Waking Up in Medical School

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Waking up in medicine is easy for some, but hard for many. And even for those who have it down pat, there are days when waking up feels more challenging than usual.

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Zachary Bernstein, Emory University School of Medicine, Class of 2025

Zachary Bernstein headshot

Your alarm blares. Maybe you’re a morning person and the sound excites you for the day ahead, prompting you to vibrantly spring out of bed. Or, maybe you hit snooze once … twice … seven times, and to you, there could be no worse of a screech which pierces your soul as you start to dread the day ahead. What do you do next? How do you wake up?

Waking up in medicine is easy for some, but hard for many. And even for those who have it down pat, there are days when waking up feels more challenging than usual. It’s often early — 4am, 5am, 6am — on an insufficient amount of sleep to recover from the previous day’s work, and then you’re on your way to do it all over again. Or perhaps you’re “on nights,” and your circadian rhythm is turned 180 degrees. Day after day you take care of patients that count on you to help them heal from their trauma; you study; you perform; you’re evaluated and you evaluate; you show up. Day after day you endure.

How we wake up and start the day is an overlooked, yet incredibly important part of our self-care and mental health practice that, when prioritized, can be a vital tool for resilience and happiness, as well as a protector of burnout in medicine. Below are some ideas to think about regarding how we wake up. These practices need not be time-consuming. After all, you don’t necessarily have an hour at 4 a.m. for your morning routine … you may only have 5 minutes. Still, I urge you to set aside 5 minutes or more to build mindful, intentional habits in how you wake up that can help to set your days off to a good start.

  1. Hydrate. Sleep is dehydrating for no other reason than you generally don’t drink water while you sleep. It’s a refreshing way to start your day, and it’s important to replenish your body with water.
  2. You time. No phone, computer, or any other technology that connects you to external happenings for the first 20 minutes of the day (or 5 minutes if you are in a rush). The outside world can wait. Honor your solitude, your existence, and the fact that you are alive to live another day. Be alone with yourself as you begin the day without distractions, notification bells, interviewing patients, writing notes, or mindless scrolling through social media. This sets the day with a grounded, humble, and focused start. This is also a good time to practice ideas 3, 4, and 5.
  3. Move. However you can and however you’d like, move your body. Maybe this is a stretching routine, some push-ups and pull-ups, a dance, a walk, or a run. Maybe it’s loosening your joints. Get the blood pumping, proverbially and literally, as you combat the stiffness that’s accrued throughout your sleep and you prime your body for the work of the day ahead. It’s important to move intentionally and cautiously to avoid injury.
  4. Breathe. You don’t have to be a meditation expert to focus on your breath. A simple exercise is to inhale and exhale slowly a few times while you try to focus on nothing else except your breath, the different sensations in your body, and the current moment. Breathwork and meditation are evidence-based practices that not only feel good for most, but instill calmness, resilience, and mindfulness. There are great resources online to find more complex routines.
  5. Profess. It may feel weird at first, but I challenge you to say, out loud, a few comments of gratitude and acceptance about yourself, your life, and your family or friends. Here are some ideas: “I accept my past and present and I’m excited for the future”; “I love my people and my people love me”; “I am reliable, resilient, and focused.” You can come up with your own and make them unique to you. There are other ideas online as well.
  6. Self-care. Shower. Skincare routine. Brush your teeth. Work out. Coffee. Tea. Whatever self-care means to you, do it.

    Zach Bernstein is a third-year medical student at Emory University School of Medicine. He graduated college with a degree in neuroscience and minor in business from the University of Michigan (Go Blue!). He is a co-president of the Neurosurgery Student Interest Group and chair of the Student Wellness and Mental Health committee at Emory. He is passionate about student, trainee, and physician well-being, as well as limiting barriers to medical education. Outside of medicine he loves to cook, play basketball, and spend time with friends and family.

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The views and opinions expressed in this collection are those of the authors and do not necessarily reflect the positions of the Association of American Medical Colleges.