What Are Strategies to Avoid Burnout During Intense Studying?

Written by: Joshua Ginsburg an emergency medicine physician in Chalmette, LA. He received his medical degree from the Tulane University School of Medicine, completed his residency in emergency medicine at the University of Virginia, and completed a fellowship in medical education at the University of Virginia.

What Are 5 Strategies to Survive Burnout During Intense Studying?

According to the American Medical Association (AMA), burnout is “a long-term stress reaction characterized by depersonalization, including cynical or negative attitudes toward patients, emotional exhaustion, a feeling of decreased personal achievement, and a lack of empathy for patients.” There are clear parallels between the burnout from medical practice described by the AMA and the burnout that can arise from long periods of intense studying. The latter can just as easily lead to depersonalization, including cynical attitudes toward medicine and the subject being tested, emotional and mental exhaustion, and feelings of decreased personal achievement and wellbeing. In one study, 97% of students reported feeling some level of burnout when studying for a high-stakes exam (https://www.sciencedirect.com/science/article/pii/S2452301120300456 ). Fortunately, there are simple, effective strategies one can employ to combat and survive burnout during intense studying.

1. Simplify your studying. Thoroughly studying one or two core resources will almost certainly be more effective and less stressful than hurriedly or superficially reviewing several resources. Take some time before your study period to do some research on which resources are most efficient and effective for the test for which you are preparing. Ask around - medical school or residency leadership, fellow students and co-residents, and online blogs can all be good sources of information. Remember, you are preparing for a test, not the intricacies of clinical practice. A core textbook or review book plus a quality question bank is usually more than enough to prepare you to ace an exam.
2. Schedule. Once you’ve simplified your study plan, it’s time to make a study schedule. Do this early! Figure out what you can reasonably accomplish in one day of studying, keeping in mind that this has to be sustainable for weeks or months. At the same time, figure out how many pages or questions you need to get through per day to complete the studying you outlined in Strategy 1 above. Based on these two pieces of information, adjust your plan as needed, but do not plan to fit more studying into a day than you have decided is reasonable and sustainable. This means that if the above math indicates you need more study days, try to start your studying earlier or push your test back. Alternatively, revisit Strategy 1 to find more efficient study resources as long as they are believed to be of similar quality.
3. Allow the schedule to adapt if needed. There is nothing wrong with changing your plan if it is not working. A simple change is certainly preferable to the burnout that may result from being too rigid in the face of a study plan in which you are no longer confident. If a certain resource is redundant or not working for you, ditch it or replace it. If you find you are studying faster than normal, give yourself more time off or budget a few days at the end of your study period for a review of your weaknesses or reading of a small, high yield resource. If you find you are studying slower than normal, make an appropriate change. This will be easier if you set aside catch-up days in your study schedule.
4. Give yourself dedicated time off. On your study days, give yourself a 10-minute break for every 50 minutes of dedicated studying and at least an hour break in the middle of your study day if you plan to study all day. Dedicated studying should occur in the absence of distractions, so you should find a quiet space for studying, and you may want to download a computer program or cell phone application that blocks you from browsing the internet or using social media unless you are at a scheduled break. Additionally, give yourself the evening off by deciding not to study past a certain time of night. Falling asleep while reading the same paragraph over and over is not an effective study strategy, and drinking another cup of coffee in the evening when you are already tired is sure to make the following day worse and accelerate burnout. I also recommend you plan for one full day off of studying per week. 
5. Take care of yourself. Use the time off you created in Strategy 4 to energize yourself in whatever way makes you happiest. In your 10 minute breaks, you may want to call a friend or make a snack. In your mid-day break, you may benefit from some exercise. In your evenings, spend time with your friends or family or watch a show or movie. On your full days off, you may want to go on a day trip or spend time with people whose study schedules overlap with yours. Days off are also a great time to do some meal preparation, which will help you eat well throughout your study period. 

If you are experiencing signs and symptoms of burnout during periods of intense studying, know that you are in the majority. Remember that you have control and are armed with a number of strategies to help combat and survive burnout.

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Written By: Myles Mowery, OMS-IV, incoming interventional radiology resident

Make A Schedule

We’ve all been there before, you’ve got a final exam you’re not prepared for, you’re hours of lecture behind, you’ve got a skills practical coming up, your Anki reviews are piling up, and you haven’t had time to unwind. You feel like you need to work on everything all at once, but the stress has fried your brain so you can’t begin working on anything. What do you do now?

I can’t tell you how many times in medical school I felt EXACTLY like the above paragraph describes. One strategy I’ve found useful is making a study schedule.

First, write out everything you need to accomplish leading up to your exam. Once everything is out of your mind and in front of you, you can think more clearly because you no longer have to stress about remembering everything you have to do. I like to think of this as “brain emptying” because when I would do this, the brain fog accumulated from the anxiety of my seemingly unmanageable to-do list immediately cleared.

After you’ve got your list of things you need to do laid out in front of you, make a daily schedule. When you make your schedule, don’t get overly detailed with it. It’s going to be difficult to stick to an overly detailed study schedule. You can generalize this scheduled so that you have a short AM to-do list & a short PM to-do list every day (see example below):

• Main To-Do List
  • Monday:
    • Morning:
      • RBC pathology lecture
      • Anki reviews
      • Practice head to toe exam

• • • Afternoon:
      • WBC pathology lecture
      • New Anki reviews (RBC & WBC)
      • Do/review 1 practice question set (RBC/WBC)
    • Evening:
      • 2 hours StatPearls pathology practice questions
      • Break - exercise
      • 2 hours StatPearls random USMLE questions

Keep in mind that you’re going to have days where you might have to change your schedule, and this is OKAY! On days where you don’t quite finish everything on your daily list, move it to the next day. On days where you’ve crushed your to-do list and you’re still feeling motivated, start working on the next days’ tasks.

Sleep

Everybody knows sleep is essential to function properly during the day. This is even more true if you’re trying to digest the seemingly insurmountable amount of information medical school throws at you. 

Sleep helps the with acquisition, consolidation, and recall of information you are trying to learn. If you’re putting in long hours of studying during the day, you want them to pay off, and you want to retain what you are trying to teach yourself. If you are having to re-teach yourself information due to lack of sleep, you are wasting valuable study time.   

Generally speaking, adults are recommended to get anywhere from 7 to 9 hours of sleep per night. We all have an idea of how much sleep we individually need to function at our personal best. Make sure you are adhering to a strict sleep schedule in order to get the number of hours you need so you can be efficient when you’re studying.

Schedule Study Breaks

It’s difficult to maintain focus on studying for eight hours straight; some might call it impossible. Study breaks are essential when it comes to optimizing time studying for big exams. There are many ways in which to do this, one popular one is the Pomodoro Technique, which involves focused studying for 25 minutes, followed by a short 5-minute break. This method also includes longer breaks for things like lunch and dinner. I personally adopted a similar method to this, but I don’t base it on time, I base it on the amount of work I do. For example, after getting through 100 Anki card reviews, I allow myself to take a short break to check my phone. I also take breaks after different increments of time watching lectures. These break increments (100 flashcards, 20 minutes of lecture, etc.) depends on how I feel each day though. On days I feel more focused, I push myself to only take breaks after 200 Anki reviews and maybe 30 minutes of lecture, the same is true for days I feel less focused (breaks at smaller increments.) 

Also important are longer breaks in the middle of the day and in the evening. Make sure to fill these breaks with things you love to do. For example, things I fill my break time in with are playing guitar, watching Netflix, going for a run, or weight training. Listen to your body! If you are antsy sitting in your study chair, do something active on your break. If you are feeling tired/mentally drained, do something mindless on your break (take a nap, watch TV, play video games, etc.) 

The last point to make is if no matter what you do you just cannot get yourself to focus, take a day off. Everybody needs a day off once in a while. Will you fall behind in your schedule? Sure, but the gained efficiency you’ll glean from a full day of relaxation will make up for it in the long run.

Other Ways to Cope with Stress 

There are so many other ways to cope with stress, including talking to someone, whether it be a family member, friend, peer, or otherwise. Sometimes when we’re feeling stressed during times of intense studying, it helps to have someone to talk things out with. I had a few key people I would occasionally call when I was feeling overwhelmed in medical school, and these people would help me organize my thoughts, clear my mind, and get me back on track.

Another way to keep things fresh and prevent burnout is to change up your study spots. I had several different study spots I would frequent all over Kansas City so that my mind wouldn’t get bored with the environment I was in while I was studying.

Lastly, plan things to look forward to. Whether it be a night out with friends, a trip after a big exam, or even something small like ordering some pizza one night a week. Having things to look forward to can really help motivate you to keep going so it doesn’t feel like days just go on and on.