The problem with medicine is that by the time you've hit third year and see what you've really gotten yourself into, you're likely to be about one hundred thousand or more in debt with a pre-med degree that's essentially useless. Then onto residency. Now two hundred thousand in debt, working on the order of 80 hours a week and making only enough to live on, you can watch your debt expand with essentially no job prospects outside of completing residency. It's easy to feel trapped and hopeless if you turn out not to like medicine.
So let's say you're in residency and matched into a program. You have no negotiating power whatsoever. It's very difficult to leave if you don't like the program, don't like the specialty, if they're abusive towards you, or for any other reason. Many programs take advantage of these facts. You've signed a one year contract, and if you violate that you may never get a new residency again. These conditions should be illegal under anti-trust rules (a rider was written into an unrelated bill to make the match exempt from anti-trust), and would not be tolerated in any other industry. I mean imagine it...You sign up one year at a time, and if you quit you will never work again in that industry, especially if you're labelled a "match violator", you evil anti-trust dodger you. Only in the military do we expect that sort of commitment otherwise. But, for some reason in medicine we tolerate low paying work for years under the threat of otherwise unrepayable debt. Thus, I call the medical training pathway indentured servitude. Sure, I'm in the thick of it myself, but I'm not going to say that the current medical training pathway is right or fair either.
Meanwhile, the overseeing organization (the ACGME) really doesn't care much if you're violating work hour rules, not getting much of an education, or whatever gripes you might have. If you report abuses towards you, you're very likely just to be kicked out, and you face the very real possibility of never working again in medicine with a useless degree and over $200k of debt. You might be able to switch specialties or to another program if you suffer through whatever conditions you're in for the months to years required. Most residents just put their heads down on the pathway to becoming attendings. I'm not sure if there are very many people at all who are actually content through it all.
So while nobody should ever commit suicide due to the pressures of the medical training pathway, I empathize with those who are depressed in medicine. What if you either can't bear the thought of several more years of abuse and misery or can't imagine life as an attending will be any better? It's very easy then to feel depressed and hopeless. What most do on SDN, as in real life, is to simply portray the few outliers as being mentally ill without examining the ridiculous conditions of our medical training. We bury our heads in the sand and think that we're so much stronger or that it could never happen at my medical school/residency program. So the depressed and hopeless simply isolate themselves from everyone else, making everything that much worse.
This is awful-we had a student during my 1st year of med school commit suicide. Is it both Columbia P&S and the residency program(s) that tend to be tough? I had no idea that people take their own lives at P&S.
We had a fourth year in my graduating class commit suicide as well. This was at the med school that pre-allo seems to think only produces butterflies and rainbows. The reality is so much different once you're in the thick of it. But by then, you're committed and really can't escape.
