MEDICUS FEBRUARY 2016

O P I N I O N

The ESSENCE of Medicine

Sid Narula President, Medical Students’ Association of Notre Dame

I n the coming weeks, 3,700 new students will join 14,000 veterans in the study of medicine. These 3,700 students may not yet recognise the pressure and vulnerability they will experience in their first year of medical school. They may be oblivious to a predisposition to feelings of helplessness, worthlessness and weakness that can plague any individual. In 2013, beyondblue released the results from a survey of medical students and doctors which unsurprisingly revealed that they are burnt out, more likely to experience psychological distress, and 25 per cent are moderate to high risk drinkers. Further, the study found that doctors are less likely to get help due to a fear of privacy, fear of embarrassment and the potential impact on their medical registration. The question then becomes, “What can we do to improve the mental health of our current and future clinicians?” Since 1989, Monash University has employed Mindfulness as a part of the core curriculum for medical students. Mindfulness is a practice of cognitive strategies that enable an individual to extricate from unproductive behaviours and negative thought patterns; its sine qua non is the necessity of the person to become present in the moment. The practice involves techniques of meditation that can be easily applied within the hustle-and-bustle of daily life. The results of Mindfulness integration have shown that it can reduce stress, anxiety and depressive symptoms,

improve peace of mind, enhance cognitive performance and improve general wellbeing. Recognising the value of such a practice, Notre Dame has integrated the ESSENCE model of healthy holistic living into the MED100 course. The model asserts that there are seven controllable determinants of health (education, stress management, spirituality, exercise, nutrition, connectedness and environment) which can reduce illness and enable a healthier, happier, and calmer life. Notre Dame’s wellbeing program sounds quite valuable, so why then are cohorts of medical students so collectively resistant to it? From my own informal survey of my peers, I have found that individual students in private discussions are accepting and enthusiastic about the program’s content. However, these same students when placed in a group, will deride the program and proclaim it as a waste of their time. This disheartens and disappoints me. Within medical schools, one will find almost every student acknowledges the growing prevalence of mental diseases, however most are shy to admit their own vulnerability. Research in mindfulness therapy suggests that meditation and self- transcendence act on an epigenetic level to modify the expression of disease through DNA methylation and histone modification. Unfortunately, for many “type-A personality” medical students, despite over 3,000 scientific studies on the benefits of meditation,

this seems unreasonably far-fetched.

Science cannot yet prove the mechanism by which meditation affects the body but a group of Harvard neuroscientists have managed to demonstrate that mindfulness meditation increases the grey matter mass in areas of the brain involved in learning, memory, concentration, emotional regulation and sense of self. Such findings are not going unnoticed. Google, Fortune’s number one rated company to work for, runs its own wellness program for employees free of charge. A director of Google’s executive development who took the course, told The New York Times . “It’s almost an emotional and mental bank account. I’ve now got much more of a buffer there.” Such a buffer is essential in an emotionally taxing profession such as medicine. The results of the beyondblue study amply reflect the stressors arising from medicine. Unfortunately, not all of these factors can be changed, but by being aware of their influence on our health, it may be possible to control the way that these pressures affect us as individuals and professionals. To the new first years joining the herds of medical students, I would like to extend a warm welcome and congratulate you on taking the first step on a challenging but rewarding journey. I encourage you to approach all opportunities with an open mind and implore you to put your own health first. ■

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