Thank you for joining me again for the Dr. Scott Massey Newsletter. We’re continuing our series on stress and the medical graduate student. In our last edition, I discussed some of the science behind stress management which illustrates why we benefit from providing our students with stress management support and techniques. 

What do I mean by “providing” this information? The stress-management culture is a paradigm that springs from the ground up. Self-care should be embedded in the program’s paradigm:

My recommendations are that PA programs:

1. Develop a culture of self-care (including faculty/staff encouraged to model self-care practices).

2. Educate students on the value of self-care.

3. Facilitate students’ developing self-care plans. I recommend a one-hour workshop on developing a self-care plan held during week 5 of the semester.

4. Provide training on different self-care methods. A one-hour workshop during Week 9 includes opportunities to learn and practice time management and anti-procrastination techniques, relaxation techniques (breathing and progressive muscle relaxation), cognitive techniques to identify triggers and evaluate thoughts, Mindfulness-Based-Stress-Reduction MSBR), meditations, and values-guided behavioral interventions

5. Encourage participation in meaningful activities to promote wellness. This can be expressed through the school itself or through simple support of student-generated activities for your PA students who need a moment to remember that they are people as well as students.

Workaholic Worship

Most of us, most of our lives, get simple (and vitally important) self-care information from our peers or family. Get enough sleep. Be sure to eat right. Get some sunshine and exercise. Take a break now and then. These tried-and-true recommendations are not only correct; they are usually enough to get the job done without us ever having to learn about cognitive techniques or meditation. These self-care rules are common sense. So why don’t we do them?

Because we hear this advice all our lives, it’s easy to forget how important it is. We also live with a double standard. Our culture tells us one thing but then rewards another behavior entirely. We admire and praise people who throw themselves completely into their work. We like hearing about people who sacrifice everything, lose sleep, endanger their interpersonal relationships, and nearly kill themselves as they battle their way to a goal. Eventually, when these heroes slay their particular dragon, the implication is, “It was worth it!” 

We don’t all have dragons to slay, but we do reflect this attitude culturally. On a day-to-day level, we compliment those who make sacrifices in one part of their lives so they can put all their energy into another. I’m not talking about when it is our pleasure to go the extra mile on an important project or really put our passion into our work. I’m referring to the state of being when the work itself, rather than a result, becomes the goal, to the detriment of other parts of a person’s life. We refer to these people as workaholics. The double standard of our culture is that we discourage workaholism while simultaneously admiring and aspiring to it.

Consider these things:

• We are in awe of people who are single-mindedly focused on a project or goal.

• Workaholics appear to be doing more. Student A studies for an hour each day for 30 days before a test, but Student B studies ten hours a day for three days prior. Even if they both got the same grade, Student B appeared to have studied harder. 

• Workaholics are often singled out and complimented for their diligence – it becomes quite an ego-booster to them. “Wow, you work so hard. I wish I had your focus and determination.” The admiration of others gives workaholics a sense of fulfillment and a reason to continue.

• Workaholism can sometimes produce noticeable results in the short term, making it seem like harder workers are better workers.

We must be careful about this attitude, especially around stressed-out students in a competitive environment. Young, motivated people can burn the candle at both ends for an impressively long time –but it doesn’t mean they should.

• Workaholics often dive full-force into their work as an excuse to avoid their real-life problems – fear, loneliness, insecurity.

• We may mistake the hard work itself for results. We admire “hustle,” “fighting,” and “nose to the grindstone” behavior without any evidence that this behavior produces better outcomes. The quantity of work done should never be mistaken for the quality of work done.   

In short, self-care behaviors are focused on quality of work rather than quantity. 

Conclusion

In our next newsletter, I’ll begin sharing my program’s outline for self-care strategies we present to cohorts. I hope to see you then.