Double Suicide ~ Med Student & Her Mom

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Dr. Wible,

You seem like an awesome person. Although the death of these two woman is terrible, I'm sure they appreciate the work you are putting into improving the situation for others. You ted talks video was very inspiring. As a medical student I have the privilege of spending lots of time with patients and I love it. I really hope to continue this in the future and would consider setting up a practice such as yours if I went into something private practice (considering EM now).

Keep up the awesome work.

To the family of these two women, I am terribly sorry. I can't imagine how hard it is for all of you. I wish there was something we could do to make things easier...

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Interestingly it is always the medical students (exhausted and between exams) who arrange for me to come speak at the med schools. The institutions have not formally asked me to speak. Silence. Dead silence.

Thoughts?

I think much of it is a fascade. Schools are required to offer counseling, but beyond that, how are they addressing the stressors that students have to endure at their school that forces them to seek counseling? Much of the stress, especially during preclinical years, are related to the onslaught of constant tests (I had multiple exams in a week at times in med school) and constant required classes often with little added educational value. On top of that, the culmination of your preclinical years and what will determine your career choice is based on a test you take before you even step foot in the clinic. You are taught to be empathetic to patients in medicine but it's sad that administrations often do not offer that same courtesy to students.
 
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I think much of it is a fascade. Schools are required to offer counseling, but beyond that, how are they addressing the stressors that students have to endure at their school that forces them to seek counseling? Much of the stress, especially during preclinical years, are related to the onslaught of constant tests (I had multiple exams in a week at times in med school) and constant required classes often with little added educational value. On top of that, the culmination of your preclinical years and what will determine your career choice is based on a test you take before you even step foot in the clinic. You are taught to be empathetic to patients in medicine but it's sad that administrations often do not offer that same courtesy to students.
A lot of characteristics like "empathy" are buzzwords. Kind of like the words "patient-centered" (which makes me wonder what we've been doing this entire time up till now).

They're said, but those characteristics are not even close to being rewarded at least not on evaluations. What's rewarded is making yourself look good in front of the attending/resident, even if it involves faking it (and more importantly having the resident/attending see it). It's nothing more than Kabuki theater. It's the so-called "hidden curriculum" at work. A lot of double-speak.
 
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A lot of characteristics like "empathy" are buzzwords. Kind of like the words "patient-centered" (which makes me wonder what we've been doing this entire time up till now).

They're said, but those characteristics are not even close to being rewarded at least not on evaluations. What's rewarded is making yourself look good in front of the attending/resident, even if it involves faking it (and more importantly having the resident/attending see it). It's nothing more than Kabuki theater. It's the so-called "hidden curriculum" at work. A lot of double-speak.

Yes, this is what I'm getting at. At the same time it's very hard for schools to address the issues that you mention in the clinic. The things that occur in the classroom they can change, but choose not to.
 
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Yes, this is what I'm getting at. At the same time it's very hard for schools to address the issues that you mention in the clinic. The things that occur in the classroom they can change, but choose not to.
No matter what system schools institute, it can always be gamed by students. Academia is always that way. Just look at tenure for med school professors. Make the first 2 years "true" P/F, then that will just shift the gamesmanship to MS-3, when clerkships are graded. Make everything "true" P/F, then no one will try harder except for board scores. It's always a risk vs. benefit.
 
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In US we put $300 million per year into preventing human rabies (only 2 deaths per year now) - Imagine if we put the same money, effort, time into suicide prevention.

Not discounting the need for increased mental health services in the US, but there would be a lot more than 2 deaths a year if we didn't put the money into rabies prevention (just look at the deaths in developing countries). There is a lot of money( millions, in fact) put into suicide prevention. Unfortunately it's a lot more complex to prevent than giving a vaccine and medication after exposure.
 
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No matter what system schools institute, it can always be gamed by students. Academia is always that way. Just look at tenure for med school professors. Make the first 2 years "true" P/F, then that will just shift the gamesmanship to MS-3, when clerkships are graded. Make everything "true" P/F, then no one will try harder except for board scores. It's always a risk vs. benefit.
Yes, this is what I'm getting at. At the same time it's very hard for schools to address the issues that you mention in the clinic. The things that occur in the classroom they can change, but choose not to.

I think most realize quickly that medical school is a bunch of BS and hoop jumping. I would have gone crazy if I tried to make sense out of all the ridiculous things I've done in the last 4 years.

Keep calm and carry on.
 
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I think most realize quickly that medical school is a bunch of BS and hoop jumping. I would have gone crazy if I tried to make sense out of all the ridiculous things I've done in the last 4 years.

Keep calm and carry on.
The hoop jumping doesn't just end at med school. Med school/students more seems to be people's guinea pigs rather than teaching toward certain incentives.
 
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I think most realize quickly that medical school is a bunch of BS and hoop jumping. I would have gone crazy if I tried to make sense out of all the ridiculous things I've done in the last 4 years.

Keep calm and carry on.

but that's the thing, many keep on going only to become disillusioned and depressed as they work their way through the BS.
 
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but that's the thing, many keep on going only to become disillusioned and depressed as they work their way through the BS.
Meanwhile all the obstructions laid in front of med students don't exist for PAs and NPs. I know many med students who would kill to do Derm and yet an NP and PA doesn't even have to do a residency to practice it. Just a certain number of "contact" hours, maybe take a dinky cakewalk certfication exam for brownie points, and they can go off and do it. Once an NP/PA is done with school, they are "ready on Day 1" and that's how they sell themselves, while saying look at those stupid physicians, even at the end of 4 years of med school, they still can't practice anything.
 
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In case you all have not heard, Rhonda Elkins, mother of MS3 Kaitlyn Elkins R.I.P., has also taken her life. She found me through an SDN thread and reached out to me. We became friends and spoke often on the phone. She wanted so much to save other medical students and their families from the grief she and her family endured.

Rhonda took her life the same evening I gave this presentation to medical students "How to graduate medical school without killing yourself."
-->http://www.idealmedicalcare.org/blog/how-to-graduate-medical-school-without-killing-yourself/

Other threads on SDN that reference Kaitlyn & her mother:
http://forums.studentdoctor.net/search/3460480/?q=kaitlyn elkins&o=relevance

I will be speaking in Newark, Scranton, Philadelphia, and Washington DC next month on physician and medical student suicide prevention. Would love to meet up with anyone on the forum.


You may already be aware of this, but maybe you can incorporate this young promising woman's story into what you do as well:

http://www.derminterest.org/InMemory.aspx

Briefly, she worked tirelessly pursuing dermatology, actually starting the med school Dermatology interest group that is now nationwide. She unfortunately did not match into Dermatology. She ended up taking her life during her intern year. Another life that did not have to end so early.
 
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They never mention suicide in the link above. What method? I'm trying to track gender, age, specialty, method.
I don't believe there is any article/blog post describing method. It was within the first week of internship.
 
but that's the thing, many keep on going only to become disillusioned and depressed as they work their way through the BS.

Sure. But medical school was always built to keep people in.

Someone said earlier, "where would the medical schools be without the students?"

Where?

In the same spot.

There are tons of people lining up to be in this profession. Tons. And if you sign up, it's very difficult to leave because of the debt. You also can't change situations, schools - etc. because everything is a red flag on your application. Let's be honest, schools don't talk about this because highlighting makes their students look bad or weak (I'm just telling the truth), which then will affect their matching and therefore the school's image.

If medical school had a 100% money back guarantee, like you see on infomercials, and students could drop out anytime before graduation with the promise of just breaking even (meaning, you lose the time/effort/years you put in - but you pay no tuition, only living costs) then I would estimate medical schools would lose anywhere from 1/4 - 1/2 of the students.

Medicine with all it's hassles is still an elite job in America. People don't know the mental and spiritual price that will be paid (just like our patients have no idea what a surgery will cost), and because of all of that - there is a lot of buyer's remorse.

With all of this said, this is an opportunity to do something about it rather than just identifying problems. It's good to hear the OP is doing that. Hopefully everyone does what they can.
 
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Sure. But medical school was always built to keep people in.

Someone said earlier, "where would the medical schools be without the students?"

Where?

In the same spot.

There are tons of people lining up to be in this profession. Tons. And if you sign up, it's very difficult to leave because of the debt. You also can't change situations, schools - etc. because everything is a red flag on your application. Let's be honest, schools don't talk about this because highlighting makes their students look bad or weak (I'm just telling the truth), which then will affect their matching and therefore the school's image.

If medical school had a 100% money back guarantee, like you see on infomercials, and students could drop out anytime before graduation with the promise of just breaking even (meaning, you lose the time/effort/years you put in - but you pay no tuition, only living costs) then I would estimate medical schools would lose anywhere from 1/4 - 1/2 of the students.

Medicine with all it's hassles is still an elite job in America. People don't know the mental and spiritual price that will be paid (just like our patients have no idea what a surgery will cost), and because of all of that - there is a lot of buyer's remorse.

With all of this said, this is an opportunity to do something about it rather than just identifying problems. It's good to hear the OP is doing that. Hopefully everyone does what they can.
Same could be said for dental school, or PA school, or NP school.
 
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No not maybe. The choices aren't just Medicine or bust, as far as being part of an elite. Physicians no longer have a monopoly over the medicine pathway, as well as other pathways that lead to "elite" status.

I guess I'm not sure what you were saying exactly - I made a few assertions and I don't know which you were applying to NP/dental school.
 
Hmmm, I don't think dental/NP's are referred to as elite jobs in the sense that physicians are. I realize it's completely subjective though.
You don't think dentists hold elite jobs that pay well? If doctors are so elite, their simple white coat couldn't be copied by others so easily.
 
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You don't think dentists hold elite jobs that pay well? If doctors are so elite, their simple white coat couldn't be copied by others so easily.

The imitation is proof of being elite.

My point isn't that dental jobs aren't good, I just think the public sees physicians as elite more so than dentists. I think I can prove the point by examining NYT articles. Rarely will you see public outcry against dentists or their salaries.
 
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Meanwhile all the obstructions laid in front of med students don't exist for PAs and NPs. I know many med students who would kill to do Derm and yet an NP and PA doesn't even have to do a residency to practice it. Just a certain number of "contact" hours, maybe take a dinky cakewalk certfication exam for brownie points, and they can go off and do it. Once an NP/PA is done with school, they are "ready on Day 1" and that's how they sell themselves, while saying look at those stupid physicians, even at the end of 4 years of med school, they still can't practice anything.

Seriously, I looked at the neurosurg and derm and ENT PAs during med school and just thought...wtf. There's people in med school killing themselves to get into these specialties and a PA/NP can just scoot on in whenever there happens to be an opening. Hell, if they get bored doing derm they can spend some contact hours with the ENT department and move over there.
 
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Seriously, I looked at the neurosurg and derm and ENT PAs during med school and just thought...wtf. There's people in med school killing themselves to get into these specialties and a PA/NP can just scoot on in whenever there happens to be an opening. Hell, if they get bored doing derm they can spend some contact hours with the ENT department and move over there.
Yup. Yet for many premeds if you mention this, there is an inherent ego thing. Or they say, they don't want to be watched over (which doesn't happen in real life - a physician is not peering over the shoulder while the PA/NP are seeing the patient). It's much more clearly seen as a med student, but by then it's too late.
 
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Fair enough. Although I don't believe discussing the system / environment that played a role in this is disrespectful.

But if others believe that is disrespectful, I'm happy to oblige and end our discussion.
I"m not stating that the discussion is heretofore disrespectful, but others have gotten way off topic. I'm not sure that discussing the merits of being a dentist, or a PA is relevant.
 
Out of respect to the Elkins family, I think we should keep this thread on topic please.
Oops, sorry, I was responding to a comment saying medicine is an "elite" occupation, and saying that there are other occupations that are "elite" and medicine isn't special in that regard.
 
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I remember Mrs. Elkins posting as well after her daughter's suicide. Unfortunate to hear she passed as well. Can't imagine what Mr Elkins is going through now.... losing a daughter and a wife within a 2-3 year span to suicide?
 
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I"m not stating that the discussion is heretofore disrespectful, but others have gotten way off topic. I'm not sure that discussing the merits of being a dentist, or a PA is relevant.

I would actually argue otherwise. Although not totally on topic, remembering that these alternate routes exist for those people who aim for something and then have their already existing depression exacerbated by effectively being "shut out" of a specialty they want to go into is very relevant. Being aware of the current medical climate and the relative independence one could have in a field of your choice as something besides a physician could actually be very helpful. Take the young woman above who worked her whole medical school career for a dermatology residency, failed to match and then committed suicide. Even Kaitlyn had, if I remember correctly, taken Step 1 about a month or so before her passing. It's not unreasonable to wonder if her Step 1 score might have had something to do with exacerbating an underlying disorder. Might these lives have taken a different path if their disorder was identified early and they were not thrown into the grinder of medical school/the absolute stress of the Steps which can effectively shut you out of career paths you may have been aiming for since first year? Perhaps they could have been guided towards less stressful paths that could still allow them to work in a field they truly enjoyed.

Also, I would say that forums are meant to be places of discussion. If we simply wanted to leave posts of sympathy or sorrow, Mrs. Elkins has a memorial page which you linked to previously which anyone can post on to share their condolences.
 
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I would actually argue otherwise. Although not totally on topic, remembering that these alternate routes exist for those people who aim for something and then have their already existing depression exacerbated by effectively being "shut out" of a specialty they want to go into is very relevant. Being aware of the current medical climate and the relative independence one could have in a field of your choice as something besides a physician could actually be very helpful. Take the young woman above who worked her whole medical school career for a dermatology residency, failed to match and then committed suicide. Even Kaitlyn had, if I remember correctly, taken Step 1 about a month or so before her passing. It's not unreasonable to wonder if her Step 1 score might have had something to do with exacerbating an underlying disorder. Might these lives have taken a different path if their disorder was identified early and they were not thrown into the grinder of medical school/the absolute stress of the Steps which can effectively shut you out of career paths you may have been aiming for since first year? Perhaps they could have been guided towards less stressful paths that could still allow them to work in a field they truly enjoyed.

Also, I would say that forums are meant to be places of discussion. If we simply wanted to leave posts of sympathy or sorrow, Mrs. Elkins has a memorial page which you linked to previously which anyone can post on to share their condolences.

Katilyn had taken Step 1 but not yet received her score. She told her mother she felt she had done well, though, and I remember the Dean called her mother with it when it came out a few months later, and she had a very high score. Many other med student suicides are people who are very high achievers - for example this student who was at UPenn and had just matched into Radiology at his top choice program. I think the issue is a lot more complicated than people not getting into the residencies they want.

http://www.salon.com/2013/03/12/why_did_my_brother_take_his_life/
 
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Katilyn had taken Step 1 but not yet received her score. She told her mother she felt she had done well, though, and I remember the Dean called her mother with it when it came out a few months later, and she had a very high score. Many other med student suicides are people who are very high achievers - for example this student who was at UPenn and had just matched into Radiology at his top choice program. I think the issue is a lot more complicated than people not getting into the residencies they want.

http://www.salon.com/2013/03/12/why_did_my_brother_take_his_life/

I didn't argue otherwise. I agree that the issue is more complicated than people not getting into the residencies they want. I merely stated that this could be an additional stressor for them if it did occur. However, the various stressors put on students during medical school and residency could absolutely exacerbate underlying disorders, which is exactly what I said above.
 
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I would actually argue otherwise. Although not totally on topic, remembering that these alternate routes exist for those people who aim for something and then have their already existing depression exacerbated by effectively being "shut out" of a specialty they want to go into is very relevant. Being aware of the current medical climate and the relative independence one could have in a field of your choice as something besides a physician could actually be very helpful. Take the young woman above who worked her whole medical school career for a dermatology residency, failed to match and then committed suicide. Even Kaitlyn had, if I remember correctly, taken Step 1 about a month or so before her passing. It's not unreasonable to wonder if her Step 1 score might have had something to do with exacerbating an underlying disorder. Might these lives have taken a different path if their disorder was identified early and they were not thrown into the grinder of medical school/the absolute stress of the Steps which can effectively shut you out of career paths you may have been aiming for since first year? Perhaps they could have been guided towards less stressful paths that could still allow them to work in a field they truly enjoyed.

Also, I would say that forums are meant to be places of discussion. If we simply wanted to leave posts of sympathy or sorrow, Mrs. Elkins has a memorial page which you linked to previously which anyone can post on to share their condolences.

Kaitlyn's Step 1 scores came back after she died. She did very well. She did, however, feel desperately lonely in medical school. I think we need to have peer mentorship programs in med school (a sort of match.com pairing system) in which you have been placed with someone who is a year or so ahead of you and has similar values and goals. How hard could this be. People meet the loves of their lives online all the time through online dating services. Why can't we do the same with peer mentorship in stressful careers such as medicine.

I also think the same type of pairing system with someone in your selected specialty like derm who can guide you if you do not match etc . . . so you have a built-in support team. Kaitlyn had NO friends in med school. She always had a few friends prior to med school, but she told her mom in med school "people just go their own way."

We need a support structure for med students.

Thoughts?
 
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Just an FYI - didn't originally write the post as a way to just share condolences for a woman who was active of SDN and he med student daughter. A thoughtful discussion of why med students and docs die by suicide at twice the rate of their patients would be good to have here. Or anywhere for that matter. Let's talk about the why.
 
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Just an FYI - didn't originally write the post as a way to just share condolences for a woman who was active of SDN and he med student daughter. A thoughtful discussion of why med students and docs die by suicide at twice the rate of their patients would be good to have here. Or anywhere for that matter. Let's talk about the why.

Apologies for the sort of morbid nature of this question, but I wonder:

Do you have any sense if the stats of MD suicide refer to completed suicides or also incorporate attempts? I ask because if the numbers are referring to completed suicides, could there be confounding from the fact that med students and physicians would have the knowledge base to do it successfully the first time while lay people often underestimate what it takes to end your own life? Kind of like the classically board-tested statistic that women attempt more but men complete more because men are most likely to use a firearm.

My guess is that we just don't have enough data on this phenomenon to answer the question. Either way, something that needs to be talked about a LOT more than it is currently.
 
Kaitlyn's Step 1 scores came back after she died. She did very well. She did, however, feel desperately lonely in medical school. I think we need to have peer mentorship programs in med school (a sort of match.com pairing system) in which you have been placed with someone who is a year or so ahead of you and has similar values and goals. How hard could this be. People meet the loves of their lives online all the time through online dating services. Why can't we do the same with peer mentorship in stressful careers such as medicine.

I also think the same type of pairing system with someone in your selected specialty like derm who can guide you if you do not match etc . . . so you have a built-in support team. Kaitlyn had NO friends in med school. She always had a few friends prior to med school, but she told her mom in med school "people just go their own way."

We need a support structure for med students.

Thoughts?

UVA already does this and has done it for years...at least they did back when I started in 2006.

Here is a link to their hispanic student peer mentoring program:
http://www.virginia.edu/deanofstudents/lhla/mentors/
 
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Apologies for the sort of morbid nature of this question, but I wonder:

Do you have any sense if the stats of MD suicide refer to completed suicides or also incorporate attempts? I ask because if the numbers are referring to completed suicides, could there be confounding from the fact that med students and physicians would have the knowledge base to do it successfully the first time while lay people often underestimate what it takes to end your own life? Kind of like the classically board-tested statistic that women attempt more but men complete more because men are most likely to use a firearm.

My guess is that we just don't have enough data on this phenomenon to answer the question. Either way, something that needs to be talked about a LOT more than it is currently.

MD Suicides refer to completed. But data is sorely lacking in attempts & completed suicide (miscoding death certificates as accidents - accidental fall from roof or balcony, accidental overdose, MVA etc . . ) Since docs die less frequently of heart dz, CVA, CA then gen public but 2x as high from suicide, we obviously are not effectively taking on mental health in our training.
 
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UVA already does this and has done it for years...at least they did back when I started in 2006.

Here is a link to their hispanic student peer mentoring program:
http://www.virginia.edu/deanofstudents/lhla/mentors/

That's great. I'd like to see them apply a match.com or e-harmony-like approach so that peers are 99% matched if possible so that they bond well and can be supports for one another rather than just pairing female hispanic med students. Do you know if mentoring programs have done this? In Kaitlyn's case she would have not truly opened up to someone unless she really felt bonded. I'd like to see peer mentors become lifelong supports, BFF, and that is more likely to happen with a matching process similar to dating sites.
 
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That's great. I'd like to see them apply a match.com or e-harmony-like approach so that peers are 99% matched if possible so that they bond well and can be supports for one another rather than just pairing female hispanic med students. Do you know if mentoring programs have done this? In Kaitlyn's case she would have not truly opened up to someone unless she really felt bonded. I'd like to see peer mentors become lifelong supports, BFF, and that is more likely to happen with a matching process similar to dating sites.
What you are describing sounds a lot like the "Zanmi" program at Tulane SOM. Upperclassmen matched to incoming med students, by interests and life experiences, etc. in a mentorship & friendship role.
 
A lot of characteristics like "empathy" are buzzwords. Kind of like the words "patient-centered" (which makes me wonder what we've been doing this entire time up till now).

They're said, but those characteristics are not even close to being rewarded at least not on evaluations. What's rewarded is making yourself look good in front of the attending/resident, even if it involves faking it (and more importantly having the resident/attending see it). It's nothing more than Kabuki theater. It's the so-called "hidden curriculum" at work. A lot of double-speak.

This part of your post honestly makes me suffocate. It's probably what people with GAD with panic attacks feel. The ACTING. It ****ing kills me and wears me down. It was the rotations that I honestly did not give a **** about that I had the most fun on, even if I wasn't interested in the particular field because I wasn't dead set on putting on the show.
 
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This part of your post honestly makes me suffocate. It's probably what people with GAD with panic attacks feel. The ACTING. It ******* kills me and wears me down. It was the rotations that I honestly did not give a **** about that I had the most fun on, even if I wasn't interested in the particular field because I wasn't dead set on putting on the show.
What's your point? It's true. Your residents/attendings will go on their assessments based on what what they see. Period. If they don't see it, then it won't be assessed. Your clinical presentations in front of them, your helping the team etc. That's why you have 360 evaluations.
 
What's your point? It's true. Your residents/attendings will go on their assessments based on what what they see. Period. If they don't see it, then it won't be assessed. Your clinical presentations in front of them, your helping the team etc. That's why you have 360 evaluations.
I didn't dispute it. I acknowledge it, and I find that it wears you down after a while.
 
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Katilyn had taken Step 1 but not yet received her score. She told her mother she felt she had done well, though, and I remember the Dean called her mother with it when it came out a few months later, and she had a very high score. Many other med student suicides are people who are very high achievers - for example this student who was at UPenn and had just matched into Radiology at his top choice program. I think the issue is a lot more complicated than people not getting into the residencies they want.

http://www.salon.com/2013/03/12/why_did_my_brother_take_his_life/

And the 2 IM interns that committed suicide in New York, one at Columbia and one at Cornell, were both AOA members as well.

http://www.legacy.com/obituaries/nytimes/obituary.aspx?n=HARIKIRAN-VASU&pid=172262801
http://www.times-herald.com/obits/20140822obit-o-rourke

Although it might be the easy route to attribute suicide only to bad med school performance, this is is definitely not the case.
 
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Do you think that is a coincidence or something up about the program?
 
I would actually argue otherwise. Although not totally on topic, remembering that these alternate routes exist for those people who aim for something and then have their already existing depression exacerbated by effectively being "shut out" of a specialty they want to go into is very relevant. Being aware of the current medical climate and the relative independence one could have in a field of your choice as something besides a physician could actually be very helpful. Take the young woman above who worked her whole medical school career for a dermatology residency, failed to match and then committed suicide. Even Kaitlyn had, if I remember correctly, taken Step 1 about a month or so before her passing. It's not unreasonable to wonder if her Step 1 score might have had something to do with exacerbating an underlying disorder. Might these lives have taken a different path if their disorder was identified early and they were not thrown into the grinder of medical school/the absolute stress of the Steps which can effectively shut you out of career paths you may have been aiming for since first year? Perhaps they could have been guided towards less stressful paths that could still allow them to work in a field they truly enjoyed.

Also, I would say that forums are meant to be places of discussion. If we simply wanted to leave posts of sympathy or sorrow, Mrs. Elkins has a memorial page which you linked to previously which anyone can post on to share their condolences.
Thank you. Although I do disagree that those alternative routes exist for the reason for those who were "shut out" of a specialty", the part I bolded was my underlying point although I didn't articulate it very well above.

Medicine is such a different gauntlet than others in so many ways, that it can exacerbate already existing anxiety/depression or bring about new episodes of depression/anxiety in those without prior history.
 
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Do you think that is a coincidence or something up about the program?
I think it's coincidence. I know there will be someone who thinks it was a copycat - although I don't know how much interaction the Cornell IM residents and Columbia IM residents have at New York Presbyterian have as apparently there is a Cornell campus and a Columbia campus?

NY, esp. NYC, has very high volume of patients being herded thru in all specialties, so it's unclear if it's something about the culture, immense workload of the IM programs at Cornell or Columbia program themselves.
 
Extremely complex issue, but there are things that we can do to destabilize medical students & docs and things we can do that build resilience. There is far too many destabilizers and fewer resilience-builders in our training & workplaces. Some souls let go of their physical bodies when it makes sense to them. We should at minimum have open dialogue and M&M conferences (psychological autopsies) for each suicide if we want to stop the needless loss of life.


And the 2 IM interns that committed suicide in New York, one at Columbia and one at Cornell, were both AOA members as well.

http://www.legacy.com/obituaries/nytimes/obituary.aspx?n=HARIKIRAN-VASU&pid=172262801
http://www.times-herald.com/obits/20140822obit-o-rourke

Although it might be the easy route to attribute suicide only to bad med school performance, this is is definitely not the case.
 
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Extremely complex issue, but there are things that we can do to destabilize medical students & docs and things we can do that build resilience. There is far too many destabilizers and fewer resilience-builders in our training & workplaces. Some souls let go of their physical bodies when it makes sense to them. We should at minimum have open dialogue and M&M conferences (psychological autopsies) for each suicide if we want to stop the needless loss of life.
I think it's much easier for medical schools and residency programs to shove it under the rug for PR reasons. Talking about the destabilizing forces eventually leads to what is contributing to those destabilizing forces, which then leads back to the school or the residency program and the last thing they want is fingers pointed at them, rightfully or wrongfully. Which then can affect the number of students/MD applicants who apply. The schools/programs surely won't be mentioning it on their websites.

I think we reflexively even do that now:
Was it bc she got a low boards score (oh then that must be why he/she committed suicide - not the school/program's fault!)
Was she not doing well academically in school? (oh then that must be why he/she committed suicide - not the school/program's fault!)
Was it bc he/she had a prior history of anxiety/depression (oh then that is definitely why he/she committed suicide - not the school/program's fault!)

I think in the 3 cases you mentioned - when it isn't academics or board scores, when we realize there is no excuse we can hide behind to push it under the rug which is when the conversation gets very uncomfortable.
 
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