|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 4 | Page : 200-202
Yoga: A strategy to cope up stress and enhance wellbeing among medical students
Apar Avinash Saoji
Assistant Professor, The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
|Date of Web Publication||8-Apr-2016|
Apar Avinash Saoji
Assistant Professor, The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Saoji AA. Yoga: A strategy to cope up stress and enhance wellbeing among medical students. North Am J Med Sci 2016;8:200-2
Stress, burnout, and coping strategies in preclinical medical students by Fares et al.  made for an interesting read. I would like to compliment the authors for the commanding effort to put together a burning issue of psychological and physical stress and burnout among the medical students. The issue is often neglected both by the vulnerable population of students as well as the health-care community itself. The article definitely brings attention on the need for coping strategies and also puts together various methods for the physical and psychological wellbeing of the doctors-in-making.
Yoga, a mind-body practice of ancient Indian origin has gained significance in recent times due to its health benefits. Various practices of yoga have been found beneficial to attenuate stress and enhance functionality among medical students. Despite an array of coping strategies, yoga practices are found to reduce perceived stress, ,,, anxiety, ,,, markers of stress such as cortisol,  improved general health and well-being, ,, physical and physiological health, ,, improve cognition  as well as cultivation of positive emotions ,, such as empathy, compassion, and self-regulation. There is evidence of a reduction in work-related stress and better autonomic balance with the practice of yoga in health professionals.  The studies indicate not just the psychological benefits of yoga, but the physical benefits such as better autonomic balance, enhanced respiratory endurance, auditory and visual reaction times as well as muscle strength.  Few research studies showing the beneficial effects of yoga among medical students are listed in [Table 1].
One of the most important stressors among medical students is the examination. Malathi and Damodaran and Malathi et al. , have found yoga to be beneficial in modulating the response to stress during the examination. In addition, studies indicate that yoga could enhance the examination performance and reduce anxiety.  Another important area of concern brought out by Fares et al. is the lack of self-care behavior among medical students.  Yoga and mindfulness-based practices have demonstrated beneficial impact on the self-care behavior in counselors, who encounter similar health issues of that of medical students. 
From the review of existing scientific literature on the application of yoga in medical students, it is evident that yoga is a self-practiced, low cost, safe, efficacious as well as acceptable tool benefitting the target population. There are positive outcomes for the medical students in their physical, psychosocial, and emotional health. The practices that are safely used in the wellbeing of student community include asana (physical postures), pranayama (breathing practices), dhyana (meditation), mindfulness-based stress relaxation, and mind sound resonance technique (MSRT). [2-14], These techniques were used either as standalone modality in a combination or even as an adjunct program within the frame of medical curricula. The possible mechanisms involved with the beneficial effects of yoga among medical students include autonomic balance, relaxation, better emotional status, and self-care behavior. There is scope to evaluate the effects of yoga further among the medical students through rigorous clinical studies, wherein these mechanisms could be tested.
Considering the current evidence in the field, which indicates the beneficial effects of yoga on the physical, psychological, emotional, spiritual, and overall well-being of medical students, it could be recommended to incorporate yoga into the medical curricula for the health benefits of the doctors-in-making, medical fraternity, and community at large. The possible inclusions in such program could be the practice of simple asana, pranayama, meditation, and mindfulness-based relaxation. The following module is proposed to be incorporated for medical students keeping in mind the existing literature on yoga for medical students:
- Shithilikarana vyayama (loosening exercises) - 5 min
- Suryanamaskara (sun salutation) - 5 min
- Asana (physical postures) - 15 min.
- Ardhakatichakrasana (lateral bend pose)
- Ardhachakrasana (backward bend pose)
- Padahastasana (standing forward bend pose)
- Sarvangasana (shoulder stand pose)
- Matsyasana (fish pose)
- Bhujangasana (serpent pose)
- Padmasana (lotus pose)
- Savasana (corpse pose).
- Pranayama (breathing practices) - 10 min
- Kapalabhati (illuminating forehead breath)
- Nadisuddhi (alternate nostril breath)
- Ujjayi (the psychic breath)
- Bhramari (humming bee breath)
- Meditation/relaxation - 10 min
- Mindfulness-based relaxation/yoga nidra (psychic sleep)
- MSRT or cyclic meditation - once a week.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Fares J, Al Tabosh H, Saadeddin Z, El Mouhayyar C, Aridi H. Stress, burnout and coping strategies in preclinical medical students. N Am J Med Sci 2016;8:75-81.
Bond AR, Mason HF, Lemaster CM, Shaw SE, Mullin CS, Holick EA, et al.
Embodied health: The effects of a mind-body course for medical students. Med Educ Online 2013;18:1-8.
Erogul M, Singer G, McIntyre T, Stefanov DG. Abridged mindfulness intervention to support wellness in first-year medical students. Teach Learn Med 2014;26:350-6.
Warnecke E, Quinn S, Ogden K, Towle N, Nelson MR. A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. Med Educ 2011;45:381-8.
Simard AA, Henry M. Impact of a short yoga intervention on medical students′ health: A pilot study. Med Teach 2009;31:950-2.
Chen Y, Yang X, Wang L, Zhang X. A randomized controlled trial of the effects of brief mindfulness meditation on anxiety symptoms and systolic blood pressure in Chinese nursing students. Nurse Educ Today 2013;33:1166-72.
Shapiro SL, Schwartz GE, Bonner G. Effects of mindfulness-based stress reduction on medical and premedical students. J Behav Med 1998;21:581-99.
Malathi A, Damodaran A. Stress due to exams in medical students - Role of yoga. Indian J Physiol Pharmacol 1999;43:218-24.
Turakitwanakan W, Mekseepralard C, Busarakumtragul P. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai 2013;96 Suppl 1:S90-5.
Bansal R, Gupta M, Agarwal B, Sharma S. Impact of short term yoga intervention on mental well being of medical students posted in community medicine: A pilot study. Indian J Community Med 2013;38:105-8.
Yazdani M, Esmaeilzadeh M, Pahlavanzadeh S, Khaledi F. The effect of laughter yoga on general health among nursing students. Iran J Nurs Midwifery Res 2014;19:36-40.
Malathi A, Damodaran A, Shah N, Krishnamurthy G, Namjoshi P, Ghodke S. Psychophysiological changes at the time of examination in medical students before and after the practice of yoga and relaxation. Indian J Psychiatry 1998;40:35-40.
Madanmohan, Thombre DP, Balakumar B, Nambinarayanan TK, Thakur S, Krishnamurthy N, et al.
Effect of yoga training on reaction time, respiratory endurance and muscle strength. Indian J Physiol Pharmacol 1992;36:229-33.
Lin SL, Huang CY, Shiu SP, Yeh SH. Effects of yoga on stress, stress adaption, and heart rate variability among mental health professionals - A randomized controlled trial. Worldviews Evid Based Nurs 2015;12:236-45.
Nemati A. The effect of pranayama on test anxiety and test performance. Int J Yoga 2013;6:55-60.
Christopher JC, Christopher SE, Dunnagan T, Schure M. Teaching self-care through mindfulness practices: The application of yoga, meditation, and qigong to counselor training. J Humanist Psychol 2006;46:494-509.
Parshad O, Richards A, Asnani M. Impact of yoga on haemodynamic function in healthy medical students. West Indian Med J 2011;60:148-52.
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