grow. And I think, yeah, just a couple of principles overall. Again, finding something for your brain, body, and heart is a mantra that I always come back to.

Sometimes, it's even helpful to kind of make a menu of things that give you energy, right? And it can be on an actual piece of paper or on the iPad because now we know how to use those. But truly having a short list of energy sources for yourself, capitalizing on those as much as you can, trying to take from those experiences as much as you can, trying to share that energy with other people, being there for your friends, your classmates, because we are all going through this together and knowing that yes, it's hard, it's supposed to be hard, but you can do it.

This is what you signed up for and hopefully people are able to look back at this as a positive experience because med school, for all it is, the good, the bad, the ugly, the hard, it is certainly memorable. And I really hope that it is a rewarding experience for everyone who goes through it. Krupa, thank you so much for joining me this afternoon. This was such a great talk. I wish you well with the rest of your M3 year, and I appreciate everyone who's listening. Thank you so much. If you love today's conversation, share it with a friend. If you are a Michigan medical student and are interested in being a future guest, check out the class pages on Slack for open calls for episodes.

UMich Med Mosaic is produced by the Michigan Medicine Department of Communication in partnership with the University of Michigan Medical School. Find us and subscribe wherever you listen to podcasts. Thanks for listening and we will see you soon.