Doctor Suicides: 400/year

[NonTradJp]

Hello Everyone,

http://www.theatlantic.com/health/archive/2014/09/suicide-and-the-young-physician/380253/

This is a general news article about medical training. But since I'm a non-traditional, I thought I'll post it here and see what thoughts my fellow prospective students have on the issue of doctor suicides?

And since I rarely talk, "hi".

JP

---

Members don't see this ad.

 

[Promethean]

My friend Dr. Pamela Wible has made this issue a central focus of her career. She has written and lectured extensively on the subject, and offers retreats for physicians who need an opportunity to reach out to other physicians for support. I strongly recommend checking out her TED talk or any of her articles.

I love her dearly. She publishes her cell phone number and you can call her directly if you ever need a sympathetic ear. She is my model for the kind of doctor I hope to be someday.

 

[operaman]

I think it's a very complex issue and has very little to do with the rigors of training. If I had to venture some guesses:

1) Highly intelligent individuals with mental illnesses often go undiagnosed because their intellect allows them to function where others couldn't.

2) Substance abuse often goes undiagnosed in intelligent people.

3) Admissions selects for hard working, driven people who have known little or no failure in their lives. No, 2 weeks on a mission in Africa is not adversity, especially if you got bumped to business class thanks to your parent's FF miles.

4) By definition, half of the admitted students who have been accustomed to being at the top will instantly become "below average."

5) Most people in medical training are NOT brilliant. Intelligent and hard working, yes, but brilliance is still rare and those who have it are the rockstars who glide through effortlessly wondering why everyone else has a problem. Many will be working consistently at the limits of their intellectual ability.

6) Most students, especially traditionals, have very little support structure for either med school or residency. As a result, coping may not be ideal. See #2

7) Substantial debt burden makes quitting not seem like an option.

I think non-trads are probably less likely to fall prey to suicide for many reasons. They've had more time for underlying mental illnesses to come to light, they've experienced real challenges and adversity before, they don't define themselves by their scholastic achievements, they often have family support, etc. That maturity and experience of dealing with stress is a huge help. We're don't like rejection but we've accepted it as part of life. We've screwed up plenty of times and had to work past it. Many traditionals -- including the two suicides mentioned in the article -- are having to adjust to the realities of the professional world AND learn medicine at the same time.

No easy fixes I'm afraid. The biggest fix would be at the admissions level, perhaps requirements for 1-2 years of full time work, although the whole process takes a long time as it is. Perhaps more weight given to MCAT scores than GPAs as a means of selecting more people with innate intelligence versus the people working hard to compensate for average-or-less intelligence. I know that sounds awful, but there's no way to sugar coat the idea and we're all grownups here.

 

[Law2Doc]

Couple of thoughts. The article makes much of the suicide rate being more than twice that of the "general population", which it apparently defines as people ages 25-39. Is that really the appropriate comparison? When the comparison is not an obviously similar group it always should raise the suspicion that the author is cherry picking to make the article stronger. I would suggest that the more appropriate group to compare to are people in other professional schools. Is the suicide rate in law school all that different?
While I guess it's a positive sign for nontrads that the media apprently acknowledges that people may still be in training at age 39 by this comparison, most residents are a decade younger, so when you increase the group to include all those people with stable jobs and kids and homes, aren't you stacking te deck to make residency look worse?

We all know residency is stressful and isolating and ends up not being the right place for people who don't have the best coping mechanism or support systems. I've suggested on other threads that it sometimes seems that people with prior exposure to mental health get drawn to medicine like moths to a flame. I don't know how best to address this but people should know going in that there are stresses that require a certain internal sense of balance beyond that needed for a lot if other jobs. I don't know that residency actually pushes people over the edge so much as this field sometimes attracts those standing too close to the edge to start with and then isolates them from those who might pull them back.

Anyway, food for thought/debate. Hope I didn't offend anyone.

 

[kendrick lamar]

I'm curious about this topic too. My cousin, who's a doctor posted this article on FB.
I am overall curious about those who suffer from anxiety and depression wanting to go to medical school or those who have anxiety/depression who are already in medical school. I have anxiety/depression that tends to vary on how bad it gets depending on the situation. During my undergrad, my anxiety/depression became quite bad for many reasons: I went to a school with less diversity and as a minority I started feeling isolated/depressed, I was burning out not because the academics was hard but I was losing interest in learning about drugs (I am a visual learner so I wanted to always go in the health field because of anatomy/phsyiology), I was having a lot of stress at home. I also tended to be sleep deprived, but I feel that while it's overall not a good thing, I functioned OK on 3-5 hours of sleep sometimes. My anxiety/depression is the primary reason I am considering dropping the idea of medical school. I really loved the idea of medical school when I was on pharmacy rotations rounding with doctors and attending morning/noon conferences. I was more happy to learn in one week than I have been in six years of pharmacy school. At that point, I felt like I didn't want to do anything except go to medical school. But I am seriously reconsidering due to my mental health condition. I read about doctors and medical students suffering from anxiety and depression and it worries me because I already have low-confidence, tendency to burn out quickly especially when I am not interested/around people who are not interested or in a high stress situation. I had a pretty bad group of friends in pharmacy school who used me because I was the only one going to class, and I was getting more unsure about this career as most people around me were just going through the motions to get out, graduate and work.
I'm 23 and looking into public health jobs and want to take time to decide whether or not medicine is truly for me. I figure I could be a reasonable candidate by the time I'm 27 or 28 and could use that time to evaluate my stress, anxiety, depression as well as my work situation. I have always worked hard since high school and afforded little time for fun. I did go to concerts in college and find ways to enjoy myself but due to the student population at my school, I didn't make any friends that really became taxing on my health and overall esteem. So I don't want studying to become something where burn myself out and regret the decision. I do think it would be good if I find a reasonable working environment which can afford me some free time and evaluate whether or not I will be okay to sacrifice that time for school again.
If anybody has any insights they can offer me about anxiety/depression and medical school, please PM me! I would love to hear more about it.

 

[QofQuimica]

My advice would be that you make sure your depression is very well controlled before even contemplating going to medical school, let alone residency. Whatever issues with depression that you have before you start your training will be magnified manifold during training, as you will be regularly stressed out, sleep-deprived, and isolated from friends and family for a period of 7+ years. It's a lot easier to work a humane schedule as an attending, but you still have to make it through to that point first.