Staying Fit in Medical School

2017-03-20 15.49.30

A few months back, I received a question from a blog reader concerning staying fit during medical school. Jonathan writes:

“Benji, I have some questions regarding maintaining overall health and fitness during medical school, something which you obviously appear to have done. What did you personally do and what advice would you give to incoming students? Was there a specific training routine, method or practice that worked out the best for you? If you had to physically and mentally do it all over again, what would you do differently?”

I wanted to address this in a post because I believe this is an important topic. With classes, studying, tutoring sessions, and all things academic, it can sometimes seem like there’s no time for anything else when you’re in medical school. And you’re right… sometimes there isn’t. However, it’s important to keep in mind that you gotta take breaks, so that you don’t burn yourself out. Some people take smoke breaks (not healthy) while other people get on Facebook (although with what’s going on recently in the news, you may need to find another way to take off the stress). I think exercising is a great way to destress the mind. It gives your mind a break from memorizing the branches of the brachial plexus in anatomy, or making sense (or not) of the clotting pathway in physiology, or trying to understand when to use the chi-squared test in biostats.

One great thing about exercise is there’s so many ways to do it – there’s weight lifting, yoga, tai chi, cycling, team sports like basketball, swimming, or just plain old running. Which ones you do depends on what you enjoy and what your goals are. If your goal is to destress, I can imagine that all of these are great. I personally like the solo sports of weight training and running. I never really cared much for team sports growing up, never had a good aim, let alone know the rules of basketball or football. I never had the patience to sit through an entire game, let alone play it. Tai chi and yoga are slow sports that I never found the patience to do. I’ll talk about running first.

Running for me is an activity where I don’t have to think, and we all need a break from thinking sometimes during med school. I just put on my earphones, turn on some classical music, and I’m off running. Running involves repetitive motions, which can get boring, so I think it’s good to counterbalance it with non-repetitive music. Classical pieces Dvorak’s New World Symphony, Holst’s Planets, or Smetana’s Ma Vlast are long symphonic pieces, with little repetition, and they tell stories. I forget that I’m running, and I end up running longer and feel less tired.

For me, I like weight training, because you don’t have to spend too much time to get a good workout. You can work out 2-3 muscles per day, hitting the muscles with high intensity to the point of soreness, not spending more than 30 minutes in the gym – if you do it right, you’ll be spending the next few days recovering those muscles, burning calories even while you sleep.

Personally, I don’t like following strict work-out routines. My goal isn’t to be the next Mr. Universe. However, I do follow a few principles:

  • I’m not the type of person to say workout biceps on Monday, chest on Tuesday, quads on Wednesday etc… Instead, I just work out whichever muscles that are not sore that day. If a muscle is still sore, I wait until it is no longer sore before working it out.
  • If a muscle does not get sore the next day, I didn’t work it out enough. I try to put enough intensity so that I make sure it feels somewhat sore. It does not always happen, but it pushes me to work harder.
  • For weight training (or any high-intensity workout), I don’t believe you need a long workout to have a good workout. I try to focus on 2-4 muscles per day, and I’m usually in the gym no more than 30 min.
  • I try to workout 4-6 days a week. It doesn’t always happen, depending on my schedule, but it is an ideal I try to go for. Even if I can’t make it to the gym, I try to do something at home, like push-ups, even if it’s just a few minutes.
  • Feeling tired is not an excuse to skip a workout. For me, feeling tired is a reason to go workout, to wake me up.
  • Eat right and get enough sleep, otherwise you’ll negate the health benefits of the workout. I don’t consider myself having a strict diet, but in general, I don’t buy cookies, cakes, ice cream, sodas, or juices. I drink sodas on less than a handful of occasions per year, if that. If I have a sweet tooth, I usually eat fruit. The only beverages you’ll find in our fridge are water, milk, and soy milk. We cook a majority of our meals and I bring my own lunch to work.We almost never cook with butter, cream, or cheese – these ingredients aren’t really found in Chinese cooking anyway. We boil, steam, and pan fry. If we pan-fry, it is with olive or vegetable oil. We dont ever deep fry, and we dont use lard. Generally, about half of what we eat are vegetables. I don’t mind drinking out of the faucet. I don’t mind eating canned or frozen foods. I have no problems with GMO or non-organic foods. I don’t take protein powder (tried it in the past but gives me diarrhea, maybe from all that sugar alcohol?). I believe I get more than enough protein from my diet already. Though I’m not opposed to it, I generally don’t drink alcohol either (I have the “Asian flush” and I’m also allergic to red wine).

I’ve heard some of people say that they do not want to exercise because they are happy with their weight and comfortable in their own bodies. I think the reason to exercise shouldn’t be just to lose weight and look good. You can be thin but still have a high cholesterol level and a bad heart. One should exercise to stay healthy – to maintain a healthy heart, muscle mass, and strong bones – all of which would deteriorate as we age if we did nothing at all, and none of us are getting any younger. If you don’t use it, you lose it. Exercise also helps with many conditions people may come to a doctor’s visit for… Did you know studies have shown that moderate exercise (earlier in the day) is just as effective as benzodiazepines in the treatment of insomnia, and has a SORT evidence rating of “A” to recommend it as a treatment for chronic insomnia? Did you know supervised exercise has been shown to be more effective than cilostazol for the symptomatic treatment of intermittent claudication? Aerobic exercise is also a SORT A recommendation for being an effective treatment for fibromyalgia, just to name a few examples.

I think as future physicians, med students should practice what they preach and maintain a healthy lifestyle. If we are going to be battling cardiovascular disease, obesity, COPD, diabetes, etc. then we need to make sure we also stay fit, eat right, don’t smoke, and don’t develop those conditions we are training ourselves to fight for our patients. We need to be role models in our communities and be advocates for health.