Volume I: What do today’s medical students do when they need help?

I’m happy you’re joining me again in our weekly blog. You may have noticed that my current topic references “medical” students rather than Physician Assistant students precisely. I have my reasons for this, namely that medical education across the board faces remarkably similar issues. Medical school is hard work, and just about anyone who comes to a medical education expecting it to be a cakewalk is in for a big surprise. Well, I wouldn’t want to be in the care of a medical professional who attended the “easiest” medical school - would you?

That being said, there is a difference between a student challenged to achieve a higher level of understanding and a student driven to the brink of nervous collapse. The most significant part of that difference may lie within the students themselves. A significant facet of our Student Success Coaching program directly addresses this: many students reach higher levels of education without having been taught effective study skills to cope. Students who managed well in high school may find college overwhelming; capable college students may land in graduate programs to find themselves sinking under the weight of the material. Teach students the skills they need, and often, their stress and anxiety are alleviated. 

Student Success Coaching, however, largely remains a service to which students are referred when the most obvious sign of trouble arises: their grades are poor. Poor grades are obvious warning signs, but they are only one indicator that a student is struggling with a specific (albeit fundamental) aspect of medical school.

Students deal with much more than that, and their need for help is not always apparent.

Suffering in silence

Despite our commitment to training the next generation of healthcare providers, we've created an environment where depression, burnout, and anxiety thrive. Medical graduate students report experiencing significantly higher psychological distress than their same-age peers. Half of all students who leave medical school do so during their first year, highlighting the critical importance of effective graduate student resources. 

The educational demands of medical school are frequently described by students as "drinking from a fire hydrant" or managing a "stack of pancakes" that quickly accumulates if not addressed on a daily basis. The academic journey typically includes:

• Intense workload with strict absence policies

• Frequent high-stakes examinations

• Increasing clinical responsibilities for patient care

• Constant pressure to maintain academic excellence, from peers, family, and themselves

• Depression and burnout, which can impair performance

• A cultural archetype that seems unsupportive, or considers emotional struggles a “weakness.”

• An abundance of “remote” classes (while many students appreciate the convenience, others find the experience monotonous and isolating)

First-year students often experience the most significant deterioration in mental health, primarily related to staying afloat in competency-based curricula. Furthermore, the competitive medical culture compounds these pressures, with many institutions fostering environments that prioritize achievement over well-being.

Barriers to getting help

Unfortunately, many students don’t seek help, even if it is technically available to them. Why is this?

• Finding relevant information about support services may be difficult. Students may lack awareness of what is available to them, often feeling they must chase down the right person or ask just the right question to be sent in a helpful direction.

• Navigating the process of accessing help can be lengthy and exhausting. There may be numerous forms to fill out, or exceedingly long wait times for appointments. Usually, when a student reaches the point of desperation and asks for help, the need is immediate; delays and complications will increase stress and discourage the student from pursuing the help they need.

• Students fear the stigma of “getting help.” Medical students often believe seeking help, particularly psychological help, signals weakness. Many fear appearing less capable than peers in the highly competitive medical environment. The belief that debilitating stress is “normal” for a medical career becomes internalized.

• Students worry about confidentiality and the potential career impact. Many avoid university services entirely because they fear practitioners might know them in academic contexts. They may deliberately downplay symptoms during assessments. Students are particularly concerned about “fitness to practice” proceedings and the potential implications for their career progression.

Ultimately, these interconnected barriers create a troubling paradox: the very resources designed to support wellbeing remain inaccessible precisely when students need them most. So, to answer the question posed in the title of today’s blog, when medical students need help, they often do nothing.

It doesn’t have to be that way.