A growing body of research has found that post-secondary music students frequently suffer from health conditions and have relatively poor general health. While most studies have examined this problem at the individual level, researchers have expressed concerns about the degree to which educational institutions may contribute to music students’ health problems in various ways. Some studies have documented “environmental barriers” within post-secondary music education that may be harmful to students’ health, but almost no research has explored how students’ health occurs within the socially organized work activities of their post-secondary music program. Without this information, we may call for greater “institutional responsibility” or “cultural shifts” around music students’ health, but it becomes difficult to identify specific changes that can impact the lives of music students. This presentation will outline a subset of findings from an institutional ethnography (IE) examining the social organization of students’ work and health at a post-secondary music school in Canada. This study was conducted as part of an international IE project in partnership with three post-secondary institutions: two in Canada and one in Australia. Data presented here were collected during four months of fieldwork at one Canadian site. Interviews were conducted with 21 students and 21 faculty/staff. Observational data were collected using field notes and sound recordings. Analysis involved methods common to IE: mapping, indexing, and writing accounts to understand students’ activities and how they are socially organized through the use texts and discourses related to music education, university governance, and health. The findings outlined in this presentation will focus on the discourse of “preparation and performance”, which organizes students' activities during private instrumental or vocal study. Students work independently and with their instructors to prepare musical selections for evaluated performances, which take place at the end of each year. This presentation will illustrate ways that health challenges occurred for students in the context of this musical work. The findings will show how these challenges produced tensions for students looking to both succeed in their program and maintain their health. Finally, the presentation will demonstrate how these experiences fit within the wider institutional context, organized by university timetables, program requirements, musical texts, performance standards, and educational methods. This study can provide insights into the health implications of many taken-for-granted aspects of standard post-secondary music education practice, which can assist educators and administrators in better supporting students’ health in instructional/evaluation methods and curriculum design.