As physicians know, medical training shapes far more than clinical knowledge. It influences where you live, how you spend your time, and, often, who becomes part of your closest social circle. Years of intensive education, long work hours, and emotionally demanding experiences create relationships that few outside the profession fully understand.

While friendships with fellow physicians can offer a shared language and experience, relying exclusively on those relationships also narrows physicians’ perspectives and social support. As growing research highlights the health benefits of strong and diverse social connections, experts say cultivating friendships both in and outside medicine may be an important part of a physician’s well-being. Still, given the nature of medicine, friendships beyond healthcare may be desirable but not always plausible.

When Medical School Becomes Your World

Medical training consumes the years when many adults establish lifelong relationships. Students often enter medical school in their early twenties, just as their peers are beginning careers, building families, and developing social networks. Meanwhile, future doctors spend those years surrounded almost entirely by other future doctors.

“Many people go straight through school into medicine,” said psychiatrist Brent Schnipke, MD. “Those are the formative years when people are building relationships. If you’re always around premed students or medical students, it naturally becomes the group you make friends with.”

Even those friends may feel peripheral, and research supports this. According to a 2024 lifestyle report from Medscape on medical students, roughly one quarter rarely see their friends. Although sustaining friendships can be a challenge for any adult, medical students claim they have a hard time fitting relationships into their packed schedules.

Recent studies have linked strong social relationships to lower rates of depression, improved cardiovascular health, and longer life expectancy. Conversely, loneliness and social isolation have been associated with increased risks for coronary artery disease, stroke, depression, and premature mortality. A better social life is something every doctor would recommend to a patient.

Those findings are particularly relevant in medicine. According to a 2024 physician relationship survey, more than one third of physicians reported that work had at least a moderate negative impact on their personal relationships. The report notes that loneliness and social isolation are themselves significant health risks, reinforcing that relationships are not simply pleasant additions to life but are protective factors for health.

Schnipke agreed. “Adult friendships may be a challenge for many people, but they are really critical to help foster support and be able to get joy out of life.”

‘Trauma Bonding’

“In training, you just didn’t have any time to meet people,” said Priya Misra, MD. “And my pediatric cardiology training was residency on crack. You are just living in the hospital trying to absorb everything because you only have 3 years to learn everything.”

Misra also notes that the competitive nature of medical school isn’t always conducive to forming friendships. “I didn’t have a lot of friends at first in medical school,” she said. “I’m not a very competitive person, and so it was a little isolating in that sense.”

Misra did form close ties with her anatomy lab partners, three other medical students with whom she wasn’t in direct competition. The group remains close to this day.

“It’s a lot of trauma bonding,” Misra added. “We’re in class together, we’re in lab together and then we’d go to the library and study together until 9 or 10 PM, shower and rinse and repeat.”

“Trauma” might be an exaggeration, Misra admitted. But medical education arguably compresses years of knowledge and experience into an extremely intense period of overwhelming academic expectations, self-doubt, little self-care, and the constant pressure to prove oneself.

Ben Spitalnick, MD, a pediatrician, said “trauma” isn’t far off. He compared his formative years in medical school to another intense social experience: rush week. “Going through medical school is a lot like going through fraternity hazing,” he said. “You really form a bond going through the trauma of it.”

When Life Outside Medicine Feels Distant

Shared experiences and values accelerate intimacy, Schnipke pointed out. “Medicine is a difficult field,” he said. “We see difficult things. Sometimes there’s a perception — or a reality — that people outside medicine won’t fully understand those experiences.”

For Misra, after spending a day diagnosing a newborn with critical congenital heart disease or counseling frightened parents about open-heart surgery, everyday frustrations from friends outside medicine can feel difficult to process.

“I don’t have the bandwidth after a day like that to hear someone tell me their chakra feels off and they’re looking for advice,” she joked. But the reality is, “I have to bite my tongue. That’s why I end up surrounding myself with those in medicine.” However, Misra stresses that the severity standard isn’t fair to those outside healthcare. “Their issues are still valid and important to them,” she said.

Spitalnick noted that those outside medicine often see the profession through rose-colored glasses, a view that doesn’t always align with the experience of physicians.

“For those of us who have been in medicine a decade or more, the luster sort of wears off,” he said. “Everyone thinks doctors have everything going for them — they make tons of money; their life is so polished. But the reality is that a lot of people who went into medicine aren’t as happy as they thought they were going to be, and it takes someone else who is in medicine to appreciate that.”

Still, losing — or having to let go — of friendships can be difficult. Misra and Spitalnick encourage medical students to remind themselves that these sacrifices are sometimes necessary and that true friendships will endure.

“Your priorities have shifted,” Misra said. “Do not lament the friendships you have lost but instead look forward to this small but sacred community you are joining and the relationships you will develop amongst your colleagues.” Those are the friendships, she said, where “you can relay your entire experience and mental state without having to utter a single word and be vulnerable without judgment.”

Spitalnick encourages medical students to accept that some aspects of life have been put on hold. “Your friends may be eager to get married, start a family, and have a lot of disposable income from their grown-up job to do exciting adventures,” he said. “But once you catch up in life, the real friendships will pick up right where they left off.”

When Shared Experiences Matter Most

Spitalnick said most of the adult friendships he has formed are with those in medicine but not in his practice or even his specialty.

“I don’t do a lot of socializing after work with my colleagues because when you do, you just end up talking about work,” he said. “Whereas when you go out with medical friends who are not necessarily in your practice or field, you can share global concerns that aren’t really day to day specific but similar shared experiences. It’s important to be able to separate your workday from your personal life.”

Those are the friends he can share stories with about “the patient who doesn’t want vaccines” or “the patient who just goes to a Teladoc to get the antibiotic they want even though they don’t need it but then want to know why they aren’t getting better yet.”

However, Spitalnick does maintain a small network of friendships outside medicine that he made during his formative years when everyone was “exploring their identity and getting into all sorts of mischief.” They are who Spitalnick feels most comfortable reaching out to for “life concerns or advice. These are the friendships you tend to keep for life.”

While relationships outside medicine can offer perspective and meet different emotional needs, they can also create tension when it comes to respecting professional boundaries.

Spitalnick recalls how he used to avoid going to kids’ birthday parties with his young daughter because he’d constantly get approached by well-meaning parents looking for medical advice. With physician friends, that threat isn’t there, he said. “People within medicine typically don’t do that to each other.”

Expanding Your Social Bandwidth

Arya D. May, DO, an endocrinologist, points to her nomadic childhood and introverted nature as reasons she’s struggled to make and maintain friendships in and outside medicine throughout her life. Because of her father’s career in the aviation industry, May moved frequently. Then came medical school, residency, and fellowship. Each move meant leaving another community behind.

“With each transition point in my life, I kind of let everyone go,” May said. “Some people have really big social bandwidth and can keep up with people in multiple locations, but I’ve never been that way.”

For May, COVID created a significant social shift from year 1 of residency compared to her second and third year. “Year 1 of residency, we were like a Scrubs episode, skipping down the hallways, and it was phenomenal,” she recalled. “Then the pandemic hit, and we were forced to segregate to assigned computer stations and had less contact.”

After that, May said, her residency locations involved primarily working alone, and she had also met her now wife. “I was mostly wrapped up in that relationship and rotations,” she said, yet she didn’t feel isolated. “I’m an introvert by nature, so I didn’t mind. I get my cup filled with my patients and staff and socializing during the workday and then I recharge quietly after work.”

Today, May has settled with her family into a community, and without board examinations constantly looming, she finally has the bandwidth to start saying yes to neighborhood gatherings, book club meetings, and other social activities. Three years into practice, Misra has reached a similar point with enough breathing room, finally, to explore interests outside the hospital.

The Value of One

Physician friendships offer validation that few others can provide, allowing clinicians to process the emotional realities of their work with people who inherently understand them. But friendships outside medicine may provide something equally valuable.

Research from the University of Birmingham suggests that diverse social networks that include people of different ages, educational backgrounds, occupations, and life experiences are associated with greater resilience and well-being. Diversity, the researchers found, strengthens not only communities but also individuals.

“A variety of relationships are important, and it’s normal that you’re closer to some than others,” said Schnipke. “Most people only have a few really close friends and then concentric circles with people who are more like acquaintances, and I think having a variety is healthy.”

But Schnipke is quick to note that while diversity matters, there’s something even greater at stake.

“Even just one really important, secure, healthy relationship can go a really long way,” he said. “For many, the difference between zero and one is much more significant than the difference between one and any other number.”

The experts cited in this article reported having no relevant disclosures.