How to cite this article:

Muhammad Saaiq. MEDICAL STUDENT’S

DISEASE (MSD): A FACT NOT FALLACY.
Cenna, Khyber Medical College Peshawar 1998.

TITLE:
MEDICAL STUDENT’S DISEASE (MSD): A
FACT NOT FALLACY
AUTHOR:

MUHAMMAD SAAIQ
4th Year MBBS,
Khyber Medical College, Peshawar
muhammadsaaiq5@gmail.com

Medical student’s disease (MSD) is an interesting but

miserable phenomenon that has long been experienced by

medical students. Every medical student owes the risk to

suffer from this condition. The risk peaks particularly in

the fourth and final year classes where diseases and

pathologies become the main topic of discussion in

lectures and ward rounds.

What happens is that after studying the symptoms and

signs of an illness, the medical student starts thinking that

these features are characteristically the same as those of

his own, so diagnosing himself as a sufferer of that

illness. Most often there is a narrow margin between

physiological and pathological phenomena within our

body; that’s why a medical student can easily jump to the

conclusion that he has the same features that characterize

a given serious illness. This is especially true for

psychiatric illnesses.

We all in our daily life experience a wide range of

fluctuations in our moods, emotions, feelings, behavior

and subjective experiences. Our mind often jumps

between happy and sad states. At times we are quite

happy, satisfied and hopeful with our minds remaining

sharp, keen and interested in work. Nevertheless it is not

unusual to feel unhappy, indifferent and anxious on other

occasions. In fact, it is the persistence, intensity and

consistency of such feelings that determine normal as

well as abnormal behavior. If a person has been

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previously certain about the normality of his behavior

and health status then it is quite unlikely that reading

about others’ diseases may prompt him to think that he

himself is a sufferer of the same conditions. Owing to the

common and vague features which many diseases share,

one may easily apply many diseases to his own. The

health consciousness among medical students is also an

important contributory factor that may prompt a student

to re-evaluate his health status.

During the last four years of my medical school, I have

seen several interesting cases of MSD. I want to share my

experience with my readers in the following.

We enjoyed our first day at the college with a scholarly

opening lecture on AIDS by the then college principal.

At that time we the blank new entrants couldn’t

understand the much advanced medical terminologies

and could only follow common features such as

weakness, weight loss, night sweating, loss of appetite,

fever and diarrhea etc. For the same reason we linked

AIDS to the same symptoms. After having attended the

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lecture, one of our colleague, in a very sad tone told me

that he was surely a suffer of AIDS because he

experienced some weight loss, night sweating, and low

appetite. The guy was especially anxious because he had

the habit of masturbation and the lecture had given us the

impression that sex and AIDS go hand in hand. It was

only after several years when that guy gave up that idea

and became a healthy person because by then he had

acquired adequate knowledge on the subject.

Diseases of the thyroid gland are very common in our

settings and our teachers lay special emphasis on these

diseases while teaching endocrinology. One will be

astonished to know that after attending lectures on the

thyroid hormones, hyper and hypothyroidism, many of

our class-fellows rushed to the medical outpatients

department with self-perceived signs and symptoms as

the sufferers of hyper and hypothyroidism. Universal

student’s problems; which are mostly nonexistent in true

sense but students are often captured by them, (such as

lack of concentration, drowsiness, lethargy in study, dull

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memory, lack of interest in college work etc). are such

vague symptoms which can be true of any one and

everyone. Thus under the Barnum effect any student can

be under the false impression that he is hypothyroid.

Another group of students may accept symptoms like

fatigue, exhaustion, increased sweating, insomnia, mental

disturbance, and diarrhea etc. as valid description of their

personality, thus diagnosing themselves as hyperthyroid.

In such case the student’s prejudice may reach to such a

degree of firmness that the clinician if not very careful in

history taking and making his own observations, may

erroneously label these MSD sufferers as actual patients.

Once when I was third year student, I was travelling to

my hometown on weekend. I was accompanied by one of

my colleagues. Unfortunately when he was entering the

vehicle, he accidentally hit his head against the roof,

producing a loud tuqq. The passengers already seated

there asked him to see if there was any bleeding from his

head. Fortunately there was no bleeding. On the same

day we had attended a forensic medicine lecture in which

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intracranial hemorrhages were discussed. From that

lecture we had come to know that extradural hemorrhage

usually occured after head trauma in young adults while

it didn’t occur in children and elderly individuals because

of the strong adherence of their dura to the skull. My

friend was worried that he might have torn his middle

meningeal artery, thus developing an extradural

hematoma. On the next day morning he met me in

college, telling me that he felt a little drowsy and was

therefore a sure case of extradural hemorrhage. I then

accompanied him to the surgical outpatient department

where his examination was undertaken by a competent

surgeon. The patient had no history of vomiting,

unconsciousness or other signs of meningeal irritation, so

the surgeon paid him a smile, telling him in a funny

mood that he was a medical student and had to encounter

many more hemorrhages till he become a complete

doctor.

Once we received a case of varicocele in surgical

outpatient department. Our teacher told us that in this

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condition the scrotum felt like a bag of worms. The next

morning one of our batch-mates spoke me in whispers

that he had palpated his scrotum and experienced a bag

of worms like sensation, therefore he had varicocele. He

also told me anxiously that he was afraid of becoming

infertile. That intense feeling rushed him to the surgical

outpatient department, but he turned out to be absolutely

normal without any varicocele.

After reading gastrointestinal pathology, one of our

hostel fellow became a suffer of recurrent appendicitis

but after examination and investigations it proved to be a

case of MSD.

A few months back, our pathology professor took our

class test in parasitology. All our friends gave a thorough

read to parasitology and not surprisingly two of our

friends came up with the view that they had some worm

infestations because they ate more and still didn’t gain

weight. Labored under this prejudice they tested their

stool and blood but couldn’t justify their false

perceptions.

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CONCLUSION:

These are just a few cases of MSD which I myself have

seen in a short duration of four years. The iceberg

phenomenon should be kept in mind-----surely there

are many other cases of similar nature hidden in our

medical student community. Indeed any medical

student can be a case of MSD at any stage of his life. Of

course medical students are the worst patients and

clinicians should be very careful and shrewd in talking

them.

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