Understanding the different types of stress related to studying abroad and how they differ from one another is essential for managing these types of stress effectively when pursuing a career in health overseas. Along with the rigors of your education, there are several unique factors to consider when undertaking an overseas program.
These can create extreme amounts of pressure on you to adapt to life in another country without your family and face ‘expectations’ that come with studying dramatically in a foreign country, and the negative effects that living away from those who provide you with love and support can inflict upon one’s mental and emotional health are tremendous. Knowing the different ways students studying abroad experience stress allows educators and administrators to provide the tools to help students effectively manage the levels of stress they may experience so they can succeed academically while still having their basic needs met through comfort and security.
- Academic Pressure and Information Overload
Students pursuing a medical education are required to learn many different and complex concepts. In addition to anatomy, biochemistry, and pharmacology (all of which require learning multiple items and how they interact with each other), there are also clinical subjects that require both theoretical knowledge and practical skills.
Students studying in another country may feel even more pressure, especially if they have had no experience with that country’s educational system or the language being spoken. In English-medium countries, students can have difficulty understanding medical terms and accents and will likely face additional challenges due to differences in teaching style.
- Cultural Adjustment and Homesickness
When studying in another country, students must learn how to live according to the customs, communication styles, and food of their new environment. This learning process can create significant tension in social situations and can often leave students feeling lonely, confused, and frustrated.
Homesickness usually comes on suddenly and unexpectedly—in the middle of a conversation at a holiday party, when you are sick and all you want is to be with your family, or when you have accomplished something, but the people you want to share it with cannot be with you to see it.
- Language Barriers
Even English as a Second Language (ESL) students cannot escape the difficulties of learning English as an Additional Language (EAL) while they pursue their degrees. In some instances, the patients seen during clinical rotations are unable to speak any English and only speak their native language. Understanding lectures given in an accented form of English may require extreme effort and the utmost focus.
Another challenge is that many ESL students encounter a combination of both language and cultural barriers when attempting to navigate the daily lives of foreign cultures. They must be willing to navigate the language barriers of the local government, the grocery store, and their own daily interactions with their fellow citizens. These and many other parts of life that domestic students don’t have to endure because they have grown up speaking English present obstacles to ESL students.
For ESL students in programs that provide their medical education in the local language, whether that language is Russian, Ukrainian, Chinese, etc., the challenges of studying medicine in another country become even greater.
- Financial Stress and Resource Management
The financial stress created by studying medicine in another country is compounded by having to manage your finances in a foreign currency. The fluctuation of foreign exchange rates, budgeting for unexpected costs, and the feelings of guilt associated with the financial strain placed upon your family by your medical education all contribute to the increased stress of this situation. Furthermore, in most countries, students who study medicine cannot work legally. Therefore, they lose the opportunity to earn extra money to assist them in meeting their financial obligations.
- Isolation and Loneliness
While creating lasting friendships takes time, the first few months that ESL students spend abroad may be some of the loneliest periods in their lives. Although surrounded by people, they feel alone. They miss the easy friendship of those who have known them for years, the unspoken understanding of family, and the feeling of belonging in a place without effort.
Stress Management Strategies
Students enrolled in MBBS programs abroad have a variety of options available to them when it comes to managing their stress levels. Every individual is different and will use different strategies based on their personal situation, preference, and personality. The following suggestions are examples of evidence-based practices that may work for some people; however, they are not prescriptions for everyone.
Establish a weekly schedule that incorporates academic obligations such as classes, lectures, and clinical placements, along with self-care (such as exercise), socializing, and resting. Treat these appointments with the same importance as academic lectures and clinical rotations. You would never consider skipping an anatomy class, so do not overlook your scheduled exercise and relaxation time; they are just as critical to your success as attending lectures.
Allow for some flexibility within your daily routines to avoid being derailed if you miss one of your scheduled activities. If your study session is missed for any reason, continue to follow the schedule that you have established by returning to your routine at the next available opportunity.
- Mindfulness and Meditation Practices
Ongoing research shows that mindfulness promotes relaxation and reduces anxiety by helping to develop self-awareness and coping skills; however, taking time to develop and sustain a daily mindfulness practice is very useful for medical students who struggle with many different sources of anxiety at the same time.
Before you begin, all of this will take time and should be done with compassion for yourself and through self-compassion. For example, setting a timer for five minutes to simply breathe in a calm environment works best.
Take time to sit comfortably, close-minded, and draw all your attention to your own breathing in and out. When you find that your thoughts start to drift away from your focus (they will), return them to your breathing with patience and no criticism of yourself.
Taking a brief time to gently breathe into and out of yourself helps develop an awareness of where you are at any moment, instead of wondering about what you did in the past or may do in the future.
Some great resources for getting started with mindfulness include the Headspace App, the Calm App, or the Insight Timer App. They all provide guided meditation experiences tailored to each individual, whatever stage they are at in their mindfulness journey, and most of these services provide free content that would be sufficient for establishing a long-lasting practice.
Additionally, progressive muscle relaxation is an excellent technique for reducing muscle tension that builds during times of emotional stress. This method can be used for relaxation prior to going to bed and during short breaks when studying.
- Sleep Hygiene and Rest
Medical students find themselves skipping sleep to study; however, this type of sleep-deprived study will not work and can impair memory consolidation, decrease cognitive function, weaken an individual’s immune system, and actually make studying less effective than if sleep is prioritized. Prioritizing sufficient sleep is not a sign of laziness; rather, it is a smart strategy.
Establish a consistent sleeping/waking schedule 7 days/week. A consistent sleep/wake schedule helps to maintain the strength of your body’s circadian cycle.
Create rituals associated with sleeping that signal to the brain to begin winding down—reading, light stretching, a warm shower; anything that calms the body and engages it physically should be done instead of engaging your eyes/storing energy by watching a screen.
Sleeping in environments that promote peace—dark, quiet, comfortable, and cool—will provide the best sleep experience. Use earplugs or white noise applications if you have noise issues at hostels. If light is an issue, use blackout curtains or sleeping masks to block this light from disturbing your sleep.
Be cautious of the amount of caffeine consumed during the later part of the day because it can stay in the system for a lengthy period of time after consumption, which means it can cause issues for your ability to go to sleep at your desired time if consumed later than the earlier part of the day. While more students pull all-nighters, it should be treated as a rare exception to your normal studying strategy.
- Social Connection and Community
Connecting with other people is one of the best ways to reduce stress in our lives. Putting effort into building relationships with family and friends will also greatly benefit your mental well-being.
Make a point to build relationships with fellow students in medical school. They can understand the pressures of being in medical school and help you get through tough times. Group study sessions give you the chance to connect with others while also improving your grades.
Set aside time every week for lunch, coffee, or another activity with friends. It’s a great way to build friendships and form bonds outside of studying for exams. Organizations, student groups, and activity clubs are great places to meet new people who have similar interests to you.
These communities give you a sense of belonging and allow you to have a life outside of being a medical student. Joining a club or group allows you to engage in something you enjoy, whether it’s photography, volunteering, church, or athletics; it allows you to relieve stress and reconnect with your true self.
Stay in touch with your friends and family from home through video calls, texting, or letters so that you can remember who you were before you started medical school. Be careful to not spend too much time communicating with those at home, as it may prevent you from fully engaging in your current surroundings and developing a strong desire to go home.
EOCL India
EOCL India (Educational Opportunities and Career Links) helps to assist students find institutions that provide both academic excellence and support for maintaining students’ emotional health.
EOCL India provides guidance to students as they adapt to living away from home and connects students with other alumni who have successfully negotiated the transition to studying in a foreign country. Additionally, EOCL India offers suggestions on how to utilize university resources and has mentoring programs designed to minimize feelings of isolation and encourage student success.
To learn more about EOCL India, please contact us.
