We invited positive psychology practitioner, Jordyn Feingold, MAPP to share her tips on improving well-being while in medical school. Jordyn, in a week-long series, will explore the concepts of REVAMP—a novel approach to well-being. Here, she discusses the third element of the model: vitality.
Vitality is what enables people to feel awake, alive, and able to thrive in everyday life. When I discuss vitality, I specifically refer to deliberately taking care of our physical bodies and minds through regular physical activity, a healthy diet, and ample sleep. As with relationships and engagement, improving medical students’ vitality is a worthy personal goal that may also have important effects for our patients. Since medical care entails helping patients to change their habits and make better decisions about health, including diet, exercise, smoking habits, and sleep, physicians who serve as role models for their patients may be more effective at improving their patient’s health.
When it comes to physical activity, my recommendation is simple: start moving. Physical activity is just as important for your physical health as it is for your mental health. The U.S. Department of Health and Human Services recommends that for substantial health benefits, adults need to achieve at least 150 minutes per week of moderately intense aerobic exercise, or 75 minutes per week of vigorously intense aerobic activity. Increased activity attributes to:
- Lower deaths, blood pressure, and metabolic syndrome
- Decrease in cases of falls in the elderly
- Improvements in cardiorespiratory and muscular fitness
- Improved body mass, body composition, and bodily health
- Lower cases of depression
- Enhanced executive function
All of these brain-enhancing effects are mediated by BDNFs (brain derived neurotropic factors), which promote neurogenesis and act like Miracle-Gro for the brain. Even Hippocrates understood the relationship between physical activity and emotional well-being, when he said, “If you are in a bad mood go for a walk.”
With such vast benefits for both physical and mental health, physical activity is a great way for medical students to combat burnout and improve resilience.
Certainly, medical students are aware of the importance of good nutrition. We still may have difficulty eating the way we should, because of our on-the-go lifestyles and constrictive budgets. However, developing healthy eating habits now is an investment both for our own health, as well as for our future patients. Research shows that physician’s personal habits are strongly correlated with their tendencies to counsel patients about health practices.
We know that while foods high in fat and sugar (think everything you can purchase in vending machines or at fast food restaurants) are highly accessible to us, they are the worst options and can decrease our cognitive functions and work performance. On the other hand, natural super-foods that are filled with antioxidants and other nutrients are ideal for medical students’ working brains. Foods such as cumin, garlic, onions, broccoli, blueberries, pomegranates, spinach, and beets, repair our cells and trigger beneficial stress responses within the body.
Foods rich in healthy fats, such as unsaturated fats and omega-3s, which are found in fish (i.e., salmon, cod, and tuna) may be excellent for physical health and brain function, and can lower blood pressure, cholesterol, and neuronal inflammation. Further, vitamin B and folate, found in dark leafy greens such as spinach, citrus fruits and berries, lentils and beans, seeds, cauliflower, nuts, and avocado, are associated with improved memory and processing speed. Vitamin D, important for absorbing calcium and strengthening bones and has many other benefits, can be consumed in fish, as well as in eggs, dairy products like low fat yogurt, and tofu.
Planning and preparing healthy meals with friends or roommates can be an amazing way to relax and decompress after a long workday. Cooking large batches of food once or twice a week can be a time- and cost-efficient way to make sure you have healthy meals on hand all week long without having to order takeout or “cook” frozen meals. We can properly nourish our bodies and minds, and maintain healthy habits throughout our medical careers.
Sleep is the third factor for maximizing medical students’ vitality. Although medical students in their pre-clinical years may not be experiencing chronic sleep deprivation that is prevalent among their senior colleagues, classroom work, extracurricular demands, and achievement anxieties may keep us awake at all hours of the night. Since our clinical years are just around the corner, now is the time to start working on developing a routine of healthy sleep habits.
In one study, fatigue was cited as a cause of 41 percent of 254 internal medicine residents’ most significant medical mistakes, with a third of those mistakes resulting in patient fatality. Surgical residents have been found to make up to twice as many errors during simulated laparoscopy following an overnight call, and anesthesia residents have demonstrated sleepiness on par with narcoleptics even when not on call in the preceding 48 hours. Overall, after extended periods without sleep, physicians have demonstrated declines in the quality of performance as well as emotional well-being and cognition.
To counteract chronic sleep deprivation, medical students and trainees must use their time away from work to improve the quality of their sleep. Research suggests us to disconnect from the digital world (cell phones, televisions, and computers) for at least one hour before bed and sleep in a completely dark room. Artificial light, such as that of 100-watt light bulbs and LED backlight have harmful effects on sleep quality: they disrupt the production of melatonin, which regulates our sleep and circadian rhythms.
Additionally, spending daytime hours in natural sunlight may be just as important as turning off lights during sleep to harmonize our body’s circadian rhythms. Taking a walk outside in the morning while drinking your first cup of coffee may be a great way to jump-start your body and mind. Further by being self-aware about your energy levels and speaking up to supervisors if you are feeling sleep-deprived and unable to perform certain tasks, may be crucial for ensuring patient safety. While caffeine use and napping may be helpful countermeasures to medical student exhaustion, improving our sleep quality at night is the most effective way to achieve vitality.
Finally, due to chronic sleep deprivation, medical students and trainees can develop a sleep and/or anxiety disorder which prevents them from restoring the quality of their sleep. If you think that you might be suffering from a sleep disorder, or if you have anxiety about falling asleep that prevents you from sleeping, it’s important to get assessed and begin addressing these problems. Now is the time to start prioritizing your sleep. It is one of the best gifts that you can give to yourself, your colleagues, and your patients.
IcahnBeWell—the student-run wellness program at the Icahn School of Medicine at Mount Sinai—provides resources for emotional and physical well-being.
Contact IcahnBeWell for more information.
ABOUT THE AUTHOR
Jordyn Feingold is a first-year medical student at the Icahn School of Medicine. She is passionate about integrating the science of well-being into medicine and creating cultures that enable practitioners and patients to thrive. Jordyn completed her undergraduate studies in Health and Societies as well as her Master’s of Applied Positive Psychology (MAPP) at the University of Pennsylvania. For more information about positive psychology or the REVAMP theory, reach out to her at: Jordyn.Feingold@icahn.mssm.edu.