The end of the academic year brings a number of transitions. Whether finishing your first year of medical school, approaching boards and clerkships, choosing a career field, or starting residency, transitions are a hallmark of this time. The good news is that you are physically designed for transition. Your brain is wired for problem solving. Your mind and body thrive with the activity of change.

To help manage the stress that can come with a transition, it is useful to distinguish between fear and anxiety. Fear occurs when the cause of discomfort is known and well-founded, anxiety when the cause is vague and difficult to define. Thinking about the uncertain future, you may experience anticipatory anxiety.

Some say that the best strategy for coping with situations beyond one’s control is to calm down and accept them. Easier said then done!

If you are feeling anxious, recall how you’ve calmed yourself in the past and try new ways as well. Possible calming strategies:

• Do deep breathing, starting with a slow exhale, pause and slow inhale
• Exercise regularly in ways you enjoy
• Practice meditation, twice a day for at least ten minutes each time
• Engage in stimulating conversa- tions with people whom you like and trust
• Express yourself through art

Don’t forget that some healthy denial may be useful. Constant discussion and repetitive analysis/ reporting of your anxiety probably does not help.

Another way to deal with life’s ambiguity and/or your ambivalence is to focus on what you are able to influence. For instance, you can improve close personal and professional relationships, and you can strengthen yourself. There are many ways to develop your strength. (Some overlap with aforementioned calming methods.) For example, enhance your mental health by:

• Staying/becoming more socially involved
• Continuing to learn
• Expressing yourself through art
• Maintaining physical and/or spiritual health
• Understanding the natural ambiguity of life

In addition to the above suggestions, how else can you strengthen and care for yourself? Remind yourself of who you are and what you want in life, personally and professionally. Remember why you started on this educational path, and revisit the ideals you had when you decided you wanted to become a physician. Although you cannot easily and immediately actualize your dreams, you can move toward them. Each small step confirms that you have choices, even in this challenging educational environment where you do not have a lot of free time. When you make progress in concert with classmates and teachers, you not only draw on their resources and encouragement, but also contribute to their progress.

Finally, another way to care for yourself during transition times is to be clear about what you need. It may be attention, physical care, respite, fun or tangible goods. Do not postpone tending to yourself. This may be difficult for people studying to be caregivers for others (especially if you do not have enough time in the day to eat, let alone practice other types of self-care). By reinforcing your mental and physical health first, you will be all the more capable of helping others…and helping others is probably one of the main reasons you chose to go to medical school.

Please contact us in the Well-being office at (415) 476-0468 if you want to talk about your experience making and anticipating transitions or if you want to talk about other aspects of your well-being.