Starting off medical school, I felt very overwhelmed – a combination of excitement, imposter syndrome, and anxiety as everything felt different from undergrad.

This anxiety and worry actually started translating into sleepless nights – I was consumed with these thoughts during the night, and had trouble falling asleep. I realized that I had started using television as a medium to help me fall asleep, watching Netflix to avoid my anxious thoughts.

After a few weeks, I realized how this had become my routine, and how this dependency was unhealthy. So I booked an appointment with my school’s counselling session, and made the conscious effort of having a positive sleep schedule.  

I had never consciously paid attention to my sleep routine before – I would simply sleep whenever I was tired, or had completed the day’s tasks. In fact, I had the perception that bedtime routines are only for kids. But I learned from this journey how important it is to have a routine, training your mind and body for sleep.

Below are a list of things I tried to adopt for a healthy sleep routine, and my experiences related to them.

1. Setting a specific time

Having a set time to sleep – 12am for me – really made me aware that it was time for bed, and allowed me to prioritize sleep. It was difficult at first to remember to wind up work at 11:45 in preparation for bed, but after a few days, my body was naturally tired around 12am, and I was ready to sleep.  I found that I had less trouble convincing myself to sleep, because my body was naturally inclined to rest at the time. Also, having a set time for bed really pushed me to complete all my day’s tasks before the time, making me more efficient in terms of my daily schedule.

2. Reading a book before going to bed.

I found this to be extremely relaxing – even reading for 10 minutes before bed had a significant impact on my mindset. I was able to forget about my daily life stressors and immerse myself into the story, which consequently made it easier to sleep. Also, by reading a book instead of watching TV, I was able to avoid being on my laptop, which felt like a break from the daily work. It gave me the sense that work-time was now over, and got me into the mindset for sleep. Also, I was able to avoid the bright light from my laptop right before bed, which may have helped attain a proper sleep as well.

3. Taking deep breaths

I had heard of the benefits that breathing techniques/meditation provides, but only recently experienced it. I decided to breathe in and out for about 3-4 minutes every night before bed, as suggested by the counsellor. I found that this was very relaxing – I was able to concentrate on breathing correctly instead of my anxious thoughts. Also taking deep breaths also triggers a change in the nervous system from ‘sympathetic’ mode – which is what we associate with fight or flight – to ‘parasympathetic’ – or ‘rest and digest’ mode, indicating that I was ready to sleep.
I have stuck to these three activities that I do on the daily – they take only about 15-20 minutes of my time before bed, and have really helped establish consistent, peaceful nights. This inevitably then also helps me start off my day well-rested.  I urge you to try these activities and adopt your own sleep schedule, and notice the dramatic improvement in sleep and mood these simple changes can make.

I’d like to open with an experience from last week during my Family Medicine clerkship rotation.  A patient (let’s call him John) was next on the list, and my preceptor warned me about a severe language barrier, and that he expected me to take about twice as long as normal for that reason.  So it was with some trepidation that I walked into the room, mentally rehearsing the hand signals and charades that I would have to use.  What a surprise when I walked in and realized the patient spoke my mother tongue: Cantonese.

The look of relief that crossed his face (probably mine as well) was unmistakeable when we both realized this would go a lot better than expected.  What we didn’t realize, however, was that although I was fluent in Cantonese, I was not at all medically literate in Chinese.  Google Translate made more than one appearance as I searched for terms like “sciatica” and “post-nasal drip”.  Although we both laughed about it during the visit, it was bizarre to be both fluent, yet not, in a second language.

Canada’s medical student population is culturally diverse, and students speak a large variety of languages.  This is, of course, invaluable given the diverse patient population.  However, I encourage medical students to brush up on medical terminology in other languages lest you run into the same experience as I did.  If nothing else, it will win you extra points with your preceptor and with the ward nurses!

There is a hidden bonus to practicing a second (or third) language on the side of medicine: you continue to exercise your mind in different ways yet within medicine, refreshing it from the mundanity of reading Bates’ Clinical Exam yet another time.  Research has shown that speaking more languages puts off the incidence of aging disorders such as Alzheimer’s.  Finally, for the pragmatic and career-oriented students out there, remember that if you speak “medicine” in another language, you make yourself more marketable in competitive fields.  Just a side bonus!

When I sat down with a friend to work on what would become the first provincial suicide intervention workshop for medical students, there were a ton of doubts.  Who would go?  Who would pay for it?  Where would this happen?  The questions kept going.  It was discouraging.

But meeting after meeting, plans slowly fell into place.  We got funding, we got special rates, we got institutional support from the Ontario Medical Association.  Through work and perseverance, we happily launched a successful Applied Suicide Intervention Skills Training workshop that is still making waves now.

Where am I going with this anecdote, you ask?  Well, my message is a simple one: Just Do It.

At few points in your life do you have as much free time as during medical school (sounds weird, but it’s true).  Classes are pass/fail, your clinical work is overseen by a preceptor, and most of us don’t have families to take care of.  Contrast this with our medical future, when work and family begin taking a greater percentage of our lives.  Talking to my peers, many med students fall into the trap of thinking medical school is about work, studying, and then de-stressing.  Rinse and repeat.  As we all know, this is no way to live your life!

Enrich yours and others lives.  If you have an idea for something that could work, be it a quality improvement project, community advocacy, or even putting on an art gala, follow it down that rabbit hole!  We hear stories of students doing amazing things every month, as OMSA posts its Student of the Month blog post.  Bear in mind that there’s nothing inherently separating you from them, save for the audacity of going just one step further than their peers, and another, and another.

I’m not going to belabour the importance of living a balanced life, but I will emphasize the importance of diversifying one’s life.  Like Jack Nicholsen in The Shining would say, “All work and no play makes Jack a dull boy.”