Journaling is one way of reflecting and can include your thoughts about anything. For some, the process of writing, which forces us to sit down and slow down can be both catharteic and a means to gain insights. (Perri Klass wrote an excellent book based on the journal she kept while matriculating in medical school called A Not Entirely Benign Procedure: Four Years as a Medical Student, 1994.)

Some people choose to limit their reflections to patient-related matters. This type of journaling was dubbed “parallel charting” by Rita Charon, MD, PhD. She decribes this as a “chart” outside of the traditional medical record where personal and clinical considerations critical to the care of the patient that do not belong in the official chart can be recorded. (Charon R. Literature and medicine. Am J Med Sci, 2000; 319(5):285-91.) For example, how your patient, dying from prostate cancer, reminds you of your grandfather so it is hard to go in the room.

Journaling for Non-journalers

Medical school and practice are times of tremendous rewards and stresses which often can lead to burnout and even depression. Resilience is the ability to remain positive despite adversity and it can be both learned and nurtured. Social support and reflection are important in resilience and we try to foster these in the reflective writing sessions.

Other specific factors that promote resilience include:

  • Finding meaning in your work
  • Engaging in recreation
  • Maintaining a positive outlook

Many third year students struggle to find their role. Furthermore, faced with a very sick internal medicine patient population staying positive can be a challenge. The following are a few quick suggestions that may help remind you how blessed you are, that you do make a difference, and perhaps remind you to take care of yourself. *

1. Gratitude journal

Try to write down one thing you are grateful for every day. (If you are more visual, you could create a pictorial journal, sort of like pinterest.)

2. Making a difference journal

Try to write down one thing you did each day that made a difference to someone.

3. Wellness journal

Pick one area of personal wellness you want to focus on this clerkship (physical, emotional, spiritual), devise a plan, and track your progress. If this goes well, there won’t be much to write but on days you have trouble, take a moment to jot down what you thought got in the way, you may find a pattern that will help you with work-life balance in the future.

 *These suggestions were informed by medical education literature that is nicely summarized in a commentary by Dyrbye and Shanafelt in Medical Education 2012; 46:343-348.