The stress of medicine

Pre-Med & Medical School Pre-Med Topics
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…“But in my opinion they will fall far short of addressing one of the root causes of this national epidemic of burnout, depression, and suicide: a culture of performance and achievement that for most of our students begins in middle school and relentlessly intensifies for the remainder of their adult lives. Every time students achieve what looks to the rest of us like a successful milestone — getting into a great college, the medical school of their choice, a residency in a competitive clinical specialty — it is to some of them the opening of another door to a haunted house, behind which lie demons, suffocating uncertainty, and unimaginable challenges. Students bravely meet these challenges head-on while we continue to blindly ratchet up our expectations.”

http://www.nejm.org/doi/full/10.1056/NEJMp1615141#t=article

What a heartbreaking story of a medical student suicide. D2 sent me this. She is an extremely happy, positive, even-keeled person with good friends and does non-medical things that are important to her and keep her sane. Even after these grueling 2 years, there’s no other place she’s rather be. But she and her friends, like I’m sure is true for most, have had ups and downs over their 1st 2 years of med school, moments of doubt, exhaustion, second-guessing of abilities (sometimes for the first time ever), and yes, some of her peers are being treated for depression. And, as stated above, it will just keep getting harder as “we continually ratchet up our expectations” in the clinical years, residency, practicing physician.

There is so much to learn, and medicine is a difficult and demanding career - but how to we ensure that mental and physical health aren’t a trade-off for becoming a doctor? Thoughts?

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My D is helping to correlate raw data from a study of doctor burnout in her specialty and she mentioned a while back that a surprising number of people come into residency still talking about academic validation and competitiveness. They must want to deliver care but D was surprised to what degree the validation factor came up.

JMHO, This is a group of people who have been academically successful their whole lives but may not cope well when grades aren’t the point any more. At the med school level clinical rotations can throw some really good students for a loop. You can’t just grind through it to get the A. The unknown of the Match can be hugely stressful.

This is coming from me and not from D, but I would incorporate mandatory programs to work on stress management and coping mechanisms. You better get a game plan going during med school to help with how you are going to handle the bad stuff. Not a lecture or two but mandatory stress management training through all of medical school. There are going to be a handful of people that won’t be able to handle it no matter what but mindfulness training is a useful thing. Residency is when it gets real and you want some tools.

I feel very fortunate that my D seems to be like dheldreth’s. Some of that is hard wiring but some of it is having figured a few things out about how she handles stress.

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I did not mention above how terribly I feel for that young woman, her family, and everyone who knew her. Such a very sad thing.