Fitness: When doctors practice it, they’re better at preaching it

Med students in Athens want to maintain their fitness levels while studying to become doctors

Med student Brian Brewer is working on a body — his own.

He grips the pull-up bar and slowly uses it to raise himself, then goes back down and repeats the procedure. After completing a set of pull-ups, he drops to the floor for pushups. He follows that with core training to work his lower back and abdominals.

Keeping fit has been a lifelong habit for Brewer, a former “walk-on’’ running back on the UGA football team. Now, at age 25, he’s a second-year medical student at the Georgia Health Sciences University-University of Georgia Medical Partnership in Athens. And although his workout routine has evolved since his gridiron days, he still does an hour of exercise five days a week.

“I feel like it’s very important to be almost like a guide to the patient on physical fitness, because it can be used in so much prevention work,” Brewer said.

Once he becomes a practicing physician, he plans to be a fitness role model for his patients.

It’s widely known that physically active people are healthier overall than people who are sedentary. To note a few medical specifics, active people are less likely to gain excess weight, and they have a smaller chance of developing chronic conditions such as high blood pressure, diabetes and heart disease.

But while fitness is important, doctors have not always gotten that message across to patients.

Although U.S. doctors are giving their adult patients more advice on exercise than they used to, only about a third of all doctor-patient encounters in 2010 included such counseling, according to a report published by researchers at the CDC.

“If exercise is a viable option it would be mentioned, or should be mentioned, by a physician,” said microbiologist Brian Higgins, Ph.D., an assistant professor at the Medical Partnership. “There are definitely going to be patients who have to clear a few other physiological hurdles before they approach exercise.”

An embarrassed silence?

Out-of-shape patients are only one part of the equation. Doctors’ own sedentary habits can be an issue.

Physically inactive doctors are more likely to sidestep the subject of exercise than are fit physicians, according to an international study published in the British Journal of Sports Medicine in 2008. The researchers found that physically active doctors were more likely to encourage and motivate patients to do the same.

“I think it’s a lot easier to communicate the importance of it to a patient if you are physically fit,” Brewer said.

In addition to its physical benefits, staying active improves mental health, aids in sleep and can sharpen learning and judgment, according to the CDC.

“Basically, you would expect exercise to enhance cognitive function,” said UGA psychology professor Philip Holmes, who chairs the interdisciplinary neuroscience program at the university and teaches at the medical school.

Holmes, whose research focuses on the effects of exercise on brain function, also believes medical students can benefit from the stress relief that exercise provides.

Exercise enables people to let off mental steam, decreasing their stress and helping protect them against mounting anxiety or depression.

“We’re constantly sitting and studying,” said Brewer. “I think sometimes we just want to get up and move so we can reset.”

Medical school is so time-consuming that students can feel they have time for nothing but classes and studying. Once doctors enter practice, they often cite their busy schedules as an obstacle to keeping fit.

But Brewer is not the only GHSU-UGA med student who makes physical activity part of his daily routine.

When the clock strikes noon on weekdays, some medical students converge on Pound Hall, the cardio and strength training facility on the new Health Sciences Campus.

“Because the students have structured their schedules so well, depending on the time of day it is at Pound Hall, I can tell you which students are going to be in there,” said Higgins.

Some of the students grab basketballs or volleyballs from a bin by the door and head down a ramp into Wheeler Gymnasium, where the sounds of practice and competition soon resonate.

By 1 p.m. the rush is over. The medical students are back at their studies and Pound Hall is quiet again — until the next surge of activity.

Building doctors’ confidence

[youtube][/youtube]The Medical Partnership’s student body includes people with all sorts of exercise experience. Some were into running or cycling before they began medical school. Some competed in sports, including football, soccer and rowing.

Most of these people want to maintain their fitness levels while studying to become doctors, Higgins said, but they’ve had to dial back their workouts “because they just don’t have the same kind of time.”

Lack of confidence in their own counseling ability, or recognition that they don’t practice what they preach, can keep doctors from offering exercise advice. To counter this, the American Medical Association offers continuing education activities to medical students and practicing physicians, as well as a “personal health toolkit,’’ a sort of manual for doctors.

This guide, written by physicians and scientists, lays out what it takes to maintain a healthy lifestyle, including the 150 minutes a week of moderate-intensity activity recommended by the CDC.

Although 150 minutes sounds like a lot of time, especially for the busy and the tired, it doesn’t have to be one big block. Instead of a single long session, the activity can be spread out during the week. The CDC says short bursts of moderate or vigorous activity are beneficial if they last at least 10 minutes each.

“I don’t think the exercise has to be really strenuous to be beneficial, so they may not have to exercise to the point of being tired,” said Holmes. “Even if it’s just 20 minutes or a half-hour a day, that may be enough to get the benefits.”

Lacey Avery is an independent journalist and graduate student at the University of Georgia pursuing health and medical journalism. Avery also works with Georgia Sea Grant, a program that promotes research, education and outreach on the Georgia coast; additional work can be found at