Medical students’ perceptions of stress due to academic studies and its interrelationships with other domains of life: a qualitative study

Figures & data

Table 1. Quotes illustrating the perceived effects of academic studies on one’s private life and associated personal challenges.

A1	During the first semester, just mentally (,) I think we had to take eleven exams (.) and everything else and, er, I was completely exhausted. I couldn’t eat, couldn’t sleep, I was, well, I really was a nervous wreck.
A2	But somehow my whole life is centred around studying. In my spare time, I hardly do anything but study. (.) And things like exercising once a week, I don’t even begin to do this because I think then I will miss out on studying for yet another day. That’s the only thought one has.
A3	And each time I do something else than studying I have a bad conscience because I ought to study. And each time I study I feel terribly stressed because I think I need a break. A kind of balance develops because you feel bad when you study and you feel bad when you don’t. It’s like that all the time.
A4	We even studied during the Christmas break. With a heavy heart, but still. You visit some relatives and take along your flashcards. (.) You sit on the sofa with earplugs in your ears, but at least you stayed with your relatives.
A5	This is simply the pressure one feels, that you know that if you fail three times, and that happens really, really quickly, then you will never be able to do it again. (.) I don’t know what else I would do with my life and if I failed three times and it was over then (.) my life would be in shambles.
A6	Well I think there are a lot of people who, er, also a lot of drop-outs who are deeply disappointed and exhausted, particularly in the pre-clinical phase, because there is so much stress and pressure that they can’t cope with. (.) I believe there are some people who don’t break down but who feel it impacted their personality.
A7	It happens every semester (.) I went through some phases, I had never experienced this before, I was just lying there and crying and I thought I really can’t, I can’t go on anymore. That was really, really, really exhausting. (.) I don’t know if I will succeed.
A8	What is quite severe for me, well I think that a student of medicine who lives alone, that’s at least my experience, will become quite lonely when preparing for exams. (.) I lived alone during the first two semesters and when we had exams I went shopping at 11:30 at night, because the one particular grocery store was open until midnight, the shop I frequented was a bit further away, but there was always a student working as a cashier, (.) I could chat with her. I always found that a bit sad because if I have time now (,) and then I went shopping last night again just to meet another person. That really wasn’t, er, quite nice.
A9	I’m almost finished and I derive a certain kind of self-confidence from this. If my studies didn’t break me then it doesn’t matter what else is going to happen, more or less. I will be able to cope with other things as well, I will be able to handle other things successfully.

Table 2. Quotes illustrating the perceived effects of one’s private life on academic studies and associated personal challenges.

B1	When worse comes to worse, sure, everyone feels low sometimes, then I always call my parents (.), because it’s such a great support.
B2	It also happens that my mother comes to my room when I want to study, and then she wants to chat with me for half an hour, you can’t just ask her to leave. Therefore, one gets easily distracted by so many different things.
B3	I am not as close to my old friends as I used to be, they all study (.), but they went on holiday last week and I couldn’t join. (.) But on the other hand, I found a lot of new friends here and therefore I don’t perceive this as very troubling.
B4	On the other hand, I’m glad that I have some very good friends here who also study medicine, whom I can tell, 'well, I couldn’t cope ‘well with the autopsy, how about you?' (.) In a way this is important, because my boyfriend or other people don’t understand it. I tell them a person had this and that and it takes a long time to explain what that is and so you have, people with a medical background, you can tell them that you felt distressed by something and perhaps they feel the same.
B5	I think that because studying takes so much time and one spends a lot of time at university and is only around people from university. It’s the only subject to talk about. No matter where you go. There are always some students of medicine. (.) Then you talk about university. Then perhaps you feel stressed out by someone else because he’s better at something than you are. That there’s nothing but medicine in my life. That’s terrible. Somehow you don’t know how to change it, because you always have to study. And never have time to meet with friends.
B6	What really makes me terribly sad is that when I call my friends (.) and then they tell you, I’m going out tonight with this friend and yesterday I met for coffee with another friend and now we plan on going shopping tomorrow. (.) And you sit there and think, great, I can’t do any of these things. That makes me terribly sad.
B7	A couple of weeks ago I had to work all night for four days and it was always the same thing, get up in the morning and go to university, then skip studying because one’s too tired, and then another course. Half asleep. Then go to work in the evening.
B8	Work can really be a problem. For example, this month I can’t work half of the month because of exams, because sometimes I need time for studying, and then I don’t have enough money.
B9	I used to have about 10 different hobbies. And every day there was another activity I participated in. (.) And here you basically have nothing besides university.

Table 3. Quotes illustrating the role of personality in the interrelatedness of one’s academic studies and private life.

C1	Well, when you think 'OK, I will pass the exam regardless of the result', then you feel less stressed as when you aim at achieving a good result. (.) I think much depends on what you expect from studying and on how much one expects from oneself, and that’s perhaps what adds to or distracts from the stress.
C2	That’s like another type of school with tests, but for people (.) who tend to procrastinate. And the number of things left undone keeps growing and growing and then one day it’s shit, I still have to do all of these things.
C3	Especially during the preclinical phase, I can make a decision, either I want some kind of private life or I will excel at university, one of these two.
C4	But I really feel so bad that I don’t sleep well quite often. That in the last one or two weeks I have recurring dreams of standing in the autopsy room and have exams. It sounds ridiculous but it’s a real burden for me.