By Sujata Ojha, MS – III
This article was originally published in the July/August 2022 issue of the Tarrant County Physician.
As medical students, we have an incredible opportunity to discover a vast amount of medical knowledge, learn about the normal and the pathological, and to immerse ourselves in clinical settings where we witness the complexity of diseases. In the process of learning about life-threatening diseases, the risk of nosophobia, or illness anxiety disorder, can develop. More commonly termed “Medical Student Syndrome,” it is a concept that medical trainees are well acquainted with.
What is Medical Student Syndrome? It is the phenomenon that causes fear of contracting or experiencing symptoms of the disease that the students are studying or are exposed to.
Medical students learn the pathophysiology, the diagnosis, the treatment, the prognosis, the best-case scenario, and the worst-case scenario of diseases. We learn about teenagers diagnosed with melanoma and hear stories about patients in their early 20s diagnosed with breast or cervical cancer. The worst-case scenario tends to grab our attention. This reinforces us to not ignore a patient or symptom that doesn’t follow the general pattern of the disease, allowing us to widen our baseline scope of clinical suspicion when it comes to debilitating pathologies. The constant medical stimulation and limited clinical experience earlier on in our education can cause students to become preoccupied with symptoms and construct connections between what we are experiencing with the worse-case scenarios we learn about.
“I booked an appointment with the dermatologist because I thought I had a melanoma,” said one classmate after we shortly finished our dermatology unit. After undergoing a biopsy, the classmate discovered that the melanoma in question was a benign nevus. During the cardiopulmonary block, another medical student said he went to the ER after experiencing mild epigastric pain and tachycardia, thinking he was experiencing symptoms of atypical myocardial infarction. He had recently encountered a patient in his late 30s with a history of MI who presented with similar symptoms, further reinforcing the “worst-case scenario” in this trainee’s mind. After hours spent in the ER, he was diagnosed with gastritis and sent home with a prescription for a proton-pump inhibitor.
Throughout my medical training, I have heard countless stories resembling these. This is not an uncommon phenomenon that trainees experience. It is a topic that everyone in medicine is familiar with, whether through personal anecdotes or through stories discussed with classmates, mentors, and acquaintances. Understanding the complexity of medicine takes more than four years of medical school. Medicine is a field that requires life-long learning and an internal motivation to be updated with evidence-based practice. Expertise comes with clinical experience and after encountering numerous successes and failures. I believe that these experiences can help future physicians connect with their patients more effectively. If we as medical trainees can fall victim to an overwhelming fear of vague symptoms, how can we expect our patients with limited medical knowledge to be immune to this? With Dr. Google, a benign tension headache can be escalated to look like brain cancer. Understanding these fears and reflecting on the days when we experienced these uncertainties can bridge the gap in patient-physician encounters. It allows us to effectively address the patient’s fears without judgement, urging us to educate our patients about their symptoms instead of dismissing or minimizing them.