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We talked to physicians and medical students about their caffeine habits

Kate Welsh
May 04, 2018

My brother Jack is in his first year of medical school. After years of only having caffeine to benefit his workouts, he has started to take a caffeine pill or two in the afternoon to give him a boost through long days of studying. We’ve talked about this change a lot because his early non-caffeinated approach was, frankly, pretty weird. The whole world tends depend on at least a little caffeine—a cup of coffee, a pot of tea, a soda—to get through the day.

But being doctor—or even training to be one—is no joke. It’s intense, demanding, and fast-paced, and to get it all done, the adrenaline boost caffeine provides can be essential. A 2010 study found nurses and physicians to be the most dependent of all professions on coffee to do their jobs well. While the average caffeine consumption of a typical adult is about 180 milligrams of caffeine a day—or roughly two cups of coffee—an Australian study found that doctors reported needing 400 milligrams a day, more than two times the average amount, to stay awake. That’s a lot of caffeine.

I was curious about how the medical community approached their caffeine consumption, so I surveyed about 30 physicians and medical students about their habits.

Here’s what I found out.

 

Some people don’t get buzzed—at all

Perhaps most shockingly, there are MDs who don’t consume caffeine at all—and I think because people like to talk about their caffeine habits, I heard from a lot of them. A lot of these people prioritized sleep and exercise, and found that extra stimulation from caffeine just wasn’t necessary for them. To stay awake or get re-energized, a lot of people said they’d take quick five-to-30 minute power naps, go on brisk walks, drink cold water or juice, or have conversations with friends or colleagues.

 

But for those that historically had caffeine, they just started drinking more

But for almost everyone who consumed caffeine before getting to med school, the amount of caffeine they consumed increased, if only a little. Some people started to drink more green tea. Others started having an afternoon energy drink in addition to their one morning cup of coffee. Others still went from a fairly standard two cups of coffee to drinking a whole pot each day.

There is a personalized caffeine order of operations

For many, there is a caffeine order of operations dependent on need and situation. A resident in St. Louis, Missouri, shared, “[I’ll always have] a morning espresso out the door and then a mid morning coffee to get through rounds. At least a soda or low-potency common room coffee in the PM. [That escalates] to double espresso in bad mornings and a big energy drink on really bad days. When I do 30 hour shifts, I will have a Crystal Lite with caffeine to make it through the next morning and home safe (and stave off a headache). Also, I keep a bottle of 100mg caffeine pills handy for when I don’t have time to get a cup of coffee or I need help at midnight.” A Boston, Mass.-based surgery resident pointed out that, “You can't drink too much fluid before a long [surgery], so if you can get your hands on it (hard to do late night at the hospital) espresso has always been my go-to. I love those Starbucks double shots when in a pinch.”

 

Sometimes caffeine is not enough

When straight caffeine doesn’t seem to do it, medical students resorted to some extreme—or extremely weird—tactics to stay awake. Among them: “‘Beezin’:” “A friend told me putting Burt's Bees lip balm on your eyelids (the outside!) gives you a nice cool/numbing sensation and really helps keep you awake in class. She called it ‘Beezin’.’ I tried it—would not recommend.” Others talked about studying outside in the winter, snapping a rubber band on their wrist, or continuously slapping themselves in the face to keep alert. They also reported using stimulants like Adderall, pseudoephedrine, and cocaine to push through long study sessions. Of course, one medical student also said “Ever growing stress and anxiety” tends to do the trick. No doctors reported using any substances besides caffeine.

 

When doctors and medical students really need it, they go hard

I asked people about the most caffeine they had ever had at a given time, and a number of people talked about drinking 600-800 milligrams (roughly six to 9 cups of coffee) in a day. Combined with sleep deprivation, this proved to be a bad combination for many. Some reported feeling “out of body” and “in a fog,” and experienced excessive sweating and severe thirst. One med student reported “seeing sounds and hearing colors.”

 

A lot of doctors and med students worry about their caffeine consumption—and those that don’t use science to back it up

The people that worry about their caffeine consumption tend to have experienced the most negative symptoms: heart palpitations, vomiting while exercising, and losing too much weight from a decreased appetite. The people that don’t are quick to justify their choice: “The amount of coffee I drink has been shown to decrease risk of heart disease, diabetes, and some cancers so I feel great about it.”

 

Though the way one’s body processes caffeine differs from person-to-person, the Mayo Clinic recommends not exceeding 400 milligrams of caffeine—or roughly four cups of coffee—a day. That’s considerably less than many doctors are having. So, I have a feeling that, for the most part, these medical students and doctors would be the first to tell you to “do as they say, not as they do.”

 

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