Island Med Student

A few months ago, I received a phone call that I’ll never forget. An obviously distressed friend and fellow med student was on the line. In between the sounds of sobbing, she related to me the most unbelievable truth. Another friend and fellow medical student was dead. He had committed suicide the night before. I nearly dropped my phone. I was, of course, in complete shock and didn’t understand what was happening. Time has passed since then, but the shock has still not faded. I can’t believe he’s gone.

Unfortunately, my experience is not all that unique. Many studies have documented the fact that medical students have higher rates of suicide than that of the general population. And guess what profession has the highest rate of suicide? You guessed it, physicians.

We have known for many years that medical students and physicians have higher rates of suicide. Studies have shown that psychiatrists, anesthesiologists, and emergency physicians, in particular, have the highest of all physician suicide rates. It’s been posited that this is because these fields involve incredibly high levels of stress, and access to drugs of abuse. For years, researchers have documented that depression combined with drug or alcohol addiction contributes to the likelihood that someone will commit suicide. And perhaps not surprisingly, the rates of depression and drug or alcohol abuse have also been found to be high amongst medical students and physicians.

A study recently published in the Annals of Internal Medicine has started to shine some much needed light on one of the variables involved with med student suicide. The authors found that one factor, in particular, was linked to the probability of a med student committing suicide. And guess what that factor was? Burnout. Should we be surprised?

I wrote an article last month that expressed my own feelings of burnout, and questioned whether or not torturing medical students was a valid method of education. I’ve since had even more time to reflect on these thoughts. I’ve also spent a good deal of time thinking about the death of my friend, and the factors that might have contributed to him making the choice he did.

Can I say that the pressures of medical school absolutely led to his death? Definitely not. But do I believe that the unbelievable amount of stress and pressure to do well in school contributed to his choice? Yes, I think I do.

Just today, I sat in an open discussion at my hospital, led by a senior physician. One student spoke up and complained about the fact that some residents and attendings had been very mean to him at times. He also mentioned the long hours, and the sometimes belittling treatment that med students receive. The physician’s response? That’s just the way it is. That’s what he himself had to deal with to make it through medical school many years ago. And he said that when that student eventually becomes a resident or attending physician, he will also treat medical students the same way.

So, are we to believe that this is all simply a fact of life? Is this just the way it has to be? Is the stress simply inevitable? Are the resultant deaths also simply inevitable? Must this cycle of abuse continue, similar to the cycle of abuse in families?

I’m sorry, but I refuse to accept this as truth.

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