Merwan Faraj, ENS, MC, USNR, is a second year med student at Edward Via College of Osteopathic Medicine-Carolinas campus and the American College of Osteopathic Family Physicians-Carolinas Chapter President.
Merwan Faraj, ENS, MC, USNR, is a second year med student at Edward Via College of Osteopathic Medicine-Carolinas campus and the American College of Osteopathic Family Physicians-Carolinas Chapter President. He has been a huge advocate for the wellness of his colleagues, has published a previous article on practicing gratitude, and continues to promote the use of body, mind, and spirit in osteopathic medicine on his road to DO Licensure. Coming from a background as a cardiovascular ICU nurse, Merwan has a lot of insight into how one can learn to cope with the stressors of being in the field. Read on to see his thoughts and advice!
You were an ICU nurse before you decided to become a doctor—what inspired you to become a DO, specifically?
I was inspired by the osteopathic tenets of mind, body, and spirit being applied to the treatment of patients. This was similar to what I’d already learned during nursing school—you don’t take care of a patient; you take care of a whole person. This is was what I wanted to do at a much higher level, but because I am so big on spending time with my patients and I enjoy being there for them, I didn’t want to lose that in my decision to become a doctor. I felt that by choosing to become a DO, I would be able to maintain that same practice for my patients—that I would always be there for them.
On top of that, DOs also learn OMM. When I discovered this, I thought it was a more hands-on way to take care of somebody without having to rely heavily on medications. Just being able to use your hands to diagnose and treat someone is amazing. Just touching a patient can go a long way. This also aligns with my ideas of prevention because DOs do our duty to avoid prescribing meds if we don’t have to, or if we do, making sure to offer and incorporate non-pharmacologic treatments. OMM is a great way to take care of people that can improve their quality of life with minimal risks and expenses. I wanted to learn that skill so I could become a more well-rounded physician and help patients to the best of my ability.
What mental challenges are you facing as a 2nd-year osteopathic medical student as you prepare for your first level of COMLEX-USA and how are you addressing them?
The sheer amount of information that we need to know can easily be overwhelming—just looking at the big picture. What I realized I needed to do was to break down all of that information into chunks a little bit at a time. I need to understand the bigger concepts before digging down to the smaller details, and then I need to recognize where my weaknesses are so I can go after them. I’ll spend more time on those weaknesses than I will on the things I already know, prioritizing my study time. Also, doing tons of questions—they will show you what’s important and how your brain works—how you’re thinking and if you know why you got something right or why you got it wrong. If you think you’re going to memorize nine text books of medical knowledge, then good luck, but take comfort in realizing that you don’t have to know everything; you just need to know enough. What will make you one of the best doctors is being compassionate with your patients. No matter what anyone does for a living, I think you need to recognize that you are interacting with another human. Empathy should be everywhere—it will make the world a better place.
Also, setting goals is important. I set a daily goal for the number of questions I will do that day. Once I hit that number, it’s over—I’m clocking out! You have to have those breaks in between and not try and do it all in one sitting. Do a set of questions and then take a break to just relax or do something you enjoy. Then, do another batch, and before you know it, you’ll have reached your goal and it wouldn’t have been that tolling.
Although it varies from person to person, what do you feel is most important to a medical student’s mental well-being and why?
You need to do things for yourself. And that may sound selfish, but from what I experienced, taking care of yourself might actually be one of the most unselfish things you can do. Because when you’re in a better place, you’re more able to be there for others. I think if you take care of yourself by making time to exercise on this day at this time or decide that at seven o’clock, you’re going to meditate for 10 minutes no matter what, you’ll keep burnout at bay and find yourself thriving. It’s easy to get caught up with grades and other worries, but I think if people realize that taking these little timeouts for themselves is not going to negatively affect their scores; bur rather improve them, they would be much more likely to do them on a regular basis. There’s a myth that more studying equals better performance, but that may only be true to a certain degree. I believe in quality over quantity, and performing better because you physically and mentally feel better. I think taking some pressure off yourself, especially when you’re always feeling you have to achieve at such a high level, is extremely important.
I hope students can carry this mindset into their practice as physicians. If you adopt—that sure there is school, there is work, but there is also me, my friends, my family, and my life—you will be happier and better for it. I have both witnessed and been someone who just works all the time and is always under this certain level of stress…it’s not exactly the recipe for providing excellent patient care. You’ll find yourself being fatigued, not as sympathetic or compassionate, and even may not be as cognitively present. It becomes easy to miss things that otherwise you would have caught when you’re burned out. It’s a valuable practice to take time for yourself, and I hope it carries over to every facet of your life.
VCOM featured you in an article about practicing gratitude and its positive impact on mental health. What other practices, both mental and physical, do you find helpful for improving wellness while preparing for COMLEX-USA? What advice would you give to other COM students?
For your physical health, you definitely need to be making healthy food choices, drinking lots of water, and you absolutely should be exercising. You don’t have to do them 100% of the time, but if you can pull them off on a regular basis you will still reap the rewards.
As for your mental health, I recommend some form of meditation. And don’t worry about whether or not you’re doing it right— I love the quote: “Meditation, if you're doing it, you're doing it right.” But, especially when you first start out, I think it's easy to get frustrated if your mind wanders off or you internally feel like you're messing up. I would tell anyone that they should expect for this to happen as part of their progression in learning about themselves. You’re only human and it’s natural. Don’t judge yourself when that happens, and instead, use it as a tool to practice self-acceptance and bring yourself back to the present moment.
The goal of meditation isn’t about not having thoughts—the goal isn’t about not having your mind wander; the goal is just to be present in the moment and to be able to let go. Just be there. There is so much time in our day where we are bogged down by work or distracted with other things. I think meditation is an opportunity to practice awareness and “be here now.”
One of the most important things you can do is give yourself permission to relax. A friend of mine, at one point, was constantly quizzing himself so much that he couldn’t sleep. When he came to me with this issue I told him, “Man, you already study for 13 hours a day. It’s okay to go to bed, but you gotta give yourself permission to not think about school.” If you’ve studied 12 hours a day for X number of days for your exam, you’ve already put in the work. Being able to let go and give yourself permission to relax comes from trusting yourself, trusting your work, and trust that you’ve put in enough time.
For me, I anticipate my success on the exam because I know I busted my butt. Now I can relax—now I’m going in to get the reward for all my hard work. And if you’re not succeeding, know you need to go get help. I always believe in asking for help, guidance, advice, or coaching no matter what. From there, you can reformulate how you study.
Work-life-balance is important for every field, how do you recommend osteopathic medical students start now to be sure that they maintain this throughout their career?
This is definitely tough because we do have a lot of pressure. We have school, we get involved in organizations, we do volunteer work, etc. Work-life-balance was definitely something I struggled with, also because I hadn’t gotten involved in many things until going into med school. I wasn’t used to juggling everything.
The best thing you can do is maintain your relationships and stick to your hobbies or find new ones. For me, it’s exercising, hanging out with friends, meditating, learning a new language, NASA/space, and I even had a guitar that I hadn’t touched in 12 years that I just picked back up. I know others who jumped on instruments too. I feel like no matter what you’re passionate about, you need to make time for those things. It’s so important to your mental health and well-being. If you just make time to study for 13 hours a day, then that’s all you’re doing. Having those personal aspects to your life will allow you to succeed more in school and clinically (especially for connecting with patients), but also enjoy yourself and stay who you are.