Q: As a student in medical school, and a mountain athlete, I often find myself having to balance the stresses of training with the physiologic and psychological stresses of my work. For example, if I go ahead with a planned workout after an unexpected night shift or taxing day, I can find myself feeling very flat, and my training feels possibly unproductive or even harmful. I would appreciate your perspective on strategies for quantifying life stresses or recovery state to guide training volume in parallel to a busy life. Do you use heart rate variability? Is there any way to make good use of the ‘flat’ days, or should they be for recovery

A: As you are no doubt well aware, stress is stress, regardless of its cause. The effect of too much stress is to reduce our ability to handle more of it. You must consider the stress inherent in your school/work/family life before deciding to pile more on in the form of physical training.

The reason professional athletes essentially just eat, sleep and train is so they can eliminate all excess forms of stress and maximize the training stress. This lets them make the most of their training. You are currently in a very demanding (inherently stressful) occupation. Given that fact, it would be very challenging for to train effectively while in med school. A healthy level of exercise may prove to be more beneficial to you both mentally and physically and mentally at this point in your life as opposed to trying to adhere to a strict training schedule which may leave you exhausted, less fit and frustrated.