• Team Project You

Medical Student Syndrome- Fact or Fiction?

"At first, the experience was reasonable. I was a first-year medical student at Case Western Reserve University, taking Normal Physiology. I began to picture my blood flowing smoothly in my kidneys, exchanging ions across tiny renal tubes. I also imagined my other bodily systems chugging along nicely as we studied them in class. It was a sort of biological mnemonic system.

But things changed in my second year. During Pathophysiology, I began to grasp when normal becomes dysfunctional or diseased. Inflammation. Obstruction. Neoplasia. The dismaying terms were coming at me.

Classmates also began sharing “aha!” moments about conditions that touched their families. One had a cousin with cystic fibrosis, and many had relatives struck by cancer. It was a quick mental jump to the idea that something we were studying could affect any of us. Or me.

I found learning about malignancy and metastasis particularly frightening. There was martial language involving effaced boundaries, invasion, hijacking of the blood supply, and cellular 'takeover' I knew that I was 'too young' statistically, but still, a nagging thought arose: there are always some rare cases.”

This is an excerpt from an article written by Dr John Henning Schumann about his experience with Medical Students Syndrome. This description paints a vivid and uncomplicated picture of how things must seem like in the mind of a person suffering from Medical Student’s Syndrome.

For those of you who are still confused, Medical Student’s Syndrome (MSS) - also called as second-year syndrome or intern’s syndrome, is a condition frequently reported in medical students, who perceive themselves to be experiencing the symptoms of a disease that they are studying. Some definitions also claim that it is a type of hypochondriasis, although the evidence for doing so is not particularly reasonable.

(Hypochondriasis/ Hypochondria/ Illness Anxiety Disorder is a psychosomatic disorder in which a person is excessively and unduly worried about having a serious illness.)

What sets MSS apart from being a subtype of hypochondria is the fact that this phenomenon does not translate into an increased number of consultations which is typical to the latter. References suggest that ‘the condition is associated with an immediate preoccupation with the symptoms in question, leading the student to become unduly aware of various casual psychological and physiological dysfunctions; cases show little correlation with the severity of psychopathology, but rather with accidental factors related to learning and experience’. Moreover, classifying it under hypochondria also brings along with it, ominous therapeutic and prognostic implications. The common denominator in both these conditions is that the person experiences a wrong belief or fear of suffering from a severe disease based on the misinterpretation of physical symptoms.

There are often debates and deliberations around whether MSS is fact or fiction- in the sense that it rarely gets translated into help-seeking behaviour, unlike in the case of hypochondria. Another notion associated with MSS is that medical students and other people in fields with knowledge centring on health and disease are more prone to have such anxieties. Some studies show that this is not the case. In fact, medical students have less disease anxiety compared to others.

There are various possible explanations as to why this myth has existed. A couple of small studies in the 1960s had indicated that the prevalence of Medical Students’ syndrome was at a whopping 70-80% of medical students. However, these studies were uncontrolled and one of them was solely based on case records. Later studies then proved that MSS is no more pronounced in medical students than non-medical students. One major reason for this observation is that the internet has now become a very popular setting for accessing websites with medical information. Quite a few of these sites are infamous for providing alarming and unreliable information. This has given rise to the number of people diagnosing themselves via the information available online and developing hypochondriacal reactions- described by the term cyberchondria or, in layman’s language, ‘Google disease’.

In any case, students suffering from MSS must be dealt with an empathetic approach and counselled properly after ruling out an organic cause of their illness. A step to circumvent it further would be that MSS must be thoroughly discussed among medical students during their training. Failure of treatment may lead further to hypochondria.

Another reason why this needs to be taken more seriously is that students suffering from MSS often overuse medical resources and outpatient’s services. Therefore, clinicians should be aware of these students, to avoid unnecessary procedures and treatments. However, it is vital that a proper evaluation is done before labelling a given student with MSS.

If you are someone who is suffering from MSS, what we’d like to tell you is that don’t be disheartened! Seek help from trained individuals. One interesting take that we’d like to share is something we further read in Dr Schumann’s article. He said that his experience with MSS has made him more sympathetic to patients who research their own conditions, as in the case of cyberchondria. Many physicians encounter such situations and it’s easy to get frustrated then. He said that he knows how it feels like to think you’ve contracted a particular disease and that makes it easier for him to empathize with similar individuals. Doesn’t this seem like the perfect embodiment of the saying, “Every cloud has a silver lining!"

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