‘It is very real’: All about Medical Student Syndrome, a condition that can significantly impact mental health of MBBS students

“This also feels real when you have an emergency case and you don’t know the patient’s HIV/HBV (hepatitis B) status but have to manage,” Pune-based Sagnik said, recalling an incident that happened with a senior posted in Assam’s Tezpur, who attended to a patient had walked 80 kms from Nagaland with a complaint of severe uterine bleeding after a botched abortion.

“More than four hours into the surgery, they get to know she’s HIV+ve. So, in such exposure cases, there is a protocol to start medication as soon as possible, but still, the fear and uncertainty (of being infected by the patient) remain,” Sagnik told indianexpress.com.

Echoing similar sentiments, Dr Agarwal said: “Yes, MSS is real. Most medical students start co-relating diseases and conditions they read about in books or see in patients they attend to in the OPD.”

So, this Mental Health Awareness Month, observed annually in May, let’s understand the nuances of this ‘syndrome’ and how it is interpreted in medical circles.

Why does MSS occur?

Explaining the science behind such thinking (and feeling), Drisha Dey, a Kolkata-based consultant psychologist, said that MSS is actually a “trick” the mind plays wherein any pre-existing behaviour or manifestations get linked to the diagnostic criteria of diseases once the latter is learnt. “When we look for answers, our brain will search to provide us with some. The reticular activating system is a mechanism in our brains which show us more of what we focus on,” said Dey.

According to 22-year-old Sagnik, there are multiple facets to understanding why MSS may occur. Every MBBS student or doctor is trained to investigate according to the history and symptoms provided by the patient. “We are trained to make a list of D/D (differential diagnosis) based on patient complaints, history, and investigation reports (like X-ray, USG or ultrasonography, etc). After everything else has been ruled out, our last D/D is psychogenic illness — that the patient is either feigning illness or its a psychological condition (called somatoform disorder). This is a diagnosis of exclusion which you hit upon only after ruling out everything else. That is what happens with us, the students, too. If a medical student complaints of any symptoms, he/she won’t immediately think MSS but only about the conditions he/she may have read about,” Sagnik elucidated.

Here’s how the syndrome may be felt (Source: Getty Images/Thinkstock)

He added that then, there is also an over-analytic bent of mind that occurs due to “studying too much theory” which also “leaves a deep imprint”. “To top it all, the high pressure environment in MBBS only adds to the cocktail of stress, academic insufficiency, personal life issues, and the mentally fragile/over-imaginative minds too,” he continued.

Symptoms

The symptoms of MSS can vary from person-to-person, said Dr Gautami Nagabhirava, neuro psychiatrist, Kamineni Hospitals, Hyderabad. “Some students may experience mild symptoms such as a headache or a stomach ache, while others may experience more severe symptoms like chest pain or difficulty in breathing. These symptoms can cause significant distress and anxiety to the student, who may start to worry that they have contracted the disease they are studying,” Dr Nagabhirava elaborated.

How does it impact medical students?

Also known as hypochondriasis or medical student disease, Dr Nagabhirava informed that the condition is not a recognised medical diagnosis but is only listed as part of ‘hypochondriac disorders’ classified in ICD-10 and DSM-5 (two major globally accepted classifications of diseases).

Yet, Dr Nagabhirava said that it is “very real and can have significant impact on the mental health of medical students”. “MSS often manifests itself in medical students who are studying complex or life-threatening diseases such as cancer or heart disease. It is not uncommon for medical students to become so engrossed in their studies that they start to believe they have the disease they are studying,” mentioned Dr Nagabhirava.

Sharing that it can be “extremely jarring to constantly be apprehensive” about what new disease one has, Dey said that it is better to seek a senior or other professional’s help.

Is everyone at risk?

Like Dr Sneha Sarraf, MD, obstetrician and gynecologist, who revealed not experiencing any such symptoms as a student, psychiatrist Dr Deepak Raheja pointed out that “not all students are at risk”.

“The severity and duration may vary. Some students may experience mild and temporary symptoms which could resolve on its own, whereas for others it may persist and require professional help. Having said that, MSS is not a sign of weakness or being inadequate, it is rather a natural reaction to the intense training and education medical students go through,” Dr Raheja explained, stressing that MSS is, however, a “real phenomenon”.

What can help?

Medical students who are experiencing symptoms of MSS should seek help from a mental health professional, said Dr Nagabhirava. “Counselling or therapy can be helpful in managing the symptoms and reducing the associated anxiety and stress,” he said.

They should try to maintain a healthy work-life balance, mentioned Dr Nagabhirava, adding that this means taking breaks when necessary and engaging in activities that are not related to their studies. “Additionally, medical students should try to stay informed about the signs and symptoms of MSS so that they can recognise it early on and seek help if necessary,” added Dr Nagabhirava.

It is easy to cope with?

Noting that in his peers, “it has never been very serious”, Sagnik said, “it’s like a phase that goes out when you mature.” On the contrary, as one “grows up in MBBS”, according to him, by the final year, you’ve seen and read of so many diseases that there’s a bit of “de-sensitisation” to the same. “You start seeing them as medically interesting cases rather than get emotional or hyper about the disease/person itself. The first death, for example, you see usually in the internship period is hard but by the end, it becomes a normal part of the profession,” said Sagnik.

Objectivity is one’s best friend, stressed Dey. “There are a host of symptoms that one has to fulfil before one is diagnosed with a disease. It is best to remain calm, go over that checklist like one would do with any patient, and then come to a composed conclusion. It is always advised to not isolate and instead converse about this with peers and seniors who would get where one is coming from,” Dey said.

📣 For more lifestyle news, follow us on Instagram | Twitter | Facebook and don’t miss out on the latest updates!