1st Year Med Student Suicide

[mshollywoodmd]

I personally really dislike this "destressing" medschool nonsense. Medschool isn't supposed to be easy, and having peoples lives in your hands should not be a stress free experience. This is not beauty school, if you aren't prepared for a little stress, you should have chose another profession.

I don't think its a question of "destressing" med school but more so finding an approach that may help students deal with stress more productively rather than internalizing it and having it manifest into the tragedy that initiated this thread. I totally agree with you that the medical profession is in fact stressful as it should be all things considered. Albeit stress is usually considered a negative thing the focus should be more on how stress is handled by said individual. L2D's suggestion of implementing personality/psych screens prior to matriculating a student has actually been established in some behavioral science graduate programs but even then there are some that may slip through the cracks (I'm not sure how common occurrence this is but it does happen) so no idea is the ultimate end all although it is a worthy enough research question to attempt as a longitudinal study at different tiered med schools to see what results it may merit. Although I don't know if I'm accurate in this statement but I'm sure I read somewhere that most suicides are impulsive and rash decisions instead of contemplative ones that is why most people are shocked when they found out their loves ones committed the act. So just because you passed the initial screening does not necessarily constitute that your psychological "soundness "will continue to be intact throughout medical school. So unless med schools are willing to give these test intermittently throughout the duration, it may just be best to leave the system as is and hope that the interviewers continue to do a good job detecting the red flags. In hopes of not sounding insensitive it has to be addressed that although it is unfortunate, some people are lost causes and no matter what is done ,it won't be enough.

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[OncoCaP]

... Although I don't know if I'm accurate in this statement but I'm sure I read somewhere that most suicides are impulsive and rash decisions instead of contemplative ones that is why most people are shocked when they found out their loves ones committed the act. ...

Many suicides seem to be attached to certain "warning" signs. Many of these warning signs are ambiguous. Some are more straightforward, such as someone who talks about taking their own life. Looking at the list below seems to point to the kinds of things that med students experience.

http://www.helpguide.org/mental/suicide_prevention.htm#who
It can be a frightening experience when someone you care about may be suicidal. You might just have a gut instinct that something is wrong. Or the person might have shared that s/he has been thinking about suicide, or even has a plan. Some risk factors are:

Have the person's circumstances changed recently? Was there a breakup of an important relationship, such as a separation or divorce? Has the person survived—or has someone close been affected by—a traumatic event, such as a natural disaster, physical assault, or a crime? Has the person recently become unemployed?
Has the person been struggling with a difficult situation, such as a chronic illness, physical, sexual or emotional abuse, long-term unemployment, or loneliness and isolation? Does the person abuse alcohol or drugs?
Has the person had problems with depression? Are these signs apparent now: loss of pleasure, a sad mood, a change in sleeping or eating patterns, feelings of hopelessness or excessive guilt? People struggling with depression are at a higher risk for suicide.
Has the person been diagnosed with an illness like bipolar disorder or schizophrenia? People with these illnesses have a higher risk of suicide, and circumstances can change rapidly.
Have the person's actions changed recently? Has he or she talked about suicide or expressed suicidal feelings? Made a plan for suicide? Does the person seem to be putting things in order, giving away possessions, making a will? Has the person's behavior been changing recently? Is school or work performance declining? Is he/she withdrawing from friends or family, spending more time alone?


http://en.wikipedia.org/wiki/Suicide#Reasons_for_suicide
Causes of suicide
No single factor has gained acceptance as a universal cause of suicide. However, depression is a common phenomenon amongst those who commit suicide. Other factors that may be related are as follows (Note that this is not meant as a comprehensive list, but rather as a summary of notable causes) :

Pain (e.g. physical or emotional agony that is not correctable)
Stress (e.g. Grief after a death)
...
Mental illness and disability (e.g. depression, bipolar disorder, trauma, and schizophrenia)
...
Substance abuse
Adverse environment (e.g. sexual abuse, poverty, homelessness, discrimination, bullying)
Financial loss (e.g. gambling addiction, loss of job/assets, stock market crash, debts)
Unresolved sexual issues (e.g. sexual orientation[3], unrequited love, aftermath of a break up)
To avoid shame or dishonour (e.g. Under the Bushido ideal, if a samurai failed to uphold his honour he could regain it by performing seppuku.)
...
Boredom (e.g. The dissatisfaction with life has resulted in more calculated and planned suicides)
...

 

[78222]

The thing is, we already have an interview. That is supposed to weed out people who can't handle it. I really don't see the point of a psych exam beyond that. It seems excessive to me when very few medstudents end up committing suicide.

 

[OncoCaP]

The thing is, we already have an interview. That is supposed to weed out people who can't handle it. I really don't see the point of a psych exam beyond that. It seems excessive to me when very few medstudents end up committing suicide.

How much do they look at whether the student can deal with the stress of medical school? I don't remember that as a point of evaluation. It seemed like the question on the interviewers mind was more in terms of how well would I do as opposed to whether I would jump off a building when under high stress. I would tend to think that stress coping would be part of the interview, but perhaps not really adequate because they don't have a good way of assessing that? If it's not in there, maybe even considering that point would be helpful. That being said, I'm not suggesting that it makes sense to look at solutions before thoroughly understanding the problem in the first place (with an appropriate level of effort relative to other issues).

The interviews I experienced focused more on motivation, people skills, understanding of the medical field, and things like that. I certainly was never asked anything about my ability to deal with stress. I was always left with the impression that high stress was sort of a given of medical school and that this was something you just take on the chin and work through.

I think most people would agree with you that 4 med students per year nationally in the U.S is not worth bothering with, when considering, for example, thousands of people are dying of cancer, drunk driving car accidents, fishing boat accidents, mining accidents, construction accidents, etc. My concern is that these four students are dying every year for no good reason and perhaps for preventable reasons and are worth some effort in having their deaths prevented. It's a given that we don't want a "solution" that is worse than the problem. My idea is that a few adjustments might not reduce the benefits of the education and save lives and be worth doing. It's worth exploring, in my opinion.

 

[teedub]

Pain (e.g. physical or emotional agony that is not correctable)
Stress (e.g. Grief after a death)
Crime (e.g. escaping judicial punishment, boredom of incarceration)
Mental illness and disability (e.g. depression, bipolar disorder, trauma, and schizophrenia)
Catastrophic Injury (e.g. paralysis, disfigurement, loss of limb)
Substance abuse
Adverse environment (e.g. sexual abuse, poverty, homelessness, discrimination, bullying)
Financial loss (e.g. gambling addiction, loss of job/assets, stock market crash, debts)
Unresolved sexual issues (e.g. sexual orientation[3], unrequited love, aftermath of a break up)
To avoid shame or dishonour (e.g. Under the Bushido ideal, if a samurai failed to uphold his honour he could regain it by performing seppuku.)
...
Boredom (e.g. The dissatisfaction with life has resulted in more calculated and planned suicides)
...

i think most med students have at least 6 of the above at any one time during their four years (more often, it's during the first two years). there's the obvious stress factor, the adverse environment (most of us are somewhat poor by society's standard, in huge debt, etc...and all our friends are buying houses and stuff...i don't care how much you don't care about money that's still depressing...especially when you have, like, six years until you can do that yourself), financial loss (again with the debt thing), unresolved sexual issues (i'm sure the divorce/breakup rate for med students and residents is quite a bit higher...and the baseline rate is pretty high anyway), the shame of not keeping the grades you wanted, or having to fail at something else because of med school (you know the freshman 15?? well there's a 15 that can happen in med school too...i so far have been blessed enough to avoid it), boredom (you're always studying, your friends are always out doing stuff...everybody has fun but you), and not to mention the fact that you're pretty isolated from your former support group (which was probably your family, or friends you had somewhere else). SO, that's baseline grief at many points for med students....hopefully, none of the others get added.

most people make this adjustment pretty well (all but the 126/100000, apparently)...if you can just work your ass off through the "what's the point" phase, but others don't. i'm not sure what separates people who commit suicide from those that don't, but i don't think it's the school's fault. they do a pretty good job (at least at my school) of making sure there are social events to go to (we organize "academic societies"...they're more like drinking clubs, which i'm totally a fan of), of lying to us and telling us there's "no competition here" (yeah...everybody gets the same residency slot), and of providing actual support services, but it still doesn't help the fact that we have to sit on our ass for 12-14 hours per day and struggle to sort stuff out while the rest of the world lives balanced lives. triple that, the six problems we all have from the list, and the kind of people that are often in med schools to begin with (the "Self-actualization or die" kind of people) and there's the reason for your suicides...

anyway, long story short: there's nothing the school can do that i would want them to do....anytime you have this environment you have suicides, but, as horrific as it sounds, i'd rather have a few more suicides (no doubt we'd still do everything we could do to prevent them) than have everybody be a crappy doctor (by making it less stressful and info-packed).

 

[OncoCaP]

Maybe medical school acceptance letters should carry a "black box" warning label: "WARNING: Nationwide, attending a U.S. medical school has been shown to increase the risk of suicide by 300% when compared to other advanced education programs. Accept at your own risk."

 

[stoic]

i'd bet a large sum of money that the amount of stress in the average day of a physician has been, is currently, and will continue to trend upwards as the years tick by for us.

we all knew this coming in.

medical school is stressful; at times very stressful. they do it on purpose both to teach us some useful information and to teach us to deal with stress. unfortunately sometimes medical school isn't the only thing going on in a persons life. it can be a dangerous combo when personal troubles start mixing with med school troubles. it can snowball, fast. our class, the one before it, and the one after it have lost REALLY smart students (though not to suicide). it can happen to the last person you'd expect. a parent's death, divorce, a major illness etc; sometimes its too much for people to deal with all at once.

i think my school is pretty normal. and they do go to a great deal of effort to make sure we at least hear about services available to us if we need them. or at least know who to email if everything goes to ****, either for you or a friend.i've been stressed out through med school, but i never paid too much attention to that stuff. but....

i haven't exactly kept it a secret that life and med school just finished kicking me in the teeth about as good as i've ever gotten it. i'm bitchy, but generally doing ok. i have to say that a lot of credit goes to my school for letting me pull the e-brake and take an excused abcense on a test right during the thick of everything. all this **** happened right before finals and if i hadn't have had that chance, i honestly could have punted the semester and really ****ed myself. (the rest of the credit goes to my friends, here and elsewhere)

i think the best thing we can do is A) aknowledge that this ride is gonna stress you like crazy and B) acknowledge not only the potential for that snowball disaster senario, but that it does happen reguarly. the key is convincing people that if they do feel things spinning out of control, to go ahead and reach out for help. there's some cultural bs against doing that in medicine. fear of being perceived as weak or less compitent. that attitude has got to change.

 

[Samoa]

I totally agree. Although I think at my school, asking for help, and especially before things spin out of control, is actually perceived as a very mature and professional thing to do.

Anecdotally, it's rumored that my class had the highest utilization of campus counseling services EVER, and that was BEFORE the hurricane. Coincidentally or not, we're also the class with the highest Step scores.

 

[Law2Doc]

The thing is, we already have an interview. That is supposed to weed out people who can't handle it. I really don't see the point of a psych exam beyond that. It seems excessive to me when very few medstudents end up committing suicide.

The interview has nothing to do with stress or psychiatric make-up. A good chunk of interviews are not carried out by physicians (lots of scientists and students do interviews as well), a negligible percentage are carried out by psychiatrists/psychologists, and, at least in the interviews I have had, no one ever asked any questions designed to elicit information about my mental state. Which is fine because that is not the purpose of the interview -- they are trying to decide if the interviewee has an interest in medicine, the school, and would be a "good fit" for the class.

Law enforcement (police, FBI, CIA) all have elaborate personality tests they administer to applicants to ferret out existing personality, emotional and pychiatric issues, so such tests do exist. I don't know that it would be effective here, but it is something one could try.

But I still think that it is less about med school curriculum and more about the collateral things that happen on top of med school that tend to be triggers. Relationships fail due to time constraints, people are isolated because their peers don't have a lot of time to "hang out" like they did in college, you face death head on during dissections, and many A students suddenly find themselves very average or below for the first time in their lives. None of these things are related to the curriculum. Schools are already struggling to fit all the info you "need" into a mere 4 years, and the first year is already one of the lightest loads. I don't see a viable quick fix, other than a preliminary screen.

 

[OncoCaP]

Like anything death or injury related, things generally don't improve until the lawyers get involved and start suing the dickens out of medical schools for creating a hostile or otherwise suicidal environment. After a few $100 million lawsuits (maybe 4 per year), the schools would change their tune and implement some measures ... much like resident "hazing" changed and improved somewhat (hours limitations, etc.) ... most likely due to the cost of lawsuits associated with this. Once the lawyers start hitting the medical schools in the pocketbook, things might improve.

 

[Law2Doc]

Like anything death or injury related, things generally don't improve until the lawyers get involved and start suing the dickens out of medical schools for creating a hostile or otherwise suicidal environment. After a few $100 million lawsuits (maybe 4 per year), the schools would change their tune and implement some measures ... much like resident "hazing" changed and improved somewhat (hours limitations, etc.) ... most likely due to the cost of lawsuits associated with this. Once the lawyers start hitting the medical schools in the pocketbook, things might improve.

I don't see a viable case here. The easy defense to such a suit is always going to be that the student had a preexisting but unrecognized illness. And every med school can point to ample counselling resources they make available for those who seek them. So don't hold you breath for any $100 million judgments.

The key difference between something like this and the Zion case (assuming you believe that long residency hours actually contributed to the outcome of that case) is that a patient -- someone who didn't VOLUNTARILLY subject themselves to the educational/training system-- died.

 

[1Path]

I don't see a viable quick fix, other than a preliminary screen.

I believe admitting more older students and/or having a minimun age at matriculation would help.

 

[Law2Doc]

I believe admitting more older students and/or having a minimun age at matriculation would help.

I don't think too many of us nontrads would disagree.
But I wonder if there's any statistics showing that risk of suicide in med school diminishes with age? I'm pretty sure the elderly have among the highest suicide rates nationally, so I don't know that youth is going to be the key contributing factor. (according to the CDC, suicide rates increase with age -- see http://www.cdc.gov/ncipc/factsheets/suifacts.htm).

 

[1Path]

I'm pretty sure the elderly have among the highest suicide rates nationally, so I don't know that youth is going to be the key contributing factor.

Elderly people aren't applying to med schools in droves, so I fail to see a coorelation here. And were talking about a specific subset of people, older PREMEDS.

It's true for the overwhemling majority of the people I know. Maturity IS helpful in dealing with challenges in life and I find more "the sky is falling" people under age 25 than over. Just take a look at some of the threads in preallo for proof then compare to Old premeds. HUGE difference!

 

[Law2Doc]

Elderly people aren't applying to med schools in droves, so I fail to see a coorelation here. And were talking about a specific subset of people, older PREMEDS.

It's true for the overwhemling majority of the people I know. Maturity IS helpful in dealing with challenges in life and I find more "the sky is falling" people under age 25 than over. Just take a look at some of the threads in preallo for proof then compare to Old premeds. HUGE difference!

I agree that there is less of a tendency to sweat the small stuff. But who knows if it's the small stuff that's pushing this small handful of people over the edge. The one person I know from my prior education who committed suicide was an older student and not straight from college.

 

[78222]

Good lord, judging by the posts in this thread you'd think medstudents were dropping dead left and right. There is more fear mongering going on here than a Fox News Special about Jihadist African Bees!

 

[Law2Doc]

Good lord, judging by the posts in this thread you'd think medstudents were dropping dead left and right. There is more fear mongering going on here than a Fox News Special about Jihadist African Bees!

It doesn't happen much, but people you know dying always makes a pretty strong impact.

 

[Doctor Bagel]

Hmmm. Not sure I understand. What's wrong with picking students who have already gone through a sort of "selection process"? The point is to pick the applicants so that when you send them through flaming hoops they have the greatest chance of success and the least chance to be looking for a bottle of sleeping pills when things get rough.

I agree. I think schools can do students a disservice by admitting people who don't have the ability to succeed (and by succeed I mean pass). Students should have demonstrated through prior coursework that they can take a rigorous courseload and do okay.

As for the screening, is there a suggestion that this be used for admissions? If so, I think you'd be treading into messy territory. How legal is it? How accurate is the screening? Honestly, I don't think it's something you want to mess with.

As for what schools can do, I think med schools actually do a fairly decent job, at least compared with law schools. At my school, they talk to us about the availability to counseling services all the time. They also mention that it's free and confidential and state that there's nothing wrong with going to see a counselor. At my law school, they never told us how to get counseling, and they never mentioned that law schools do have increased levels of mental illness. I actually had to seek out counseling at one point, and it was really hard. One of my classmates did kill himself, and I honestly hold the school somewhat accountable because they really didn't do what they could to let us know about counseling opportunities.

 

[OncoCaP]

I don't see a viable case here. The easy defense to such a suit is always going to be that the student had a preexisting but unrecognized illness. And every med school can point to ample counselling resources they make available for those who seek them. So don't hold you breath for any $100 million judgments.

The key difference between something like this and the Zion case (assuming you believe that long residency hours actually contributed to the outcome of that case) is that a patient -- someone who didn't VOLUNTARILLY subject themselves to the educational/training system-- died.

Yeah, you're probably right. On the other hand, given the right situation a case might proceed and given that the suicide rate is 3X of college and on a per-person basis 2X the fatality rate of something like construction (maybe a student with parents who are very upset and have the resources to go the extra legal mile ... or maybe a student who was somehow denied help or a prof who really did something stupid) I could see this making headlines given how edgy people are about this kind of thing. However, chances are clearly in favor of no lawsuit as you say.

 

[OncoCaP]

I agree. I think schools can do students a disservice by admitting people who don't have the ability to succeed (and by succeed I mean pass). Students should have demonstrated through prior coursework that they can take a rigorous courseload and do okay.

...

As for what schools can do, I think med schools actually do a fairly decent job, at least compared with law schools. At my school, they talk to us about the availability to counseling services all the time. ...

Yes, agreed, just filling a roster is a bad idea. Simply asking the question during the application process ... to what extent has this applicant demonstrated the ability to deal with the stress of medical school ... might be a start.

A number of students have pointed out that schools are offering services to help students cope. That's a great thing.

 

[78222]

One thing that I think should be done is pairing students up with an actual physician advisor. Not a preceptor, but someone they meet with on a semi-regular (2-3 times a year) basis and discuss the issues they are facing in medical school. I think a lot of times people just need someone who has been there to tell them that a lot of people go through what they are going through. Medical school is a stressful and oftentimes lonely experience - medical schools could certainly stand to devote a little to helping students deal with this.

 

[78222]

Also, I didn't think to mention this earlier but my own experience with school support services has been quite positive. A friend of mine was having some trouble with classes and decided he didn't really want to be here anymore. He was depressed and just sitting around the house not doing anything. I went down to the student services and talked to them and they asked me a lot of questions about whether he was suicidal or making references to dying (he wasn't). They then gave me a bunch of resources for him and scheduled an appointment to meet with him. In the end he decided to quit anyway, but they certainly tried to help him out with his decision.

 

[OncoCaP]

One thing that I think should be done is pairing students up with an actual physician advisor. Not a preceptor, but someone they meet with on a semi-regular (2-3 times a year) basis and discuss the issues they are facing in medical school. I think a lot of times people just need someone who has been there to tell them that a lot of people go through what they are going through. Medical school is a stressful and oftentimes lonely experience - medical schools could certainly stand to devote a little to helping students deal with this.

Yes, makes perfect sense. I plan to make a friendly acquaintance with students ahead of me and other friendly physicians and various personnel.

 

[evade]

As a small example as a potential improvement, we make not getting in or dropping out of medical school as something that is a better fit out to be a "failure." Just changing that attitude alone might save lives. There is a balance here. We want people to do their best, but not at any cost.

Glad I read the previous responses, because I came in here just to say that.

I wish I could tell all the med students who are miserable (and I know there are plenty of them) that it is okay to choose another path for yourself. There really is no way of knowing how you'll do in med school until you give it a shot. There was a guy in my class who left after the first quarter, because med school just wasn't what he thought it would be, and it wasn't right for him. That is okay. It's not a failure, it's a choice. I, personally, consider myself fortunate to be in medical school, and even when I'm suffering through exams, deep down, I'm happy to be here. But those who aren't need to find their calling, and they shouldn't keep plugging miserably along just because they feel like they'd be failing if they didn't.

OP, I'm sorry to hear of your (and your entire class's) loss. I can't imagine what I'd do if we lost a member of our class.

 

[lilnoelle]

I have a sad story of someone I know that attends the church I grew up in. He's 24 years old and he had just recently gotten married and I believe his wife was pregnant when his father (then 45) committed suicide. Apparently his grandfather also committed suicide at age 45. So now this young man not only has lost his father but has this burden on his shoulders. Is he going to end up committing suicide as well? Is there a genetic predisposition to this? Or is it simply a vicious cycle of depression related to the loss of a father?

 

[DropkickMurphy]

I have a sad story of someone I know that attends the church I grew up in. He's 24 years old and he had just recently gotten married and I believe his wife was pregnant when his father (then 45) committed suicide. Apparently his grandfather also committed suicide at age 45. So now this young man not only has lost his father but has this burden on his shoulders. Is he going to end up committing suicide as well? Is there a genetic predisposition to this? Or is it simply a vicious cycle of depression related to the loss of a father?

Ah.....the tree of life is self-pruning......

 

[PoorMD]

....
we all knew this coming in.

medical school is stressful; at times very stressful. they do it on purpose both to teach us some useful information and to teach us to deal with stress. unfortunately sometimes medical school isn't the only thing going on in a persons life. it can be a dangerous combo when personal troubles start mixing with med school troubles. it can snowball, fast. our class, the one before it, and the one after it have lost REALLY smart students (though not to suicide). it can happen to the last person you'd expect. a parent's death, divorce, a major illness etc; sometimes its too much for people to deal with all at once.

i think my school is pretty normal. and they do go to a great deal of effort to make sure we at least hear about services available to us if we need them. or at least know who to email if everything goes to ****, either for you or a friend.i've been stressed out through med school, but i never paid too much attention to that stuff. but....

i haven't exactly kept it a secret that life and med school just finished kicking me in the teeth about as good as i've ever gotten it. i'm bitchy, but generally doing ok. i have to say that a lot of credit goes to my school for letting me pull the e-brake and take an excused abcense on a test right during the thick of everything. all this **** happened right before finals and if i hadn't have had that chance, i honestly could have punted the semester and really ****ed myself. (the rest of the credit goes to my friends, here and elsewhere)

i think the best thing we can do is A) aknowledge that this ride is gonna stress you like crazy and B) acknowledge not only the potential for that snowball disaster senario, but that it does happen reguarly. the key is convincing people that if they do feel things spinning out of control, to go ahead and reach out for help. there's some cultural bs against doing that in medicine. fear of being perceived as weak or less compitent. that attitude has got to change.

Very well said. The part in bold pretty much sums it all up.

There are people at my school and surely they are elsewhere, who have not experienced the *chronic* disruptive personal life situations that some have to deal with on top of their work load. I am not saying I have experienced this kind of life, because I have not.. mine is pretty simple and I have a loving family and a small handful of non-med friends... but there are times when my personal life (family, finances, friends, etc) are crumbling all around me and yet class is steamrolling along at the usual fast paced clip... I am still grateful for not having any deaths in the family or other major disasters, like the one the OP posted about.. just saying there are people in my class who have had one of their parents die, and they showed up to take the exam the next week. That is some awesome grace under fire..

 

[oldbearprofessor]

One thing that I think should be done is pairing students up with an actual physician advisor. Not a preceptor, but someone they meet with on a semi-regular (2-3 times a year) basis and discuss the issues they are facing in medical school. I think a lot of times people just need someone who has been there to tell them that a lot of people go through what they are going through. Medical school is a stressful and oftentimes lonely experience - medical schools could certainly stand to devote a little to helping students deal with this.

This is an excellent suggestion and it fact has been done with varying degrees of success in different places. Unfortunately, in general this type of mentoring, which should be done for medical students, residents, fellows and even junior attendings is very difficult to accomplish in practice. This is because the pool of good mentors, who have the time and insight to do this for trainees is limited and the ability to make it a worthwhile experience for both mentor and trainee is even more limited. Matching folks is a real nightmare to get right and when done by "administrators" or "randomly" is almost always not very successful in my experience at trying to organize and evaluate such programs.

As such, it is necessary for students to actively seek out mentors and to cast the net widely for the right person (look beyond people who are similar to you in gender, ethnicity, etc or are in your likely future field) and be willing to "change" if the relationship isn't working.

With regard to some of the other thoughts on this thread, I would be very, very cautious about trusting med schools to make admissions or other decisions based on psychological testing or profiling. In my day we all had to take an MMPI personality test as med students and I thought that was a very intrusive and bad idea. I think a lot of very good future physicians would be excluded if anyone tried to do that and use it in admissions or residency decisions.

Above all, establishing a community in which peers and faculty are watching what happens to students in trouble and make their availability and that of professional services available to those in trouble is the key to this. As a faculty though, I can tell you that it is very difficult at times to intervene. I've seen residents that I thought were having a tough time personally but simply were uninterested in my efforts to approach them about it. Because we (faculty) are responsible for "evaluating" students and especially residents, it can be difficult for them to ask us for help or admit to a problem. If students or trainees wish to deny all problems and if they do their work, it's nearly impossible to force the issue without violating the rights to privacy of the trainees. It usually isn't so obvious that we can force the issue.

 

[mjl1717]

I personally really dislike this "destressing" medschool nonsense. Medschool isn't supposed to be easy, and having peoples lives in your hands should not be a stress free experience. This is not beauty school, if you aren't prepared for a little stress, you should have chose another profession.

(lol) I hear you baby. I think William Osler may have destressed and defused his clinical residency (especially internship) by doing a pathology residency first! But how many can and would do that? But seriously my first year at Boston U. undergrade someone committed suicide by jumping off the 20th floor of the dormitory. It was very sad.

 

[DropkickMurphy]

(lol) I hear you baby. I think William Osler may have destressed and defused his clinical residency (especially internship) by doing a pathology residency first! But how many can and would do that? But seriously my first year at Boston U. undergrade someone committed suicide by jumping off the 20th floor of the dormitory. It was very sad.

Well, if you can't leave the mark on society that you intended when you started school....you can at least leave one on the concrete/asphalt/parked car below. I reiterate.....survival of the fittest.

 

[mjl1717]

Well, if you can't leave the mark on society that you intended when you started school....you can at least leave one on the concrete/asphalt/parked car below. I reiterate.....survival of the fittest.

Dropkick you are humourous and since you help to catalyze and tickle me- 2 points for everyone.

1) As Law2Doc states and knows-- holidays are associated with depression(eg. some are lonely, some have no family)...Suicide- women may attempt it but the white male is most successful. Also more teens are doing it also.

2)Survival of the fittest? Man evolved, right. [Seriously] Man has to wipe himself after using the bathroom. A dog doesnt have to wipe himself. Do you have any thoughts on this.

 

[DropkickMurphy]

2)Survival of the fittest? Man evolved, right. [Seriously] Man has to wipe himself after using the bathroom. A dog doesnt have to wipe himself. Do you have any thoughts on this.

The dog does, in fact, wipe himself. It's just that he happens to use his tongue (or his owner's plush wall to wall carpeting) to do it that many people overlook. And man doesn't technically HAVE to wipe himself- spend some time in the ED or a nursing home and you will have these points driven home.

 

[mjl1717]

The dog does, in fact, wipe himself. It's just that he happens to use his tongue (or his owner's plush wall to wall carpeting) to do it that many people overlook. And man doesn't technically HAVE to wipe himself- spend some time in the ED or a nursing home and you will have these points driven home.

Acknowledged. you are not that crazy.

 

[Ypo.]

I don't know. I'm kind of with Cerb. Our school is at touchy feely as it gets and 99% of the time I feel like "please please PLEASE just let me go so I can go study. If I give you a hug and tell you all about my problems for five minutes, THEN will you let me go study?? All these compassion building exercises are stressing me out!"

I do agree that schools should try to encourage a cooperative/sharing learning environment, and that they should be willing to work with you if you have a personal crises. But it is YOUR responsibility to seek/find help if you need it, not the school's. And btw-you'll have to be doing that your whole life.

Don't expect them to call on you to talk about your feelings. (because you'll REGRET IT LATER!!! )

 

[DropkickMurphy]

I don't know. I'm kind of with Cerb. Our school is at touchy feely as it gets and 99% of the time I feel like "please please PLEASE just let me go so I can go study. If I give you a hug and tell you all about my problems for five minutes, THEN will you let me go study?? All these compassion building exercises are stressing me out!"

I do agree that schools should try to encourage a cooperative/sharing learning environment, and that they should be willing to work with you if you have a personal crises. But it is YOUR responsibility to seek/find help if you need it, not the school's. And btw-you'll have to be doing that your whole life.

Don't expect them to call on you to talk about your feelings. (because you'll REGRET IT LATER!!! )

"Mr. Murphy, would to tell us how this makes you feel?"
"Annoyed, pissed, upset, disracted, used, unfulfilled, cheap, dirty, and otherwise like I have lost an hour of my life that I will never get back and have gained nothing for the trouble."
"Moving on...."

 

[Sartre79]

If you read my post I spoke of depression, not suicide, around the holidays. People do get depressed around the holidays. See eg: http://www.medicalmoment.org/_content/risks/dec03/188214.asp
http://www.selfcounseling.com/help/depression/holidaydepression.html

Do you work or do something other than hang on SDN all day? I see you posting in every single thread....

 

[OncoCaP]

... As such, it is necessary for students to actively seek out mentors and to cast the net widely for the right person (look beyond people who are similar to you in gender, ethnicity, etc or are in your likely future field) and be willing to "change" if the relationship isn't working.

With regard to some of the other thoughts on this thread, I would be very, very cautious about trusting med schools to make admissions or other decisions based on psychological testing or profiling. In my day we all had to take an MMPI personality test as med students and I thought that was a very intrusive and bad idea. I think a lot of very good future physicians would be excluded if anyone tried to do that and use it in admissions or residency decisions.

Above all, establishing a community in which peers and faculty are watching what happens to students in trouble and make their availability and that of professional services available to those in trouble is the key to this.

I agree that having a "community environment" is preferred over, say, psychological evaluation during admissions (and might even be more effective). I agree that non-intrusive methods at suicide prevention should be tried first. Nobody likes their future to hinge on a psychiatrist's evaluation.

On the other hand, how many students would need to commit suicide per year at your school before you would consider trying out more intrusive methods ... 1, 2, 3, or more?

Also, if ability to cope with stress is really part of the job, why would this be ignored in admissions and beyond? Yes, it could mean that some potentially great doctors couldn't get in. However, it appears that dealing with stress is rather central to job performance (and perhaps even simple survival).

It is neat to see that many schools and faculty are making a noticeable effort to keep their students from going off the deep end. It would be nice to see some data that shows how effective this is and what works best.

 

[Punkinhead]

I just want to add that we do have a good counseling service, and actually I think we were told he was using it. I do not blame my school in particular, but rather the med school experience in general, or how it can bring out the worst in people psychologically. I think this was probably a case of predisposition pushed over the edge by personal factors (his live-in girlfriend left him) and then school stress/fear of failure/feelings of abandonment added too. I guess the key is support from within the student body. I don't know the answer, it's still too close to really look objectively...

 

[78222]

I agree that having a "community environment" is preferred over, say, psychological evaluation during admissions (and might even be more effective). I agree that non-intrusive methods at suicide prevention should be tried first. Nobody likes their future to hinge on a psychiatrist's evaluation.

On the other hand, how many students would need to commit suicide per year at your school before you would consider trying out more intrusive methods ... 1, 2, 3, or more?

Also, if ability to cope with stress is really part of the job, why would this be ignored in admissions and beyond? Yes, it could mean that some potentially great doctors couldn't get in. However, it appears that dealing with stress is rather central to job performance (and perhaps even simple survival).

It is neat to see that many schools and faculty are making a noticeable effort to keep their students from going off the deep end. It would be nice to see some data that shows how effective this is and what works best.

No, see the fear is that some touchey feely, paternalistic, douchenozzle like you would be on the admissions committee. I take it from your posts that you are the type of person who always knows whats best for everyone else and sticks your nose where it doesn't belong.

 

[Doctor Bagel]

Law2Doc, are you medical student? It seems to me, you post on this forum alot.

Law2Doc will never answer any of these questions. He's a mystery.

 

[DropkickMurphy]

No, see the fear is that some touchey feely, paternalistic, douchenozzle like you would be on the admissions committee. I take it from your posts that you are the type of person who always knows whats best for everyone else and sticks your nose where it doesn't belong.

Thank you for saying that.....it precludes me from having to say it.

 

[Sartre79]

Law2Doc will never answer any of these questions. He's a mystery.

Makes you wonder where he gets all of his life experience from that is useful when giving out advice???? He must not sleep....all those hours on SDN and living a life must be tasking.

 

[Scoot]

Makes you wonder where he gets all of his life experience from that is useful when giving out advice???? He must not sleep....all those hours on SDN and living a life must be tasking.

I second this, I don't think it is unreasonable to question someone's position when taking/asking for advice from them. There are enough internet know-it-alls as it is

 

[OncoCaP]

Makes you wonder where he gets all of his life experience from that is useful when giving out advice???? He must not sleep....all those hours on SDN and living a life must be tasking.

Some people want to remain totally anonymous ... I'm not sure why that's a problem (as it might make certain people more comfortable to speak their mind on an unpopular or sensitive subject). Also, some people can read and type very quickly, so it's certainly possible that Law2Doc doesn't spend as much time on SDN as people imagine. A law background would be suggestive of such a skill.

 

[Scoot]

Some people want to remain totally anonymous ... I'm not sure why that's a problem (as it might make certain people more comfortable to speak their mind on an unpopular or sensitive subject). Also, some people can read and type very quickly, so it's certainly possible that Law2Doc doesn't spend as much time on SDN as people imagine. A law background would be suggestive of such a skill.

It's not a problem per se, but it does help determine how much stock should be placed on his/her advice. I mean really, why would someone want to remain anonymous? Is it because they don't want things they say associated with them personally? If so, should this have an effect on how we value the things they say? Is it because they are scared of stalkers? If so, I don't blame them, but I refuse to believe that admitting to being a pre-med or a medical student or a resident or a doctor is going to allow some would-be stalker to put it all together and figure out who they are.

Is there something else I am missing?

 

[OncoCaP]

It's not a problem per se, but it does help determine how much stock should be placed on his/her advice. I mean really, why would someone want to remain anonymous? Is it because they don't want things they say associated with them personally? If so, should this have an effect on how we value the things they say? Is it because they are scared of stalkers? If so, I don't blame them, but I refuse to believe that admitting to being a pre-med or a medical student or a resident or a doctor is going to allow some would-be stalker to put it all together and figure out who they are.

Is there something else I am missing?

I'm actually rather open, so I'm more at the opposite extreme. However, over the years I have met a number of extremely talented, honest, capable people who go through extraordinary measures to remain anonymous in all aspects of their life. They receive their mail at a post office box registered to ACME Inc., pay bills in cash, only call anonymously from prepaid cell phones, etc. In the cases I'm aware of, as best as I could tell, it is was a personal preference thing that you could only contact them on their terms. I've known people who could have disappeared and there would be absolutely no trace of them ... no credit card transactions, obviously no forwarding address, no next of kin, no nothing. I doubt that Law2Doc is such an extreme case, but it's easy for me to see how there would be a range of personal preferences concerning how much of your private information you reveal.

 

[Scoot]

I'm actually rather open, so I'm more at the opposite extreme. However, over the years I have met a number of extremely talented, honest, capable people who go through extraordinary measures to remain anonymous in all aspects of their life. They receive their mail at a post office box registered to ACME Inc., pay bills in cash, etc. In the cases I'm aware of, as best as I could tell, it is was a personal preference thing that you could only contact them on their terms. I've known people who could have disappeared and there would be absolutely no trace of them ... no credit card transactions, only call anonymously from prepaid cell phones, obviously no forwarding address, no next of kin, no nothing. I doubt that Law2Doc is such an extreme case, but it's easy for me to see how there would be a range of personal preferences concerning how much of your private information you reveal.

I think you are right that people like this exist, but I feel like most people who would go to such great lengths to conceal themselves are either running from something or hiding something, and my tendency is to assume such is the case until proven otherwise. Further, even though what is presumably being obscured may have no bearing on what is being discussed, I have to assume it does and discount/devalue anything they say.

I think society is at base an accountability engine and extreme efforts to short-circuit it have to be viewed suspiciously.

 

[Doctor Bagel]

It's not a problem per se, but it does help determine how much stock should be placed on his/her advice. I mean really, why would someone want to remain anonymous? Is it because they don't want things they say associated with them personally? If so, should this have an effect on how we value the things they say? Is it because they are scared of stalkers? If so, I don't blame them, but I refuse to believe that admitting to being a pre-med or a medical student or a resident or a doctor is going to allow some would-be stalker to put it all together and figure out who they are.

Is there something else I am missing?

I don't think you're missing anything, and I agree. I probably share too much information about myself, but I like to know where people are at before I decide how much importance to give to their opinions.

 

[nyudoctor22]

I'm sorry for your loss. It is absolutely horrible that someone takes their life. May God bless his/her soul and May they rest in peace.

Just to give my opinion, medical school should be stressful but I like the current situation at my school. I am a student at a foreign medical school and we don't have any tests except finals at the end of the semester.

We have one month at the end of each semester where we have all our finals (for 10 classes!) spaced three days apart. It's nice because I've been told by upperclassmen that it reduces the amount of stress time for a medical student to the last two months of a semester as you prepare for the cumulative finals.

Some of my friends in American medical schools with midterms and finals are always falling behind in classes but with our system, most student are able to keep up at their own pace and the stress isn't really high until the last two months. What do you guys think?

 

[lilnoelle]

.