PURPOSE: To improve understanding of the impact of the third year on medical student wellness and help educators improve approaches to promoting wellness. METHOD: The authors used an interpretive description approach to conduct a qualitative analysis of required essays written by 173 third-year medical students as part of a May 2011 final exam at the Albert Einstein College of Medicine of Yeshiva University. In these essays, students reflected on how the transition to clinical responsibilities during the third year of medical school had affected their own health and wellness behaviors. RESULTS: Four themes emerged. Students described the difficulty of making healthy choices in the face of time challenges, the effect of becoming a role model for patients, and the impact of information on their view of their own health and wellness. A subset reflected on the tension between self-care and dedication to work that is inherent in developing a professional identity as a physician. Some students characterized these as challenges that encouraged them to be more active and effective in managing their own health; others viewed them as insurmountable obstacles that prevented them from making healthy choices. CONCLUSIONS: The new responsibilities in the third year of medical school comprise a unique set of opportunities and challenges that affect how students make choices regarding health and wellness. Educators should develop strategies for identifying and supporting students who are likely to experience the transition as difficult, and for capitalizing on learning opportunities by framing these challenges as part of students' professional development.
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