Whoa. I didn’t know.
Depression get even worse during residency.
From my earlier thread, posted in December–
Medical students, residents and physicians all have a much higher rate of suicide than their age-peers, in part because they tend to choose more successful methods to kill themselves and have better access to potentially lethal drugs.
http://emedicine.medscape.com/article/806779-overview
Overall female physicians/residents/med students have a higher suicide rate than their male colleagues, not because they attempt suicide more often than their male counterparts (suicide attempts are more or less even distributed between male and female) , but because they choose more lethal methods for their attempts.
When I am asked by mothers of pre-meds if I am thrilled and excited to have 2 daughters who are physicians, I always say "no"-- which earns me some very strange looks. While I am extremely proud of my daughters' success and all the sacrifices each made for their careers, I know that their risk for depression, suicide, and divorce are significantly higher than their equally educated professional peers. I view their careers with very mixed feelings-- and sometimes wonder if they would have better off as engineers or research scientists.Thanks for the link to the earlier thread, @WayOutWestMom . My D is pre-med but as yet undecided about research vs MD. It concerns me.
In total agreement - H and I respond to the “thrilled and excited” question in roughly the same way and for all the same reasons. Now that our Ob/Gyn daughter is finally getting her hands dirty ( pun intended 
) she seems to truly love the work - thankfully. Her choice plays to her personal strengths and academic background and I keep telling myself that she is a great fit. We know a fellow in a different specialty who is doubting their choice and trying to come up with a Plan B. This must be hard in so many ways after putting in so much effort.
My thoughts about D’s suitability for her chosen specialty aside, I can’t imagine maintaining good mental health if life is always a struggle. Hopefully in the future D will be able to pull off a decent work-life balance most of the time even though she has chosen a profession and specialty that doesn’t make it easy.
I knew about it. My D. talked about it. Importance of having a balanced life is crucial. Having a partner outside of the medical field may also help. Having wide range of interests and pursue them as much as time limitations allow and also regular exercise are very beneficial. Those who understood this way back at college and during medical school are definitely at advantage. “Suitability for her chosen specialty” is a very high priority. My D. ruled out several. Her personality simply did not fit in some and she took this fact very seriously. Rotations during medical school are definitely helpful in this aspect.
As a mother, I am “thrilled and excited” when I hear satisfaction in the D’s voice. The telephone conversations in our relationship are much more important than any other means of remote communication. I can always “hear it” in her voice. Overall she started sounding much better during residency in comparison to the medical school. She had one negative experience and she called me right away to discuss. There are other people in her life that are good source of positive support for her. She knows that she needs it sometime. Frankly, even having a dog at home, the live creature who is always there for you and unconditionally loves you, has been very helpful. The funny thing about the last, D. grew up without dog or cat in our house, we never had any. D. should have easier and more balanced time starting July 1, when she will be in her specialty. It will have its own challenges, she will have to study a lot. But she will not have a crazy schedule with many 30 hrs shifts and only 1 day off at random day of the week. She will start working normal human hours and being off on the weekends.
Best wishes to all very hard working medical students, residents and their worrying parents!
I often wonder if some who have anxiety/depression are drawn to the profession, particularly psychiatry because of their own situations? I’ve read some posts from premed/med students who say things like, "I have some family members with (fill in the blank mental illness), so I’m interested in becoming a psychatrist. That often worries me because mental illness is often inherited, so it’s very possible that the premed/med student may also have an undiagnosed illness…perhaps in a milder form or one that has manifested in a way that still allows him/her to do well in school.
“I often wonder if some who have anxiety/depression are drawn to the profession, particularly psychiatry because of their own situations?” - Interesting question. I can only answer based on my own D’s experience and also her best friend’s experience since both were drawn to psych.
My D. has been “drawn” to psychiatry way back in college and even was only 2 classes short of completing her Neuroscience minor, which she had to drop in senior year because of increased number of pre-reqs at one of the medical schools that she has applied. She mentioned many times that it was academically very interesting to her. Even her pre-med research was in-line with this interest. Going forward, while in psych ward rotation at medical school, her superiors told her that she has a talent in this area and if not psych, she should choose specialty that requires a lot of talking to the patient. Well, she herself got disappointed in psych because of widely used over-medication (keep in mind that it is a medical student observation, not exactly a professional assessment, so it was simply her opinion). Since psych has been always her back-up specialty, in case that she was not making it in her #1, she basically dropped it and matched in the specialty of her dream way back in HS. My assessment of my D. is that she is not prone to have an anxiety, but she does need a lot of positive support and she knows how to get it and how to “lift” her spirits.
D’s best friend is graduating this year. The psych has not been her interest initially, she just got disappointed in several other specialties that she considered while she got interested in psych. She is also the one who can easily connect and talk to others in a positive way. She has applied to psych residencies and ranked D’s location as her #1. She is not a person who is prone to feel down for a long time. She is also very up-beat and outgoing person who knows how to take care of herself.
Neither of my examples fit the suggestion that anxiety prone people are drawn to psych. Frankly, I feel that maybe “anxiety prone people” do not even belong in this profession as psychiatrist should bring a positive outlook to their patients. But again, this is just my opinion.
Overall, I agree that the prior history of anxiety / depression may be amplified under stresses in medical school / residency which was also mentioned by my D. Further, I would suggest that the people with the prior history of anxiety / depression maybe should not be considering the medical school altogether, they may get broken beyond repair so to speak or there may be other implications, like several cases of shingles in the mid. 20’s as it happened in D’s medical school class.
I agree with your D, especially with regard to what med students are exposed to on their psychiatry rotations. They are almost always exclusively inpatient psych and if they do get any outpatient exposure, they’re usually not sitting in on people who are doing analysis or other extensive outpatient talk therapy, they’re watching people come in for 15mins to get a refill on their meds and make sure their bodies are doing ok on the medication (which is also the most cost effective way to perform outpatient psych unless you’re going to go insurance free and only treat rich people).
Within the field of psychoanalysis/psychotherapy (where you have both MDs and PhDs practicing) it’s standard practice to require all trainees to go through extensive therapy early on in the process (regardless of whether they think they need it) so that they are best equipped to handle the emotions/feelings that will come up in the process of administering therapy. So they disagree that having anxiety precludes you, but they agree with you that medical professionals need to be in good mental health in order to practice medicine, particularly when it comes to practicing within the field of mental health.
I disagree with you here though (not the first sentence). Certainly if someone isn’t doing anything to manage their anxiety/depression (and I’m not necessarily talking about medication here) they’re probably going to fall apart, but I’ve seen several classmates be incredibly successful in medical school and residency placement (and in residency) with mental health diagnoses. In fact I’d bet the ones who actually acknowledge they have anxiety/depression fare better than the people who don’t think they have any mental health issues because they’re more self-aware.
Haven’t gone through the clinical years yet (starting this summer) but as someone who has done the first 2 years of MD (including step 1) and is almost done with their PhD, I can say that the PhD has been far more stressful and mentally taxing so far.
“They are almost always exclusively inpatient psych and if they do get any outpatient exposure, they’re usually not sitting in on people who are doing analysis or other extensive outpatient talk therapy, they’re watching people come in for 15mins to get a refill on their meds” - Well, maybe my D. was lucky or maybe they see that she actually have a certain “talent” in this area, but she was doing “one on one” although it was in-patient and not out-patient. The medical students have to go thru special training for that, they even have to know in which position to be in a room in relation to the door and few things like that because of safety considerations. D. enjoyed this “talking” part a lot and expressed her wish that it was used wider in place of some medications. But again, she was just a medical student, but patients that she dealt with definitely had mental issues.
“I disagree with you here though (not the first sentence). Certainly if someone isn’t doing anything to manage their anxiety/depression (and I’m not necessarily talking about medication here) they’re probably going to fall apart,” - I could not mention it specifically, but by “broken beyond repairs” I meant unfortunate cases of suicide. And unfortunately, as a medical professionals, they are better equipped to be successful at that even if it takes few attempts. I cannot be more specific / detailed about that. But I stand strongly on this: “he people with the prior history of anxiety / depression maybe should not be considering the medical school altogether,”. I have very unfortunate reason for this belief, trust me, I wish I did not have it.
Other than being a good conversationalist and being able to make small talk with a patient, what did “one on one” consist of. You’re not suggesting a third med student rotating in psych had enough command of psych issues to be actively involved patient treatment/care?
In S’s case this “special training”, in part, focused on defensive techniques in case they were attacked, or warnings not to let certain patients get you cornered as patient’s would make claims that you (student) had tried to molest them.
^exactly. That’s not the “talk therapy” I or most people are referencing. That’s a psych eval or a general patient encounter like you would see in other fields of inpatient medicine but with a psych patient. I was referring to things like a full course of CBT, marriage counseling, or other more complex forms of psychotherapy (e.g. analysis) that have fallen out of favor with MDs because those 1 hour sessions don’t pay nearly as well as four 15min visits with a prescription. Medical students might get a tiny exposure to CBT, but no one is letting a random medical student sit in on their couples counseling or psychoanalysis, and a sitting in on a couple sessions here or there probably wouldn’t be too educational anyway.
Please use old threads only for research. If you have a question or comment you can start a new one.