Let's talk about burnout amongst medical students…
On this week's episode of the Lunch and Learn with Dr. Berry we follow up last week's discussion with Kessy Joseph with another fourth-year medical student, Aprylle Thompson, MS4.
Aprylle was born in Jamaica and decided to pursue medicine after her aunt was diagnosed with the crippling disease of Creutzfeldt-Jakob Disease. Today she talks to us about how her experience with burnout has affected her as a medical student & offers tips not only for medical students but physician as well.
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[showhide type=””””””””””””””””””””””””””””””””post”””””””””””””””””””””””””””””””” more_text=””””””””””””””””””””””””””””””””Episode 126 Transcript…”””””””””””””””””””””””””””””””” less_text=””””””””””””””””””””””””””””””””Show less…””””””””””””””””””””””””””””””””] Introduction Dr. Berry: And welcome to another episode of the Lunch and Learn with Dr. Berry. I'm your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of drberrypierre.com as well as a CEO of Pierre Medical Consulting. Helping you empower yourself for better health with the number one podcast for patient advocacy, education and affirmation. This week we bring you an episode with student doctor Aprylle Thompson who's a fourth year medical student. She again continues this discussion that we have on Physician Burnout and really more aptly medical student burnout. And she was very poignant during her interview just talking about some of the trials and tribulations that she had to face as a medical student. Some of the expectations of a medical student that I think she will agree with me as well, is really at a line for what we shouldn't be expecting of medical students and she really asked the question, why don't we include medical students in this discussion of physician burnout. The discussion that is definitely had when we're talking about attendings that people who are in their career. About feeling signs of being down at a price where for some reason we don't have this discussion when we talk about the medical students and she really wants to make a point and what I love about her interview today is that please think about the medical students again and remember that we're all human. And if we're all human, understanding that not only are the distressors that the residents and the attendings are going to feel, you best believe the medical students have their own pervasive feelings of concern. So I want you to again, check out this week's episode with Aprylle Thompson, a fourth year medical student talking about medical student burnout. Let me know what you thinking. If you have not had a chance remember subscribe to the podcast. Leave us a five star review and tell one friend to tell a friend about this amazing discussion we're having here on the Lunch and Learn with Dr. Berry. Episode Dr. Berry: Alright Lunch and Learn community just heard another amazing introduction for a number two, so this is actually gonna be our second medical student on a topic at hand that is extremely important. That is extremely, I guess becoming very popular now with this discussion of Physician Burnout. And because of the matter at hand of how we started a series out, we really wanted to make sure we reached out and not only talked to just physician, but we wanted to talk to residency medical students. So I'm thankful that we got a chance to talk to Aprylle Thompson today, who is a fourth year medical student who's going to be gracing us today in helping us with our discussion. Aprylle, thank you. Aprylle Thompson: Glad. Thank you for having me. Dr. Berry: So Aprylle, I always did the introduction. I have a lot of people who love to skip right to this portion here. For someone who skipped through and they say you know what, who's this Aprylle Thompson? Tell a little bit about yourself that may not even be typically in your bio and always ask, especially since you're a medical student. Let's talk about your motivation for going to medical school, your career aspiration goals and all that good stuff. Aprylle Thompson: Well, I'm a fourth year medical student from Ross University School of Medicine, which located in Barbados. My interest in medicine started from my junior year in high school. The reason being was because my aunt was unfortunately diagnosed with Creutzfeldt–Jakob disease. So my family had to care for her around the clock and as she deteriorated she became more dependent on us. And we have to learn about the process and what to do. And because of that, my interest was piqued and I wanted to learn more about medicine and treat patients on a more intimate level. Dr. Berry: I love that. And it's so interesting, especially for a lot of us who get into the field that a lot of times our first experience of medicine is a family member who really makes us appreciate the system at hand and really helps put us in that situation where like, you know what, I can be like that doctor. I always tell people about Dr. Gaston who was my pediatrician growing up. And I just used remember thinking like, oh my God, one day I want to be like that Dr. Gaston because I just seen the hearts he was able to touch with just his interaction of being a physician. So we were talking today about Physician Burnout, which is again, especially for those who are in Lunch and Learn community. A topic that's getting much fanfare as of recently to the point where they're even classifying it as ICD 10 codes and all of these things there that are really trying to make it seem as popular as it is. And when we had Dr. Nicole on the podcast, she talked about how this phenomena isn't like a new issue. It's just gotten came out to light with that aspect of people were really being concerned about the onus of being quote unquote burnt out. And what I want to talk about today is really like how are not only physicians, but really how are people who are on the front lines, which our medical students. What's that onus like? What's their thought process? I like to start out just talking about as a medical student, what are some typical stressors that you face on a day to day, month to month basis just being a medical student? Aprylle Thompson: I believe the few stressors that we usually have, well number one is we have to impress everyone. By can go for the CEO of the hospital down to the garbage man. Not just that, as a medical student, sometimes we don't feel as if we know enough material to impress people. So we have that battle that we deal within ourselves. And then we have to also learn how to balance everything. Connect all the pieces together. So what I like to say is that we feel as if we really want to be at the table with everyone, but although we have the knowledge to get close enough, we're still not there yet. And then when you put in the hierarchy of medicine and what goes on in medicine, it just complicates everything altogether. Dr. Berry: And what was very interesting about that was, especially those who may infer, when we talk about the physician who is typically one who, again I say this all the time, that they're in a job where they're supposed to be correct 100% of the time. But a lot of times people, people don't realize too, to get to that point we face almost a daily struggle of I don't know enough. And I think and you said it right on the head, it's really bad in medical schools where we, I always say especially in on in a GME side, we train backwards, right? Where if you're a second year medical student, I start pimping you on stuff that the third year medical student knows. And if you're third year, I started pimping you on stuff for the fourth. For some reason, every time you get to a certain level, we expect you to know a level higher than you're actually at. Aprylle Thompson: Yeah, I've seen that. Dr. Berry: So question, as a medical student, and even when you're in the premed stage where some of the stresses that you've been facing, where they expected? Were you like, yeah, I'm probably going to have to deal with this type of stressors? Or was there anything like, whoa, I didn't realize medical students had it like that? Aprylle Thompson: Honestly, before I started medical school, I thought it would've been a walk in the park as ludicrous as that sounds. I thought it would like I would wake up every day. I'll go to the hospital. Helps sick patients. Get them back to their normal baseline and then go home happy. That's what I thought. I didn't understand that some days when it rains it will pour. And my thought process, what they're being sunshine and roses everywhere was obviously wrong. Dr. Berry: That’s so true. Do you have any family members in the health field prior to pursuing it? Aprylle Thompson: No. I was the first one. Dr. Berry: Same here. It's funny because most of my family, they all went like the business route and manager route. I was literally the only one who was even on the premed side. Didn't have any mentors on that side. I think it's so true that when you don't know what you supposed to know, sometimes kind of walking in the dark. I mean, a perfect example, I didn't realize until I was a, let's say a sophomore and somewhere undergrad. There was this test that you had to take before you went into medical school. I remember just walking into the career center and when Ms. Anderson, shout out to Ms. Anderson at Florida State. When she asked me, hey, what do you want to do? I want to go to medical school. Oh, have you been studying for MK? I'm like, what is that? Just to give people an idea that it's not uncommon for people who want to pursue a goal, but because they don't have the mentorship dare that they need to really be walking into, almost like the firing squad, but it kinda is. Especially in our system where we don't like to talk and we'll talk about that later too as far as how older physicians and people who have kind of been there, done that, don't really reach back enough to like say, hey, you know what you're going to get in medical school and you're going to have to deal with some of these issues that you may not be ready for. So we just want to give you a heads up. Aprylle Thompson: I think apart from that, with my id of the walk in the park, I think it's also the fact that TV shows don't do it justice either like Grey's anatomy. You think it's so happy and it is fun 24/7 but it's really not like that. Dr. Berry: Grey's anatomy, Scrub, ER, all of these. Yeah, trust me. Yeah. And they still funny. My wife can't stand watching those times shows with me because I'm like, I guess it was like I didn't need mumbling under my breath and I'm like, okay, alright. Sure that’s how it goes. For some of the stresses that you know that the typical medical student faces and then I asked especially because Ross University is an international medical school. What was that experience like? Not only going to medical school but going to medical school in an entire different country. Aprylle Thompson: It was honestly a great experience. But I think I have a little bit of leeway because I was born in Jamaica and my family is from Jamaica. So I felt like I was at home. I was in paradise. Dr. Berry: I love it because when you hear of the international medical graduate, I know a lot of times they're saying, well you're going to a medical school outside of the country, because we'd had even taken the fact that there are people weren't actually born in a country who are also going into that school as well too. So that definitely, I love that aspect of it. Now, as a medical student, what were some of the stresses that you typically faced? And just going from first year medical student all the way up in your last year now? Aprylle Thompson: Correct. My biggest stressor would have been balance. I mean, while I was in high school and college balance was a lot easier. But in medical school you have to learn that people will not spoon-feed you. You have to learn how to grow up and figure things out. And I had to learn how to balance my friends, my family, my social life and of course medicine. I believe that being a medical student or even a physician, it makes you realize that having just 24 hours in a day is not enough because everyone is pulling you in different directions and you're only one person. So you have to figure out how to break that up and split that up amongst everyone. Dr. Berry: I love about that. I think sometimes and it happens a lot, especially when you're a medical student, and I say, I always use a term like life be lifeing. Stuff is still happening, but you're in this, almost like this cocoon of being in medical school and having all of the pressures or responsibilities placed upon you. Sometimes you can't even really enjoy the typical experience of someone who normally would, you as a 21, 22, 23, 24 year old, in that range, especially in your 20s. I tell people my twenties were gone. My twenties were highlighted by me studying. And just what it is when you decide to embark on this journey. For sure, I think as a medical student, just having those pressures, not only the inside pressures that the school itself, places on this. But it's the outside pressures of friends and family and just life in general, that are still going on because unfortunately they don't pause while you're in it. Now would you say, especially with some of the stresses that you had to face and some of the stresses that medical students typically have to face, what would you say, from a preparation standpoint, what was the position of your school? And the reason why I ask that is because when we speaking with Dr. Nicole, she talked about the fact that as a physician, as an attending physician, the systems are in place for us to deal with physician burnout. So, now that we bring it all the way back to the medical student, I wonder what that situation is like as well too? How well would you say you were prepared for some of the stresses that you had to face over your time in school, by your school? Aprylle Thompson: I believe my school realized that burnout was increasing amongst physicians as well as medical students. So the clinical student affairs at my school, they promote something that was called a self-care day. And with that, that's what made the day, students are able to focus from their clinical rotations as well as within the classroom. They're able to take that day off and they can work on their mental health, emotional health, and even physical health. So that's one way my school did it. I know other schools love to incorporate therapy in which students are able to have maybe 30 to 45 minute sessions with a therapist and talk to them about what's bothering them and ways that they can plan to help improve burnout or whatever issues the student might be facing at that moment in time. Dr. Berry: I love that especially because it seems like it's coming from the top above where they're recognizing like, hey, our students are being affected by the pressures of burnout. And I talk about burnout a lot when we do this general discussion. When you say the Self-Care Day and you're able to decompress and you just get away from it. How was that one day like for you? Did you feel like it was enough? Do you feel like it was a start for things that come? How would you grade the actions of your school? Aprylle Thompson: I believe it was very beneficial because usually it comes in at the right time. Usually the day before I'm at the peak of my stress. And just knowing that the following day I can stay home, sleep in and relax or even just go to the gym. And I could just figure out ways how I can start my week or what I can do differently to help decrease rate at which I'm burning out. Dr. Berry: Now I got to ask, especially being in this stage of a graduate medical education director and really an attending in itself. Was there ever any time where your attendings either notice or even worse, probably didn't notice some of the burnout associated symptoms in the medical students? Was there something that essentially had to come from the top? Ross essentially had to say like, hey, give these guys a day off because you guys are at work. What would you say in that matter? Aprylle Thompson: I believe students spoke to Ross about it because sometimes attendance can be very oblivious because if faculty have to deal with their own issues and what's going on with their patients, sometimes medical students are overlooked. But luckily for me, my program at Ross University, they're able to identify the issues that we have and whenever we speak, they listen. So I've been very fortunate to be a part of this institute that really cares about their students to help fix the problem that's on arise. Dr. Berry: I love it. And we hedge that a lot. But when you hear the term physician burnout and understanding that you're a medical student. So you're, a few months is about to be a physician who I guess walking into this field where this aspect of physician burning out is very real. What do you think about it when you hear the term? Aprylle Thompson: I believe the term physician burnout, it's very synonymous to the word overworked. So when it happens, we don't perform our best and when we can't perform our best, we're not able to treat patients to the best of our ability, which will increase the rate at which medical error occurs. Dr. Berry: I love it and I think you really hit it on the head because again, like I said not I have a problem with the term physician burnout, but I do think it's something that's masking problems at hand. And sometimes I feel like, especially when you tie the phrase of physician burnout, you're putting the onus on the doc. But not putting the onus on all of the other factors that got the doctor to that point. It just like, oh well, Berry burnt out, that's holidays. Berry burnt out, not realizing, well Berry burnt out because the hours are too long. Very burnt out because he couldn't take care of his patients the way he wanted to take care of his patients. Very burnt out because the frustration of maybe not getting paid enough will continue to grow, all of these different reasons. But when it's titled Physician Burnout, all you hear is the physician is the onus and the physician is the responsible party associated with it. I'd definitely for sure love that definition because I think it's so true and it really cast light on a system that again, it has seemed to now trickle down and I'm not sure if it's was purposeful or I'm not sure if it was just a cumulative effect. But something that's kind of purpose all the way down to now the fact that you could be in training and still experiencing these symptoms of a burnout. Now as a medical student, I asked, you're a fourth year, you're about to be out of here. But was there ever times, especially in the mid before to self-care days and those things in that regard, there ever times you're like, yeah you know what? I'm feeling it right now. I guess this may be a little too much for me at the moment. Aprylle Thompson: I believe that time for me was while I was studying for my board examination specifically step 2 CK and while I was studying for my boards, I was also working in the ICU. So as you already know, the hours are very long. Dr. Berry: When you say ICS, oh alright. Aprylle Thompson: Yes, very long hours. So I had to balance trying to impress my attendance because as a medical student you want to be on the forefront. You want to show that you know your stuff. Apart from pressing my attendance after, make sure I impress my residents, whether that's just, I don't know, doing scutwork for them or being around the patient 24/7. Reporting back to them as soon as possible. I have to always be on my tip toes to make sure that I'm viewed in a positive light. Because as a medical student, your residents are usually they advocate for you. So if you impressed them, you can work your way up. And while trying to do that, I had to also learn as much as I can in the ICU. Because ICU is a whole another world, a different ballgame in medicine. And then when I left the hospital and I went home at about 8:00 or 9:00 PM, I had to still pull out my book to study until about one or two o'clock in the morning and then go out by four or 4:45 AM to get to the hospital by six o'clock and that cycle continued. And after a while I started to feel myself burning out and I couldn't really tell my resident or my attendant because as a medical student, we're not allowed to feel that way because we're not officially doctors yet. And while I was feeling burnout at that stage, I didn't even in the fact that I still had to eat, I still had to cook my meals for the week. I still have to go to the gym, do my laundry. But with everything like that, it's very tough to talk to people about it. Dr. Berry: And most importantly, you still got sleep. And especially Lunch and Learn community, I really want you to have to really pay attention to this story because it is not an uncommon story. First of all, again, I'm an internist. I'm a hospitalists. I take care of patients all day in a hospital. But I 100% agree when Aprylle talks about the fact that ICU is a, just a different ball game, a different beast, a different mindset that it takes to really take care of the sickest of the sickest patients. I can 100% agree with that. And just this understanding, and she touched on a couple points where she talked about one, the hierarchy aspect of it, where the attendings who are there, you have the residents who are there and then you have the medical student who is there and understanding that the work that you have to put in to impress not only the resident but also the attending, on top of juggling effect that this is I'm assuming this is your first time in ICU, right? Understanding that I'm having to learn on the fly while impressing all of the people who are above me. And because I may quote unquote medical, I've got to say quote unquote, but because I'm a medical student, no one recognizes that I can also be burnt out. Is definitely a quandary that a lot of our medical students I realize are facing, in this aspect of quote unquote training. And again, we shouldn't want to train our physicians to have to deal with that level of burden or stress. Because trust me in a light that when you're an attending, I could tell you wholeheartedly just so you can see some type of a light at the end of the tunnel. That level of work isn't there, but it's a different type of stress that you're going to be walking into. Aprylle Thompson: Yeah. You guys live the good life. Dr. Berry: Right. So it's one of those things where I'm becoming very keen now, especially with physician burnout, being discussed on a more and more aspect of it. Understanding that yes, as a physician. Because again, I used to be naive, I used saying, well when they talk about physician burnout, it was people who've been in the game, 10, 15 years and they were just tired. But then when I started walking around and I'm at a residency, let's see, five years now. So I'm five years out of residency and I'm seeing colleagues who are around my age exhibiting and talking about they're tired and done. So you can be five years out of training and already experiencing those symptoms definitely something needs to occur and change. When you're doing the ICU and you are recognizing like hey, I'm not sleeping. I'm not eating. I'm not, you're just probably not talking to friends. I'm not doing the things I needed to do to take care of my own. The support system that was there. Can you talk a little bit about it? Is this where the self-care day really came into play and really helped you or what was happening during that time? Aprylle Thompson: I believe I've been very blessed to have a big support system, specifically my family. From the moment I told you I wanted to go to medical school, they've been there with me from day one, whether if I had a bad day, if I had a happy day. For me, whenever I leave the hospital, the first set of people I call are actually my parents. We talk about my day, I try to replay how did they went. If it was good, they're happy. If it was bad, we talk about ways in which I can improve it tomorrow. And apart from talking to my parents, my fiancé has been a great support system as well. Whenever I've vent my frustration to him about what's going on in the hospital. He listens and he listens very closely and he helps me think about ways that I can distress ways that I can improve myself for tomorrow. So in that way, I don't bring the low from the previous day to the next day and it makes me feel 10 times better when I'm able to vent to my parents and my fiancé about what happened. Dr. Berry: Talk about this especially I want to hit you a follow up question. Is your fiancé in medicine or health or outside of it? Aprylle Thompson: It's funny you asked me that. A lot of people love to ask that. No, he's not. Dr. Berry: And the reason why I asked especially because you talked about how understanding he was is that sometimes a lot of our friends outside of our bubble don't really comprehend. The level of stress that we're dealing with. I definitely want to say you're very fortunate to have that person who can understand like hey, nope, she's on ICU this month. Yeah. I'm probably not gonna see her as much as I want this month. I'm not gonna make her feel guilty for not seeing her as much as I want this month. Those types of things that can build upon a relationship or hurt a relationship when there is that communication disconnect. And especially having parents as well too. Like I say, because having someone to say like, oh my God, today was crazy. And just to be able to talk about it is definitely something. Because one, our typical conversations. We just can't really have all willy-nilly. Unless you're in the field, no one's gonna really understand. I had to see 40 patients a day and being served for 10. Then I got really understand it. But if they're able to be sympathetic to the thoughts in feelings, it really helps you and really helps leave this stress that is usually there when you walk into that building. Whether it’s a clinic, whether it’s a hospital. But be able to go home and have that stress behind. Aprylle Thompson: Exactly and that's why I think it's great that he's not in the medical field as well because when I bent my frustration to him, I just vent. And then that's that. I don't have to bring work home every single day. Dr. Berry: I love it. We talked about just the system in general, of just our medical training. And again, I have some personal thoughts about just training and especially in only being, going through the process of being a medical student and a medical resident right now and attending, but also now being decided where I'm also training as physician, be attendings as a program director. What do you think about just our system in general? Is it our system that's really set up for people to burn out? And especially when we talk all the way down to the medical student, is it just set up so that people are gonna burn out just because the way we do our things? Aprylle Thompson: I believe so because in this system with medicine, not all position, but a lot of physicians, medical students are taught by intimidation and sometimes we're not allowed to feel tired or we're not allowed to know something. And if that happens, sometimes we can be scrutinized by physicians. And the culture of medicine with that, I hope it changes sooner than later and students overwork themselves because you want to impress everyone. So we sacrifice our mental health, our emotional health, and even our physical health just to prove a point that we are good enough and that we are equal to everyone else. Dr. Berry: I love that. I can tell you that's going to be a quote somewhere. We're going to definitely quote something up somewhere. I love the word intimidation because it is such a word that unfortunately does not stop. It's one of those things where I remember being a premed student and feeling like if I'm studying with this person next to me, this person may be able to take my spot in medical school. So I had to be fierce, be tougher to try to get that quote unquote last spot. And then it's the feeling that does not change when you get to medical school. Where not only are you feeling the intimidation from your colleagues and I always joke this because especially in medical, I used to think we're going to be colleagues, I'm not your like enemy. They still bring those kinds of same types of feelings into, that atmosphere. And then you walk into a system, especially for those who may know Lunch and Learn community, what typically occurs depending on the school, but some schools differ is that your first couple of years of medical school, you are essentially doing a lot of the bookwork, laying down the foundations from a basic science aspect. And then your last couple of years you're actually in the hospitals, in the clinics and awards, seeing patient direct patient care on a more, a full time basis. And for those who may not know Lunch and Learn community. But what happens is once you get into the latter years where you're a lot more direct patient care and then you're having to deal with residents or medical attendings who were either brought up differently or brought up in a certain way and don't really know how to get their point across without making you feel like you're lesser. This is a very common problem for a medical students. And again you talked about the pressures, not only the pressures of board exam, but the pressures of oh, if I don't perform and resident don’t liked me, they gave me a bad grade and they tell the attendant to give me a bad, all of these things here that they have to perform on a day to day basis, 24/7. And that's a pressure that I always tell people most career professionals do not have to deal with the pressure that the physician has to deal with. So just even make that micro and think about the pressures that the medical student has to deal with and understanding every single day they feel they're being graded and if one day right, they're human. Because I think that sometimes gets lost. If one day they're human and aren't as enthusiastic as they were the day before yesterday, they can be docked points for it. I think especially when it comes to physician burnout, because I think a lot of times I tell people when you have a physician who's burnt out and understand that they're not just gonna flat out quit, they're going to keep working. They’re going to keep seeing patients, they're not going to do it effectively. But they're going to keep on doing it. So when we talk about physician burnout and then what it can ultimately lead to, I think a very important topic and one that really I think probably should get much more fanfare than it is just the aspect of the physicians even committing suicide. And the fact that we don't have many people who are going into medicine as much as we did any more. Just this shortage that's around everywhere in that regards. What do you think about just those aspects of physician burnout, physician suicide, which is extremely high and as well as just the overall aspect that less people are going into medicine? Aprylle Thompson: Well, I believe in the rate at which physician suicides occurred. It's definitely at an all-time high. But I think for these people, it crosses the line of abuse. Reason being is because some people don't know how to distress. They don't know how to take what they're given, switch it up, and then find a way to relieve themselves. And that's because in the culture of medicine, we can't talk to each other because we're seeing as if we're less than or we're not able to keep up with the rest of the crowd. So because of that, we keep everything bottled up until we can't take it any more than fortunately some people they commit suicide because of that, because that's their way of getting away from all of the stress that they're dealing with within the workplace. Dr. Berry: Very poignant. I think you hit a home on another point. I mean, is sad is that physicians, we don't really talk to each other like that for that fear of being seen as less capable to do. And again, if you took the physician title away from us and someone just told you like, hey, I'm feeling down, I'm feeling bad about myself, I'm feeling depressed. People would automatically know, okay, this is the type of steps you need to do. But people wouldn't say that, okay, you're a less of a blank because of it. Well, for some reason when it comes to physicians and the feel that aspect of burning out, right? That automatically goes to the top of the head like oh, people are gonna think I'm less of a physician and I can't take care of the patients like I used to be able to take care of because of, I'm actually acknowledging this issues that I'm going through. Aprylle Thompson: It's funny you say that because I believe as physicians, sometimes we dub ourselves as being super human because even the burnout could just be from ourselves too. Because we actually look at one another as if we're greater than thou and we're not allowed to not know something. We're not allowed to feel tired. Because even sometimes the outside world, they don't see that. But we put it on ourselves and maybe if we can change that where it's okay to not feel fine, it's okay to let loose a little bit. Maybe that can help our culture a little bit. And the rate at which physician burnout occurs. Dr. Berry: Amazing. For the medical students, because again, you're almost added there. But if you could look back and say like, hey, if you want to, and I hate to say avoid it because it sounds like the system that we're in is going to be very difficult to avoid it. But if you want to be able to deal and manage some of the stressors and the symptoms of medical student burnout. Because I think that's the term that we need to really call it. What tips would you give to say like, hey, if you could do this and if you could do that, that could help you in the long run? Aprylle Thompson: Well I have a few tips. For one is, destress as much as possible, however you want to destress. If it's going to the movies or even a book, do what makes you happy. Secondly, I believe exercising is very important because as we all know, you'll have an increase in endorphins which will make you very happy and if you eat healthy, that can also change your health. And it can also make you feel better about yourself. Funny story is, I'm actually someone who loved burgers amongst other people. And after a while when you keep eating that you don't feel your best. But then whenever I changed my diet and I incorporate more fruits and vegetables, it's amazing how much clarity I have, how it improves, how I feel much happier. And I'm able to focus more. So if we're able to just exercise and maintain a healthy diet that can really help in the way that we react to burnout and how much we're able to tolerate before we get to that stage. Dr. Berry: Amazing tips. Before I let you go. Before we get you out of here, first of all, it has been absolutely amazing and your insight has definitely been something that I think is needed. Because I think is eye opening. I think as we continue to really highlight this phrase physician burnout, I think we need to make sure that we don't just start looking for problems once they become an attending and understand that a lot of these issues and a lot of the lack of support for these issues are happening as early as the second we start being a medical student. Before I let you go tell us about, especially because you're a medical student, so I love to hear about just your plans. What's about to happen? Where are you trying to match? Let's give all that stuff there so we can make sure we're on the lookout for you. Aprylle Thompson: So currently I'm applying for the 2020 match. Going through the hectic motion of getting my application done before September 15. I know a very big day. So I'm from Orlando, Florida. I hope to stay home, be with my family, but if I get matched anywhere else, I'll happily take a position there. So I love all aspects of medicine and as of right now, I'm loving internal medicine as well as general surgery. Dr. Berry: Okay. That's as interesting. I could tell you, I’m an internist right? You don't want me to know OR and I realized that very quickly that you want me nowhere near to OR. I just didn't have the mindset of a surgeon. I just knew it. One of the most important things that I tell anybody is just knowing yourself. Understanding like, oh, I like medicine, but that's not just have medicine I like to be. And so very interested that internal medicine or surgery still in the bread basket for you. So as a program director, I obviously definitely wanna wish you good luck on this upcoming match. I hope you get to whatever this by you're going to get. Like I say, it's a very different, internal medicine or surgery so hope you get to wherever you want to get to. But I want to thank you for sobbing vital podcast and really helping educate Lunch and Learn community on all your endeavors. From a social media standpoint, where can people find you, follow you, track your journey if they wanted to track your journey? Aprylle Thompson: So you can follow me on Facebook at just my name, Aprylle Thompson or on Instagram @cheecah_med. And you could also follow me on Twitter. I don't tweet as often as I should @ Aprylle Thompson. I don't have snapchat though. Dr. Berry: Sure. Okay. Alright. Appreciate it. Remember Lunch and Learn community, we always put all of these links in the show notes so you don't have to write anything now real quickly. We'll make sure it's in the show notes so that you can just click and then go right to Aprylle s page. Aprylle again, thank you for joining the podcast today and you have an amazing day. Aprylle Thompson: Thank you for having me. You have a wonderful day as well. [/showhide]