Lessons from Psychiatry Part 1: How I Balance Faith and Medicine and Exams

As my psychiatry end-of-rotation exams loomed, I felt more unprepared than ever in Medicine.

I had worked hard, but just found this specialty particularly challenging – by far my weakest area.

Unusual circumstances didn’t help the situation. It seemed every time I planned a weekend of study to improve, a pressing issue would interrupt: a friend needing support, a family issue to mediate, a colleague wanting to discuss spirituality. Hard to concentrate on textbooks when life gets in the way.

To top it off, I was having immense difficulty learning at hospital – a perfect storm of circumstances reduced the number of doctors on the ward from five to two. Two doctors managing an entire busy psychiatric unit left no time to teach three medical students! Our course coordinators did schedule us a weekly tutorial with a fantastic teaching doctor at another hospital who showed us patients with conditions we hadn’t seen before… only to inform us after the very first session that he too was going on leave with no replacement!

So when the week of my two practical exams arrived (14 minute VIVA and OSCE), I was genuinely afraid of failing the rotation (failure can result in having to repeat the entire year).

Pen

TIME POVERTY

With exams approaching, study time becomes a crucial commodity. Any med student will tell you how much work gets done in those last few days! One becomes desperate to maximize time efficiency and forgo their usual activities in order to cram.

My particular temptation?

Forgo my daily time with God.

Why spend time praying and reading the Bible when you could use it to get more hours of study and preparation?

The devil continued to whisper:

Look at your lack of knowledge. Surely you will fail and have to repeat!

How true these thoughts can seem in such times!

When we see problems approaching, how tempting it is for man to turn away from God as a solution and devote all of his time to a human solution.

Man Contemplating

PROMISES

But friends, how can we shake Jesus’ words from our hearts!

Matthew 6:33-34

33 But seek first his kingdom and his righteousness, and all these things will be given to you as well. 34 Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

Jesus didn’t say – seek first my kingdom, except in times where you need that time and effort for other things. In such times, make God a lower priority.

No.

He declared – never, ever let my kingdom be a second priority.

And he encouraged us with a promise – trust me on this, because if you set me as first priority, I will provide solutions for everything you are worrying about.

He declared – I am your solution.

"Blessed be the LORD, my rock, Who trains my hands for war, And my fingers for battle" - Ps 144:1

“Blessed be the LORD, my rock, Who trains my hands for war, And my fingers for battle” – Ps 144:1

MY DOUBTING HEART

Still, I doubted.

I wrote in my journal –

Can you reallyset apart one, two, three or more hours daily to seeking God in prayer and in the Bible, even in the midst of exams… and still learn enough to become a competent doctor… let alone get through exams?

In hindsight, such a question seems so obviously foolish!

For do we not call for help from a God who knows all things and does the impossible?

Do we not have a God who loves to give understanding to those who ask? (Daniel 1:21, Matthew 7:7-11)

The Bible is clear about trusting in the Lord, and not on our own efforts:

You are my King and my God…
Through you we push back our enemies;
    through your name we trample our foes.
I put no trust in my bow,
    my sword does not bring me victory;
but you give us victory over our enemies,
    you put our adversaries to shame.
3 …It was not by their sword that they won the land,
    nor did their arm bring them victory;
it was your right hand, your arm,
    and the light of your face, for you loved them [re-ordered for emphasis]

Isaiah 31:1

Woe to those who go down to Egypt for help,
    who rely on horses,
who trust in the multitude of their chariots
    and in the great strength of their horsemen,
but do not look to the Holy One of Israel,
    or seek help from the Lord.

Pen and Bible

Psalm 20:7

Some trust in chariots and some in horses,
    but we trust in the name of the Lord our God.

Jeremiah 17:5

This is what the Lord says:

“Cursed is the one who trusts in man,
    who draws strength from mere flesh
    and whose heart turns away from the Lord…”

Proverbs 3:5-6

Trust in the Lord with all your heart
    and lean not on your own understanding;
in all your ways submit to him,
    and he will make your paths straight.

Psalm 118:8-9

It is better to take refuge in the Lord
    than to trust in humans.
It is better to take refuge in the Lord
    than to trust in princes.

"I put no trust in my bow, my sword does not bring me victory; but you give us victory over our enemies, you put our adversaries to shame" (Ps 44)

“I put no trust in my bow, my sword does not bring me victory; but you give us victory over our enemies, you put our adversaries to shame” (Ps 44)

As I wrestled with these ideas, the devil whispered again:

Nathan, this isn’t just about passing exams. It’s about being a good doctor. Even if you manage to just pass… with all the time you are wasting on God instead of study, how can you hope to be anything more than a barely passable doctor. Patients will suffer – or worse! You’ll be at the center of those horror stories you hear about medical mistakes from incompetent doctors.

This thought was incredibly confronting, and I continue to wrestle with it. It touches on one of my great fears… graduating medical school as a reckless and incompetent junior doctor.

And yet… do we not have a God who can give supernatural power to learn and excel even when our time is limited?

Look to the Bible. God doesn’t promise to help us scrape through with a bare minimum pass. He promises to help us excel – even in our academic and occupational pursuits. He has done it for people before, and he will do it again and again.

In the Bible, Daniel and his three friends called upon God for knowledge and put him first. The outcome? Their academic performance was found ten times better than their colleagues who trusted only in human solutions.

Daniel 1:17-20

17 To these four young men God gave knowledge and understanding of all kinds of literature and learning. And Daniel could understand visions and dreams of all kinds.

18 At the end of the time set by the king to bring them into his service, the chief official presented them to Nebuchadnezzar. 19 The king talked with them, and he found none equal to Daniel, Hananiah, Mishael and Azariah; so they entered the king’s service. 20 In every matter of wisdom and understanding about which the king questioned them, he found them ten times better than all the magicians and enchanters in his whole kingdom.

"Some trust in chariots and some in horses,    but we trust in the name of the Lord our God" - Ps 20:7

“Some trust in chariots and some in horses, but we trust in the name of the Lord our God” – Ps 20:7

SOME TRUST IN CHARIOTS

So as you look to the promises of God in the Bible, you are left with a choice:

  1. trust in the God who does the impossible and the promises of his Word, or
  2. neglect him, take things into your own hands and trust in whatever human strength you can muster.

Though I wrestled with my doubt, I could not ignore the promise of Jesus. How could I neglect his words, which have proven so true in every arena of my life so far?

So that Monday night in the week leading up to exams, I put my textbooks away as per my usual daily routine… and took out my Bible and journal to talk to God.

I wrote down a prayer:

Lord, I’m feeling so unprepared. But show me that your promise about seeking you first is true!

The situation was clear. My offering to God was my time. If God didn’t come through for me, I would fall.

As each day passed, though tempted to put God second after study, I put my foot down and set apart plenty of time for worship and prayer to God.

The prayerful week passed, a blur of study and time with God.

Library (derived from Flickr (Friar's Balsam) http://flic.kr/p/82ipB5)

EXAM DAY

How did I feel on the day of exams?

Still nervous as anything!

So much so, that I asked my friends to keep me in their prayers:

Prayer Request

I had still spend much time studying, but felt terribly uncertain of whether I could pass.

Would God really come through on his promise?

In the waiting room before my VIVA, my heart was racing. A colleague (and friend) was there – we were both clearly nervous. I asked if I could say a prayer for us. He nodded and we both prayed together in that waiting room – God help us! We will trust in you, and not ourselves!

My name called –

Nathan, you can come in.

I walked in and sat before the two consultant psychiatrists, recognising one who was notorious for being difficult during VIVAs…

*                         *                       *

VIVA Exam Room (derived from Flickr (nateOne)  http://flic.kr/p/6koUv9)

AFTERMATH

How’d you go? my friends asked me.

They said they could see the relief on my face!

I couldn’t believe it.

By ‘coincidence’, the clinical scenario I was randomly assigned was almost identical to a patient I had encountered previously… during my very first tutorial with that fantastic doctor who then went on leave!

It’s difficult to express how such a little bit of clinical experience can make it so much simpler to recall and discuss in an exam confidently. Thank God!

The OSCE was the very next day.

And guess what? One of the exam stations was practically the very same clinical scenario… again!

Before I knew it… I was done and embracing my freedom, rejoicing at the ‘coincidences’! Driving home, I realised the same truth I have experienced again and again.

The moments before a trial when you are trying to put your faith in God’s promise can be terrifying.

But the moments after? Pure joy. 

(Photo derived from Flickr (Lel4nd) http://flic.kr/p/75bFvC)

LESSONS LEARNED

Some call it luck.

But to quote the artist Lecrae: “I don’t believe in luck; I believe in grace”

I’ve learned that when I put God first, and trust in him first, God delivers me from difficult situations. Coincidences happen. Study times seems more productive. Time lost seems to get redeemed in other ways. Friends teach you factoids that seem to come up in the exam. Favour in the eyes of the examiners. Any of this, and more happens. The promises of God become real experiences and outcomes and personal life stories.

Seek first his kingdom, and all these things will be given you.

I looked up the question I had written in my journal.

“Can you really set apart one, two, three or more hours to seeking Jesus in prayer and his Word everyday, even in the midst of exams?”

God kept his promise. My life was his answer.

15 thoughts on “Lessons from Psychiatry Part 1: How I Balance Faith and Medicine and Exams

  1. Pingback: Reblog: How I Balance Faith and Medicine and Exams | At least we made it this far...

    • Thank you sincerely for reblogging this! I have been praying that God would encourage others across the world with my testimonies about him in day to day life, and I am thoroughly humbled, moved and inspired by reading your post and seeing how he is doing just that through an ordinary Australian like me! How mysterious are his ways that strangers can encourage one another on their journeys across the oceans! But then again, the real truth is that we are not really strangers, but neighbors and family in the family of God. Only in Christ could such encouraging relationships happen. I am joyed by your honest writing – my prayer is that we may both find ever-increasing delight in God that overflows into transforming and impacting others with God’s love and light, both in medicine and outside medicine, by seeking to put the first-most commandment first in our lives!

  2. I am also a medical student – probably about the same age of you, a backslidden christian (and i use the word ‘christian’ with reluctance) and a deep cynic. Yet, I burn with jealousy when I read your posts – What do you have that I don’t? Why can’t I believe like you do? Why do I have to suffer from this doubt? Why can you believe in God wholeheartedly when I can’t? Why? Why? Why? What am I supposed to do when I can’t even help myself?

    Your posts are a source of encouragement to me, but life takes over ever so quickly and the cycle of doubt begins again. In the face of OSCES myself, I feel a bit more trapped than usual. I’m not really sure what I’m here for – perhaps some advice or words of wisdom. I’m terribly sorry to unload on you but I couldn’t help it considering you’ve undergone similar circumstances to myself. Is there anything I can do to help myself?

    PS: Feel free to ignore/delete this post if you feel the negativity is too strong. Regardless, your posts have been a great source of comfort for me in the past month – due to recent loss I’ve undergone. So, thanks for that.

    PSS: I’ve kept myself anonymous because I am also an Australian med student and I think the Australian medical community is too small for me to leave any hints of my identity. Yes, I am hiding behind the faceless mask of the internet..

    • Hey mate,
      I admire your boldness and honesty in your comment – thanks for writing it. I’m sure you are not alone in your struggle amongst medical students and Christians in general – and as someone who once had a “faith” (if you can even call it that) that was practically non-existant, I can empathise with where you are coming from. Let that encourage you – that if God can set a passion in the heart of someone like me who literally never talked to Him, never read the Bible, lived wild living of unrepentant debauchery and worse – didn’t see any of that as a problem – then surely this same God can meet your powerfully to transform your heart that is hungering for change in a way that man cannot bring about himself.

      The disciples prayed a prayer “increase our faith!” to Jesus (Luke 17:5). I think that is a very worthy prayer and I pray that it would be on your lips and that he would do a miracle in your heart and make you addicted to pursuing the intimacy he offers us in our daily walks, even in medicine. I became enamoured with Jesus’ words in John 10:10 “I have come to give life, and life to the full” (hence the name of this blog!) What is life to the full? I am still discovering it, but I do know that it is found in walking with him in all of our ways, including medicine.

      Ask and you will receive as you await the answer of your prayers patiently from God, who gives so abundantly (but almost never in the way I expect or on the timeline I expect!) Honestly, if there was hope for me, then there is abundant hope for you. And when you are in times of doubt, and do not even know what to pray or feel like giving up, know that you are in my prayers. I too am in my end-of-year exams study period now but when I received your comment last night, I could not sleep but felt wide awake praying for you. I hope that encourages you – God is setting in motion plans and actions to change your life in ways far beyond what we can perceive at times, and in ways beyond what we can imagine. You will not have to bring about change in your life all alone – but God himself is committed to changing you. That is my testimony.

      I am sorry to hear about your recent loss – that must be incredibly difficult for you. I know it was for me. But I want to encourage you in your wrestle with your faith! Though you are in a hard place – you are also in a good place – the place of wrestling.

      In the Bible, wrestling with God came before breakthroughs:
      http://www.biblegateway.com/passage/?search=Genesis%2032:22-32&version=NIV

      And let me encourage you that when we call out to him in desperation in the most broken places… God promises he will not neglect our call. As I prayed for you, I felt that this was the word God wanted to encourage you with from the words of Jesus:

      Matthew 5:3
      “Blessed are the poor in spirit, for theirs is the kingdom of heaven”

      Whilst the world sees no profit in suffering, Jesus said otherwise. If you have poverty of spirit, then you have the opportunity to be blessed my friend. This verse changed my life. In desperation, there really can be found blessing from God. He is so tender and close to the brokenhearted and the contrite of heart (Psalm 51:16-17, Isaiah 66:1-2). From contrition of heart – authentic prayers to God flow and desperation, desire and longing for God are cultivated. In brokenness, we discover that God provides, saves, and that his grace is utterly sufficient for every problem in our lives. Faith can be defined as looking to Jesus as the solution to every situation. And when we are broken about our lack of faith in God and our turning from him, we discover just how huge it is and how good it is (in our hearts, not just our minds) that Jesus died for us and saved us even in our transgressions.

      I am struggling to convey beyond a dry intellectual way my encouragements, especially over the internet. But I have faith that as you ask God to make his Word real to you in a life changing way and to do a miracle in your heart – he will answer.

      I only scratched the surface of your comment and didn’t address everything you mentioned. Please, drop me an email if you want to (see my contact me page) and we can talk a bit more in depth about some of the things you mentioned, whilst preserving your anonymity. I don’t really know what to say, but I hope my words have offered some encouragement, and that you will continue to stand firm in him!

      Peace
      Nathan

  3. Thank you for your time and prayers. I found it slightly unexpected that you would sacrifice your sleep and time for a stranger in the midst of a busy exam period. But your prayer has certainly left a deep impression on me- if I had any doubts on whether you were really ‘walking the walk’ and not just ‘talking to talk’ , there is none now.

    ” You will not have to bring about change in your life all alone – but God himself is committed to changing you. That is my testimony” – This statement has lifted a burden off my heart. I have always wondered what I needed to do/say/think to become a person of great faith. And then I realized, there were never any requirements for it. Like your prayers for me, these things are gifts – not prizes which are merit-based or something with strings attached. But a gift, pure and simple. There was never anything I could have done to earn a faith like yours. And it was great relief that I didn’t have to do the impossible, because I couldn’t do it anyway.

    I can’t say that I’ve had a change of heart overnight or that I’ve had a sudden revelation. But I know at least, I’m not ready to give up on myself or God yet. I’ll keep your words close to heart and hope that it will encourage me whenever I stumble. Thanks, Nathan – I will not forget your kindness during this time. All the best with your exams. I’ll be trying my best over here as well and unfortunately (for you), this will not be the last time you hear from me.

    Till next time & best regards,
    (Less) Lost Medic

    • Honestly, your reply gives me much joy! Your revelation about faith being a gift is profound and real and found in the Word (Ephesians 2:8)! It seems he is already speaking into your life with the knowledge you are receiving by grace.

      “I can’t say that I’ve had a change of heart overnight or that I’ve had a sudden revelation. But I know at least, I’m not ready to give up on myself or God yet.” That is a fantastic statement. Changes to the heart do not always happen overnight, but I am convinced that they will ALWAYS happen as we try to remain in him and persist in praying for him to change us and speak to us. Jesus said such sentiments in John 15:5-8 – “I am the vine; you are the branches. If you remain in me and I in you, you will bear much fruit; apart from me you can do nothing. If you do not remain in me, you are like a branch that is thrown away and withers; such branches are picked up, thrown into the fire and burned. If you remain in me and my words remain in you, ask whatever you wish, and it will be done for you. This is to my Father’s glory, that you bear much fruit, showing yourselves to be my disciples. As the Father has loved me, so have I loved you. Now remain in my love. ” Keep asking him to grow your faith and intimacy with him, and I KNOW he will bear fruit in your life in time! It may happen gradually or in a way that you do not notice at the time, but I’m sure you will look back one day and see how he has changed you by his grace.

      He is committed to bearing fruit in you and fully committed to changing you personally HIMSELF. Paul prays with such knowledge in 1 Thessalonians 5:23 (NKJV) “may the God of peace Himself sanctify you completely”.

      May the reality of that prayer be made manifest in your life as you pray and learn of him in his Word! I will continue to uphold you in prayer and look forward to seeing the ministry he does in your life.

      Please do not hesitate to write in the future. It is no burden to me and it is most certainly not “unfortunate” for me – it is my good and joyful privilege – honestly! May he bless you by producing fruit in your life, intimacy with him and the presence and light of his face in your life

      Until next time – Peace~
      Nathan

      PS. A song that prays and sings 1 Thess 5:23 is by an artist I love named Jon Thurlow. May it speak to you! http://www.youtube.com/watch?v=WEUFTOZjthg

  4. Thank you so much Nathan for this very encouraging and uplifting post! I found you when I googled -“faith for medical exams” .. Sums up my desperation doesn’t it! 🙂

    I’m a mature student writing the USMLE exams 14 years after leaving Med school and after 10 of working as a Psychiatrist in the UK. I moved to the US after my husband got a job here but my marriage imploded shortly after I arrived here.. So here I am in a new country, in the middle of a divorce with my heart broken trying to study basic medical sciences I have not done in ages so I can practice in the States. I have been a Christian for 25 years but my faith has been tested by this.. Today I felt unable to read one more line of Biochemistry but reading your blog reminded me that the battle is indeed the Lord’s and encouraged and strengthened my weary heart. Thank you!

    • Hello, hello, thank you so much for your kind words! Means a lot to me and encourages me to keep writing. It is wonderful to hear that God has encouraged you through my testimony in what sounds like a very difficult time for you. Please let me pray for you from this side of the world: I pray that he would help you by the mighty power of his name to get through the USMLE exams! I pray he would increase your capacity to learn and study. I also pray that his presence would be made increasingly known to you in your trials and tribulations, that even in spite of the hardships, you would have fresh revelation of the tenderness of Jesus Christ as you call upon him. He is near to you. I want to bless you and encourage you with this verse Psalm 34:18 “The Lord is close to the brokenhearted and saves those who are crushed in spirit.” I pray that he would show his intimate closeness and tenderness to you in a way that changes your life. In Jesus’ name – Amen!

  5. Thank you Nathan for this encouraging text. I came across this by just simply googling bible verse for medical students. And this page just came up. I’m currently preparing for my psychiatry end of posting exam as well. So it some how have a a heartfelt encouragement. Thank you. And God bless

  6. Hi Nathan,
    Thanks so much for your encouraging words. I’m in my final year in the law school and I’m preparing for my exams which starts in 2 days. I strongly believe God directed me to your blog this morning. He’s indeed a good God.
    My first year grades weren’t too good but now I understand that everything is working out for my God because I love God. Thanks once again. I’ve learnt a lot

  7. Wow. I’m so glad I stumbled across your blog! I am about to start my first year of medical school in a day and I’m so nervous! I googled God and medical school and found your blog. I’ve been so nervous about how I’m going to balance the two when I know medicine could easily take over my life. Thank you for your honesty 🙂

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