Med student suicide

[Perfect Hair Day]

Was she depressed? Depression is not the only psychiatric condition that can drive a patient to suicide. Anxiety alone can drive a person to suicide.

As an aside, medical students who stigmatize DEPRESSION have absolutely no business whatsoever studying medicine. As a physician it is not your place to judge a person for their illness. Shame for anyone who plays into the stigmatization of disease, especially medical students and physicians.

-ButteredLobster

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[Mad Jack]

Someday, when I'm an attending, I'll tell you all a story.

But for now I'll just say that getting help doesn't always work, nor is it easy, for many reasons. Saying, "just get help" kind of sells short the fact that for many, counseling just doesn't do much, and even if it did, you're basically saying, "just confront the very fears and doubts that you have head on like it's no big deal." Ultimately, if we want to have a reduction in suicide rates amongst medical students, residents, and physicians, it's not going to come from efforts that push for individuals to utilize resources that already exist. Real change would have to involve a shift in medical culture that I just don't think will happen in my lifetime, a movement from the top down to treat medical students like human beings are treated in nearly every other work and educational environment in modern society. Unfortunately so much of the culture of medicine rides on the fantasy of being inherently better than mere ordinary people that any attempt to treat physicians in training as fallible mortals would be seen as blasphemous weakness.

 

[zeppelinpage4]

Stigma is apart of it for sure, med students are a VERY prideful bunch, and the crap show of an admissions process we have tells them its not okay to be anything less than almost perfect. Second, some schools just provide crappy mental health resources because LCME makes them. Our counseling services are located in a really conspicuous area, they don't make any attempt to provide students with privacy, the only 2 therapist we have working there for the entire university aren't good, and the psychiatrist treats med students who are seeking help for depression as if they are just making excuses. There needs to be higher standards for the people providing mental health service to med students, should be at least one psychologist there.

Exactly this, if mental health is such a rampant problem, having adequate services available should be a priority. I did rotations at a separate site from my main campus and when I finally opened up about seeking help the response from an admin was "I don't get why you didn't just come to the counseling office here, it's just a one hour drive."

Someday, when I'm an attending, I'll tell you all a story.

But for now I'll just say that getting help doesn't always work, nor is it easy, for many reasons. Saying, "just get help" kind of sells short the fact that for many, counseling just doesn't do much, and even if it did, you're basically saying, "just confront the very fears and doubts that you have head on like it's no big deal." Ultimately, if we want to have a reduction in suicide rates amongst medical students, residents, and physicians, it's not going to come from efforts that push for individuals to utilize resources that already exist. Real change would have to involve a shift in medical culture that I just don't think will happen in my lifetime, a movement from the top down to treat medical students like human beings are treated in nearly every other work and educational environment in modern society. Unfortunately so much of the culture of medicine rides on the fantasy of being inherently better than mere ordinary people that any attempt to treat physicians in training as fallible mortals would be seen as blasphemous weakness.

100% agree. I've seen several students seek help, but not all of them actually get that help. I went to our CAPs office as an MS1 and it did nothing for me. They paired me with a psychologist in training. After that I tried finding a private counselor on my own, which took weeks of phone calls to find. And that second counselor ended up not helping much at all either, the guy would fall asleep during my sessions.
By the end of MS2 I tried switching again and finding a psychiatrist this time, but this had to go on hold until after my step 1 was done because I was going back home for the 1 month to study. Coming back, the only services I could afford were a sketchy NP in my area, or to commute the full hour back to my main campus to see that counseling service that I didn't like MS1. I got so sick of calling insurance companies and doctor's offices, and getting put on hold, I just gave up. I knew I had problems by Spring semester MS1...but I didn't get adequate help until middle of third year when it got so bad, I was failing exams and the administration stepped in and made special arrangements. Unfortunately, getting mental health isn't nearly as easy or straightforward as it should be for many people.

Trying to get help was a complete **** show for me. I had some very caring instructors that I met third year who went out of there way to make sure I finally got the help I needed...but it sure wasn't an easy process. Up until then, I felt like I was on my own and I was afraid to ask for help because I didn't know what they would think of me. I think the system should be better in this regard.
I still need to find a counselor or psychologist to pair with the psychiatrist I'm seeing, but between all the studying and time in the hospital working, I haven't had the time to make that search.
I'll probably have go through this whole song and dance again if I move to different place for residency too.

 

[ACSurgeon]

What is this ridiculous nonsense about "seeking help" lol...

It's the unnecessary workload that causes depression and suicides... Fix the curriculum.

There's definitely room to fix the curriculum. Lots of time wasted for little return and high levels of stress that should be mitigated. The devil's advocate argument is that being a physician is very stressful, there a lot of systems problems that you have to deal with, lots of stress to make administrators happy that don't benefit the physician or patient etc etc. Resiliance is definitely required to make it through the process and not burning out even as an attending. Not sure how to ultimately fix the process. It takes buy in from administrators who are often out of touch with the trainee's plight.

 

[W19]

There have been a ton of these stories. Several have done it by jumping. There was a med student a few years ago who killed herself and her mother became a poster on SDN, talking about suicide among med students. Her mother also had a blog about her daughter's death. Unfortunately, the mother never recovered from her daughter's death and ended up taking her own life as well.

Wow...

 

[esob]

After raising two kids with aspergers, I can say I'd be pretty leery of the stigma from seeking help as well. It seems like if you have any type of mental disorder you are labeled as permanently broken.

 

[lymphocyte]

There's definitely room to fix the curriculum. Lots of time wasted for little return and high levels of stress that should be mitigated. The devil's advocate argument is that being a physician is very stressful, there a lot of systems problems that you have to deal with, lots of stress to make administrators happy that don't benefit the physician or patient etc etc. Resiliance is definitely required to make it through the process and not burning out even as an attending. Not sure how to ultimately fix the process. It takes buy in from administrators who are often out of touch with the trainee's plight.

Agreed. Something that's controversial but I believe anyway: we don't spend enough time cultivating resilience in ourselves as medical students, where excessive self-criticism, perfectionism, and rejection sensitivity are the norm, not the exception. No judgement, no blame. But still. Resilience is to some extent a cognitive skill that gets better and better with deliberate practice and reflection just like any other skill. Strategies like acceptance, solution-centered thinking, mindfulness, and emotional openness are so key for protecting against burnout or worse. The best time to see a counselor actually isn't when you're in crisis (though you absolutely should if you are in crisis). It's to recognise that you have an at-risk personality style in a high-risk profession and start building coping skills right now. Preventative care. Lots of medical students and residents would benefit from seeing a therapist--not for now, but for later when burnout inevitably comes to visit (as it does for the vast majority of doctors). No amount of whatever can completely defend against psychiatric illness, but it does lower the risk.

And those are skills that can last a lifetime, regardless of where frustration comes from. Complaining about the curriculum and administrators--it has its place, but it's probably not helpful unless you have the time and wherewithal to actually make a difference. What's in your circle of control? It's also too easy to forget that medical students just pass through, while administrators are the stewards who've made a career out of getting all the million moving pieces to fit together just right. Their goals aren't always our goals (they have to look at the bigger picture, as well as their own jobs), and they're flawed just like everybody else. It is what it is. So what to do? Focus on what's easily within our control, like proactively reaching out for help (even before crisis), being protective about sleep and exercise where possible, investing time in meaningful relationships, finding joy in life, expressing gratitude, learning how to say: "This sucks. I hurt. What's a simple, practical thing I can do"?, etc. I'm all for reforming things--I really am--but that's not always a realistic possibility.

 

[Seth Joo]

Was she depressed? Depression is not the only psychiatric condition that can drive a patient to suicide. Anxiety alone can drive a person to suicide.

As an aside, medical students who stigmatize DEPRESSION have absolutely no business whatsoever studying medicine. As a physician it is not your place to judge a person for their illness. Shame for anyone who plays into the stigmatization of disease, especially medical students and physicians.

-ButteredLobster

I do not believe its students who stigmatize, more its administrators who create the problem, many universities do not have a good reputation when it comes to handling students with mental health issues for a number of reasons. Its not just graduate and medical schools that mishandle these issues, its also undergraduate programs.

And if it is a student or faculty member, it reflects very poorly upon them to stigmatize a person with an illness.

 

[Stagg737]

Someday, when I'm an attending, I'll tell you all a story.

But for now I'll just say that getting help doesn't always work, nor is it easy, for many reasons. Saying, "just get help" kind of sells short the fact that for many, counseling just doesn't do much, and even if it did, you're basically saying, "just confront the very fears and doubts that you have head on like it's no big deal." Ultimately, if we want to have a reduction in suicide rates amongst medical students, residents, and physicians, it's not going to come from efforts that push for individuals to utilize resources that already exist. Real change would have to involve a shift in medical culture that I just don't think will happen in my lifetime, a movement from the top down to treat medical students like human beings are treated in nearly every other work and educational environment in modern society. Unfortunately so much of the culture of medicine rides on the fantasy of being inherently better than mere ordinary people that any attempt to treat physicians in training as fallible mortals would be seen as blasphemous weakness.

I don't think the problem is limited to medicine, it's a cultural issue on a national level which is exacerbated by the stresses of medical training and expectations of those running medical institutions and the system as a whole. Just look at the demographics of mass murderers in the U.S. Without getting into a debate on gun rights, how many of the mass killings could have been prevented by having greater awareness of individuals' mental health? Sandy Hook, Virginia Tech, NIU, Columbine, the 2012 Aurora Co shooting; the list goes on...

If we want real change, there needs to be greater awareness on the national level, and an understanding that individuals with mental illness shouldn't be feared or shunned as lesser humans. Mental illness can't be some taboo topic to be whispered about in darkened rooms and pushed aside as something which can be ignored. It needs to be addressed up front in an open manner in a national forum. Until that happens, I don't think there will be any significant change in anyone's attitude toward mental health.

 

[Seth Joo]

I don't think the problem is limited to medicine, it's a cultural issue on a national level which is exacerbated by the stresses of medical training and expectations of those running medical institutions and the system as a whole. Just look at the demographics of mass murderers in the U.S. Without getting into a debate on gun rights, how many of the mass killings could have been prevented by having greater awareness of individuals' mental health? Sandy Hook, Virginia Tech, NIU, Columbine, the 2012 Aurora Co shooting; the list goes on...

If we want real change, there needs to be greater awareness on the national level, and an understanding that individuals with mental illness shouldn't be feared or shunned as lesser humans. Mental illness can't be some taboo topic to be whispered about in darkened rooms and pushed aside as something which can be ignored. It needs to be addressed up front in an open manner in a national forum. Until that happens, I don't think there will be any significant change in anyone's attitude toward mental health.

Actually you are wrong, mentally ill people are more likely to become a victim of violence, they are not likely to hurt someone else. This is an erroneous belief.

You should look up the studies about mentally ill people and violence, they are more likely to be victims than perpetrators, and if they do commit an act of violence it will usually be in a residential setting, in other words in a place where they live, not in a public place.

Anyway this is veering off topic, but one thing to note is that people with mental health issues are more likely to harm themselves or put themselves into situations where they might wind up in danger.

 

[Stagg737]

Actually you are wrong, mentally ill people are more likely to become a victim of violence, they are not likely to hurt someone else. This is an erroneous belief.

I realize that, but you missed the point of that part. I wasn't saying that those affected by such conditions aren't victims, I was trying to emphasize the anomaly in our society that mental illness is not worth addressing until something major happens. I was trying to emphasize that many acts of violence could be avoided if the individual's mental health had been acknowledged and properly addressed instead of brushed under the rug.

 

[Seth Joo]

I realize that, but you missed the point of that part. I wasn't saying that those affected by such conditions aren't victims, I was trying to emphasize the anomaly in our society that mental illness is not worth addressing until something major happens. I was trying to emphasize that many acts of violence could be avoided if the individual's mental health had been acknowledged and properly addressed instead of brushed under the rug.

Given the kind of attitudes so many people have, and given that school administrators love to cover their asses, the best advice to students with emotional issues is to get help but to make sure you do it quietly, don't tell people in school about it, tell your family but no one else.

There is a great Newsweek article about how schools react to students with mental health issues, some of the ways they react are horrific.

 

[MedicineZ0Z]

There's definitely room to fix the curriculum. Lots of time wasted for little return and high levels of stress that should be mitigated. The devil's advocate argument is that being a physician is very stressful, there a lot of systems problems that you have to deal with, lots of stress to make administrators happy that don't benefit the physician or patient etc etc. Resiliance is definitely required to make it through the process and not burning out even as an attending. Not sure how to ultimately fix the process. It takes buy in from administrators who are often out of touch with the trainee's plight.

There's a difference in being paid (good) money to be stressed vs. paying 50k to get stressed daily.

 

[Mad Jack]

I don't think the problem is limited to medicine, it's a cultural issue on a national level which is exacerbated by the stresses of medical training and expectations of those running medical institutions and the system as a whole. Just look at the demographics of mass murderers in the U.S. Without getting into a debate on gun rights, how many of the mass killings could have been prevented by having greater awareness of individuals' mental health? Sandy Hook, Virginia Tech, NIU, Columbine, the 2012 Aurora Co shooting; the list goes on...

If we want real change, there needs to be greater awareness on the national level, and an understanding that individuals with mental illness shouldn't be feared or shunned as lesser humans. Mental illness can't be some taboo topic to be whispered about in darkened rooms and pushed aside as something which can be ignored. It needs to be addressed up front in an open manner in a national forum. Until that happens, I don't think there will be any significant change in anyone's attitude toward mental health.

Physicians have a particularly worse time though. You can make it through life in pretty much any other career with a mental health issue, but as a physician, it immediately brings your judgment into question and throws your abilities and character under the microscope. The only place that has historically been a worse environment for an individual with mental health problems was the military, but they have had a serious cultural shift that has not yet hit the medical profession.

As to mass shootings, the mental health angle is a bit of a cop out.

http://mobile.nytimes.com/2015/12/16/opinion/dont-blame-mental-illness-for-gun-violence.html?_r=0

 

[MedicineZ0Z]

Someday, when I'm an attending, I'll tell you all a story.

But for now I'll just say that getting help doesn't always work, nor is it easy, for many reasons. Saying, "just get help" kind of sells short the fact that for many, counseling just doesn't do much, and even if it did, you're basically saying, "just confront the very fears and doubts that you have head on like it's no big deal." Ultimately, if we want to have a reduction in suicide rates amongst medical students, residents, and physicians, it's not going to come from efforts that push for individuals to utilize resources that already exist. Real change would have to involve a shift in medical culture that I just don't think will happen in my lifetime, a movement from the top down to treat medical students like human beings are treated in nearly every other work and educational environment in modern society. Unfortunately so much of the culture of medicine rides on the fantasy of being inherently better than mere ordinary people that any attempt to treat physicians in training as fallible mortals would be seen as blasphemous weakness.

This is true but emphasis needs to be put on the fact that humans haven't evolved to be happy while studying non-stop under a ton of stress. The curriculum needs to cut out unnecessary things, enure no one fails and ensure there is enough leisure time for everyone. Until that happens the depression thing will not change and no therapist in the world can do anything about it. "Getting help' is the worst and most useless excuse ever.

 

[Mad Jack]

This is true but emphasis needs to be put on the fact that humans haven't evolved to be happy while studying non-stop under a ton of stress. The curriculum needs to cut out unnecessary things, enure no one fails and ensure there is enough leisure time for everyone. Until that happens the depression thing will not change and no therapist in the world can do anything about it. "Getting help' is the worst and most useless excuse ever.

The only way for all of that to happen would be to significantly lengthen physician training. Most of us don't want that, so a hit to our sanity is the price we pay. Unfortunately, for some the toll is too great. I hate to say it, but if you told me lengthening physicians training by 50% would cut physician suicides by 50% care of more reasonable working hours and conditions, I wouldn't be down with the change because it takes enough time to train as-is. The only large chunks of unnecessary stuff you could cut woyld be in MS1 and 2, which are the easiest part of medical school anyway. People often start to break down in MS3, after they don't match, or during intern year if most of the suicides I've read about are any indication.

 

[Seth Joo]

This is true but emphasis needs to be put on the fact that humans haven't evolved to be happy while studying non-stop under a ton of stress. The curriculum needs to cut out unnecessary things, enure no one fails and ensure there is enough leisure time for everyone. Until that happens the depression thing will not change and no therapist in the world can do anything about it. "Getting help' is the worst and most useless excuse ever.

Problem is even therapists and psychiatrists don't help at times either, sometimes its the environment causing issues, I knew a student from Hawaii in my undergrad who experienced serious emotional issues, she decided to transfer to a school in her home state, things got better.

 

[Stagg737]

Physicians have a particularly worse time though. You can make it through life in pretty much any other career with a mental health issue, but as a physician, it immediately brings your judgment into question and throws your abilities and character under the microscope. The only place that has historically been a worse environment for an individual with mental health problems was the military, but they have had a serious cultural shift that has not yet hit the medical profession.

As to mass shootings, the mental health angle is a bit of a cop out.

http://mobile.nytimes.com/2015/12/16/opinion/dont-blame-mental-illness-for-gun-violence.html?_r=0

I agree with your first point that medicine is it's own special kind of hell in terms of mental health. I just don't think anything in healthcare will change unless the general public can both recognize that physicians are people and not emotionless robots that churn out diagnosis and treatments as well as admitting that mental health is something that needs to be acknowledged and addressed regardless of the situation.

As for the mass shooting article, I don't buy it based on some of the reports the author cited him/herself. He states that "22% of male killers exhibited signs of mental illness", but the analysis that he got that from only included psychotic disorders in that 22%. Of the 189 males that make up the other 78%, 168 had some form of personality disorder, most of which were likely untreated (that includes 11 who were 'rageful', so potentially 157 if those are just isolated incidences of those individuals). So roughly 90% of those individuals committing mass murders (not just shootings) had either a psychotic disorder or a recognizable personality disorder. The study didn't say how many were receiving treatment, but given our society's common view of mental illness, I'd guess a large percentage didn't receive the medical help they needed. Beyond violence against others, I'd argue that self-inflicted violence is an even bigger concern. From your article: "mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms–related fatalities."

I'm not trying to demonize those with a mental condition, or suggest that some kind of action should be taken against them. All I'm saying is that giving mental health the attention it deserves, as a medical condition, will benefit both those suffering from these conditions/illnesses and society as a whole far more than pretending this country doesn't have a mental health problem.

 

[Ismet]

There's definitely room to fix the curriculum. Lots of time wasted for little return and high levels of stress that should be mitigated. The devil's advocate argument is that being a physician is very stressful, there a lot of systems problems that you have to deal with, lots of stress to make administrators happy that don't benefit the physician or patient etc etc. Resiliance is definitely required to make it through the process and not burning out even as an attending. Not sure how to ultimately fix the process. It takes buy in from administrators who are often out of touch with the trainee's plight.

Agreed on both ends. Med school was stressful and I'm sure there are ways to improve things, and in an ideal world, administrators would listen to students and learn about what works and doesn't work. But then again if I didn't build good coping skills in med school, I'm pretty sure these first 2 months of residency would have crushed me.

There's a difference in being paid (good) money to be stressed vs. paying 50k to get stressed daily.

Money doesn't make the stress any better. And you won't be happy about your money situation for years to come. I've been in more stressful situations in my first 2 months of residency than I ever was in med school, and I can tell you that my salary (comes down to $7-8/hour) doesn't make it suck any less. It costs money to teach medical students just like it costs money to teach undergraduates. I'm not saying that there aren't things that can be changed, but you're likely going to be a lot more stressed in the future than you are now, and you need healthy ways to cope with that stress.

 

[girlofgrace7]

Anyone who believe stigmas surrounding mental illness don't exist needs to go spend an hour in the doctor's workroom at the ER. Even medical professionals, who should understand the necessity of seeking help, roll their eyes when someone comes in after a suicide attempt or because they're hallucinating or because they have a psychosomatic illness. It's easy to be compassionate when you have objective information that someone is ill/in pain, but it seems as though compassion goes out the window when someone comes in with mental anguish.

Speaking from experience, stigma was a large reason I waited so long to seek help for depression and anxiety. I struggled with them since junior high school, but I didn't actually seek help until my second year of residency because I was afraid of how I would be viewed, especially in a profession that essentially tells you to suck it up and just stop being sad. Were there other barriers to me not seeking help during medical school? Absolutely. Time was incredibly limited and finding a good therapist was difficult, but I still think stigma affected my decision most. Medicine is not an occupation for the weak... you sleep little, you work hard, you make life-or-death decisions frequently, you come home at the end of the day most of the time physically, mentally, and emotionally exhausted with little time to recharge or take care of yourself. So, no one in medicine wants to be viewed as "weak" by admitting that they need help. I went to an extremely supportive medical school who is doing a lot of research on medical student depression and has made amazing changes to their curriculum based on that (pass/fail grades, counseling resources, a required wellness class, social and extracurricular activities, a monthly half day check-in third year for people to voice concerns in a small group with the other half of the day guaranteed off to do something fun), and those changes did help my mental health immensely during med school, but I still didn't feel safe seeking help for mental health for fear of how it would look if residencies found out.

Medicine is hard. Depression and anxiety make it so much harder than it needs to be. It isn't a sign of weakness to seek help but a sign of strength that you're committed to overcoming and facing things head on. First and foremost, physician, heal thyself.

 

[Mad Jack]

I agree with your first point that medicine is it's own special kind of hell in terms of mental health. I just don't think anything in healthcare will change unless the general public can both recognize that physicians are people and not emotionless robots that churn out diagnosis and treatments as well as admitting that mental health is something that needs to be acknowledged and addressed regardless of the situation.

As for the mass shooting article, I don't buy it based on some of the reports the author cited him/herself. He states that "22% of male killers exhibited signs of mental illness", but the analysis that he got that from only included psychotic disorders in that 22%. Of the 189 males that make up the other 78%, 168 had some form of personality disorder, most of which were likely untreated (that includes 11 who were 'rageful', so potentially 157 if those are just isolated incidences of those individuals). So roughly 90% of those individuals committing mass murders (not just shootings) had either a psychotic disorder or a recognizable personality disorder. The study didn't say how many were receiving treatment, but given our society's common view of mental illness, I'd guess a large percentage didn't receive the medical help they needed. Beyond violence against others, I'd argue that self-inflicted violence is an even bigger concern. From your article: "mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms–related fatalities."

I'm not trying to demonize those with a mental condition, or suggest that some kind of action should be taken against them. All I'm saying is that giving mental health the attention it deserves, as a medical condition, will benefit both those suffering from these conditions/illnesses and society as a whole far more than pretending this country doesn't have a mental health problem.

Personality disorders are not treatable conditions- the only one with any accepted form of treatment is BPD, for which cognitive behavioral therapy has modest improvement in some individuals. Personality disorders are not mental illnesses, they are alternate personality types that are very much a part of who a person is- you can't cure a person of a personality disorder, it is a core part of their psyche. That's why saying improving mental health care will fix these shootings is bull****- they are caused by conditions that are abnormal but have zero effective treatment, medication or therapy-wise.

 

[Brorthopedic]

You know it's a problem when you see this

 

[Ismet]

This is true but emphasis needs to be put on the fact that humans haven't evolved to be happy while studying non-stop under a ton of stress. The curriculum needs to cut out unnecessary things, enure no one fails and ensure there is enough leisure time for everyone. Until that happens the depression thing will not change and no therapist in the world can do anything about it. "Getting help' is the worst and most useless excuse ever.

If you're studying non-stop and you don't have time for any leisure, you're not studying effectively or efficiently. I had plenty of leisure time in med school, but I managed my study time so that I had that time for things I wanted to do. Not sure how you would "ensure" that no one fails - it's not like getting into medical school means you are 100% guaranteed to be a doctor, you still have to work hard and pass the standards. There should be support systems in place to help people who are struggling academically or mentally in order to prevent failure, but there's no way to ensure that no one would fail.

You're entering a stressful profession with very long work hours. All the more reason to figure out how to obtain and maintain a good work-life balance early on. And "getting help" is not an "excuse." There are clearly many people who are able to get through it and do well, just like there are clearly many people who struggle greatly and there's no shame in needing help to get through.

 

[Seth Joo]

If you're studying non-stop and you don't have time for any leisure, you're not studying effectively or efficiently. I had plenty of leisure time in med school, but I managed my study time so that I had that time for things I wanted to do. Not sure how you would "ensure" that no one fails - it's not like getting into medical school means you are 100% guaranteed to be a doctor, you still have to work hard and pass the standards. There should be support systems in place to help people who are struggling academically or mentally in order to prevent failure, but there's no way to ensure that no one would fail.

You're entering a stressful profession with very long work hours. All the more reason to figure out how to obtain and maintain a good work-life balance early on.

I think its more complicated than just study time and leisure time, some people I knew in medical school had personal and family problems outside of school, often times these issues that are outside of school are not resolved and continue while people are in medical school, it can compound people's stress. I had a married classmate whose wife constantly got into arguments about money and his kids while he was in school and that was one his biggest sources of stress as a student. Academics were not his main problem.

 

[Ismet]

I think its more complicated than just study time and leisure time, some people I knew in medical school had personal and family problems outside of school, often times these issues that are outside of school are not resolved and continue while people are in medical school, it can compound people's stress. I had a married classmate whose wife constantly got into arguments about money and his kids while he was in school and that was one his biggest sources of stress as a student.

I agree. I was just replying directly to that user's comment which focuses on studying, stress, and lack of time for leisure.

The main things I went to talk to our school counselor about were things in my personal and family life that were affecting my ability to concentrate on school.

 

[FlowersFromTheSun]

wow is med school and residency that bad?

Yes.

if your self worth is wrapped up in academic achievement and you struggle with med school it's really bad. If you need free time to relax and social to maintain your mental health, it's bad. If you have a bunch crappy stuff going on in your personal life and you can't attend to it as you need to because of medical school it's bad. You can make huge sacrifices to get through medical school only to discover that residency is actually even worse.

There's a reason the suicide rate for doctors is higher than the general population.

I'd get out of medicine if I saw a way to do it, but, financially, I don't.

 

[bannie22]

one of the most stressful occupations in United States. significant time and money invested, with little returns except to fufill our internal desire to do others good. only oneself can decide if its worth it at all.

 

[NWwildcat2013]

Yes.

if your self worth is wrapped up in academic achievement and you struggle with med school it's really bad. If you need free time to relax and social to maintain your mental health, it's bad. If you have a bunch crappy stuff going on in your personal life and you can't attend to it as you need to because of medical school it's bad. You can make huge sacrifices to get through medical school only to discover that residency is actually even worse.

There's a reason the suicide rate for doctors is higher than the general population.

I'd get out of medicine if I saw a way to do it, but, financially, I don't.

Medicine really sucks and I think its impossible to know ahead of time and make an informed decision about going to medical school. At this point, I want to pick the lowest stress specialty that still interests me regardless of pay. I didn't sign up to kill myself working long hours with super high stress levels.

 

[bc65]

Med school can bring out the worst in anyone, and residency is worse.

Realize that many, if not most, pre-meds are used to being the smartest person in their class, and have been so their whole lives. Now 50% of them are in the bottom half of their class. In my school we were told that most of us would fail at least one exam. A lot of people just can't handle being demoted from genius to average, let alone below average. Add sleep deprivation, competition, and huge loans to that, and even people with no underlying depression or other mental illness or compromise can go downhill fast.

 

[ACSurgeon]

There's a difference in being paid (good) money to be stressed vs. paying 50k to get stressed daily.

I understand that. I also understand the insecurity that comes with being a student/resident which compounds the stress since you have no option to quit and go elsewhere.

 

[zeppelinpage4]

^^ lazymed, I agree. I think the debt plays a HUGE role as well. Not only is it a tough process, but there really aren't any simple/financially sensible alternatives for students with 3-4 years of med school debt who want to get out.. Some days, that debt and the potential social shame I'd face were all that stood between me and walking out. Glad I didn't, but I don't know any other career where you really are stuck in it for a decade until the training is done.

Med school can bring out the worst in anyone, and residency is worse.

Realize that many, if not most, pre-meds are used to being the smartest person in their class, and have been so their whole lives. Now 50% of them are in the bottom half of their class. In my school we were told that most of us would fail at least one exam. A lot of people just can't handle being demoted from genius to average, let alone below average. Add sleep deprivation, competition, and huge loans to that, and even people with no underlying depression or other mental illness or compromise can go downhill fast.

Throw on personal life related problems on top of that too while you're at it. I've had classmates fall ill, and raise families while doing all this. I have no idea how they do it, but respect to them.

 

[Stagg737]

Personality disorders are not treatable conditions- the only one with any accepted form of treatment is BPD, for which cognitive behavioral therapy has modest improvement in some individuals. Personality disorders are not mental illnesses, they are alternate personality types that are very much a part of who a person is- you can't cure a person of a personality disorder, it is a core part of their psyche. That's why saying improving mental health care will fix these shootings is bull****- they are caused by conditions that are abnormal but have zero effective treatment, medication or therapy-wise.

Depending on the personality type and severity it can be treatable. The article was ambiguous with 'personality disorders' and included diagnoses such as "rageful personality" (treatable) and "depressive personality" (treatable). While many personality disorders may not be treatable, severe cases of certain disorders like paranoid PD, which may actually be misclassified cases of other disorders (especially 30-40 years ago), can certainly be minimized to help the individual lead a more functional life. As you said, in many cases it's just a part of their psyche which can potentially be controlled if the right motivation and tools are accessible.

Even if you think that's total bs, 22% is not an insignificant number. Going off the sited study, that's over 100 people who may still be alive instead of murdered because someone's mental illness (either severe depression or psychosis) wasn't recognized. I'm not trying to say mental illness is the only cause of mass shootings, or even the main one. But to say that making a point of mental health's role is a cop out is just like brushing the issue under the rug, which is disappointing to hear from someone hoping to go into psych.

 

[Seth Joo]

Depending on the personality type and severity it can be treatable. The article was ambiguous with 'personality disorders' and included diagnoses such as "rageful personality" (treatable) and "depressive personality" (treatable). While many personality disorders may not be treatable, severe cases of certain disorders like paranoid PD, which may actually be misclassified cases of other disorders (especially 30-40 years ago), can certainly be minimized to help the individual lead a more functional life. As you said, in many cases it's just a part of their psyche which can potentially be controlled if the right motivation and tools are accessible.

Even if you think that's total bs, 22% is not an insignificant number. Going off the sited study, that's over 100 people who may still be alive instead of murdered because someone's mental illness (either severe depression or psychosis) wasn't recognized. I'm not trying to say mental illness is the only cause of mass shootings, or even the main one. But to say that making a point of mental health's role is a cop out is just like brushing the issue under the rug, which is disappointing to hear from someone hoping to go into psych.

...

 

[Mad Jack]

Depending on the personality type and severity it can be treatable. The article was ambiguous with 'personality disorders' and included diagnoses such as "rageful personality" (treatable) and "depressive personality" (treatable). While many personality disorders may not be treatable, severe cases of certain disorders like paranoid PD, which may actually be misclassified cases of other disorders (especially 30-40 years ago), can certainly be minimized to help the individual lead a more functional life. As you said, in many cases it's just a part of their psyche which can potentially be controlled if the right motivation and tools are accessible.

Even if you think that's total bs, 22% is not an insignificant number. Going off the sited study, that's over 100 people who may still be alive instead of murdered because someone's mental illness (either severe depression or psychosis) wasn't recognized. I'm not trying to say mental illness is the only cause of mass shootings, or even the main one. But to say that making a point of mental health's role is a cop out is just like brushing the issue under the rug, which is disappointing to hear from someone hoping to go into psych.

Those aren't recognized personality disorders. As to treatment, I'm going by the actual guidelines for treatment of real personality disorders, of which the only treatable one is BPD. That you take the public's view of this as an issue of mental illness shows how little you have read from actual forensic psychiatrists and psychiatric experts in the field. I've actually studied the subject pretty thoroughly, and agree with the majority expert opinion (rather than the political talking point) that, and I quote:

"It would be ridiculous to hope that doing something about the mental health system will stop these mass murders," said Michael Stone, a forensic psychiatrist at the Columbia College of Physicians and Surgeons and author of "The Anatomy of Evil," which examines the personalities of brutal killers. "It's really folly."

"I think it's the human inclination to explain behavior that is frightening and tragic as the result of mental illness because it's very hard to understand that individuals do not have to be mentally ill to do something frightening and tragic," said J. Reid Meloy, a forensic psychiatry professor at the University of California at San Diego who studies mass killings and consults with the FBI.

How could a system be devised to triangulate the risk and identify real threats? Not easily. Or ever.

"From a psychiatric perspective," Gold said, "I don't think you can design an intervention to prevent mass shootings."

http://www.azcentral.com/story/news...reforms-wont-curtail-mass-shootings/84497048/

The public wants to believe these people have diagnosable and treatable mental illnesses, but I've never read an expert opinion to that effect. That is where the disconnect with the public comes in- they think these guys are disconnected from reality, delusional in some way. But in reality, they have the same personality type as any garden variety killer- they aren't any different from some gang member in Mexico that murdered half a dozen people to for and buried them in shallow graves. It's the same personality traits that cluster in these people- antisocial, paranoid, borderline, often with a degree of narcissism. But these traits are also present in a great number of the healthy public. Surgeons, for instance, often possess the same cluster of traits that make people think these killers are defective individuals, yet function extremely well and productively for society. That is why people in the forensics field laugh when others say mental illness is at the root of these crimes- these guys generally possess psychological profiles that are variants of normal, and if you wanted to watch everyone that had them, good be watching damn near a quarter of society. It also infantilizes violence, because nothing separates most mass shooters from ordinary murderers on a psychiatric profile, yet you don't see the public trying to claim every murder in the inner city is precipitated by mental illness.

I don't believe we should be stigmatizing the mentally ill by associating those with personality disorders, which are by definition not forms of mental illness, with them. That's how we ended up with a society that has a widespread fear of schizophrenics, despite the fact that they are less likely to harm a member of the public than vice versa. The public has grappled with tragedy they don't understand by lumping it with a group of people that are misunderstood because that is convenient for them, because the idea that these people were fundamentally broken on a psychological level that merely needed treatment is comforting, because it gives them hope that by throwing money in a direction they can fix things. That's not reality though, and I've never read a single expert report or research paper from a forensic psychiatrist claiming otherwise.

Thanks for the Bernett in regard to psychiatry though. It just goes to show how little must people actually understand about mental illness that you would say as much, when every expert in the field is actually on my side in regard to the issue. The issues you would want to fight are so widespread that the only solution would be Big Brother style monitoring of virtually everyone, because there aren't many people that don't possess a trait or two that could give them a tendency toward violence. 1% of the public has psychopathic/antisocial personality disorder, do you just want them all on therapy forever even though no therapy is proven to work and most of them aren't and never will be criminals just in case? Do you want the one in ten Americans with severe anger issues forced into treatment as well, despite the fact that most of them will never commit a violent offense in their life and don't want treatment? Should we monitor all of the 6% of people with BPD and throw them on intensive therapy every time their behavior sets off red flags?

I could keep going, but the thing is, you're looking to treat a very, very large percent of the population, most of which do not have any over signs of true mental illness, in the hopes that we can catch the one in a million that ends up being a mass shooter. It's invasive. It's impractical. It can't work. And it is a cop out of a solution thrown about by politicians looking to blame anything but guns. So they blame the one group that doesn't have anybody living for them- individuals with mental illness.

 

[Mad Jack]

Depending on the personality type and severity it can be treatable. The article was ambiguous with 'personality disorders' and included diagnoses such as "rageful personality" (treatable) and "depressive personality" (treatable). While many personality disorders may not be treatable, severe cases of certain disorders like paranoid PD, which may actually be misclassified cases of other disorders (especially 30-40 years ago), can certainly be minimized to help the individual lead a more functional life. As you said, in many cases it's just a part of their psyche which can potentially be controlled if the right motivation and tools are accessible.

Even if you think that's total bs, 22% is not an insignificant number. Going off the sited study, that's over 100 people who may still be alive instead of murdered because someone's mental illness (either severe depression or psychosis) wasn't recognized. I'm not trying to say mental illness is the only cause of mass shootings, or even the main one. But to say that making a point of mental health's role is a cop out is just like brushing the issue under the rug, which is disappointing to hear from someone hoping to go into psych.

Oh, and as to the 22% remainder, that puts them right about at the level with ordinary Americans, of which 18.1% have a mental illness and half will suffer from one or more within their lifetime. Yes, we need better mental health care, but no, mass shootings are not a justification for it. They're as likely to be mentally ill as the general population. That would be like justifying spending more on driving safety courses for men because 50% of automobile accidents involve men- It's a stupid statement to make.

You want a justification for better mental health care? Instead of using the 100 or so victims of mentally ill shooters (many of whom, surprise, already were in treatment), why not use the 117 people a day that commit suicide? Everyone wants to talk about mental health funding in regard to sensational cases, but when it comes to the real issues, people don't say a damn thing. I want more funding, but for the right things and the right reasons.

 

[Stagg737]

@Mad Jack , I'm not sure why, but you keep twisting the arguments I'm making. I never said that treating mental illness and raising awareness would end mass shootings, and I'm not sure where you got the impression that I said that. I was trying to say that greater awareness towards mental health and breaking down the stigma some people perceive would be brought against them for seeking could prevent some mass shootings, particularly the ones involving mental illnesses like severe depression or uncontrolled psychotic disorders. I'm not saying that greater awareness will end the shootings, or that these people should be stigmatized. However, if a person has a disorder/illness and is afraid to come forward, or comes forward and isn't recognized, that's a problem, and it happens far more often than it should in our society. Adam Lanza is a perfect example of someone with psychiatric problems that were known about for years but didn't receive the treatment he needed and ended up committing a heinous act of violence. So am I trying to advocate monitoring the 1% of the population with A-SPD? No. Am I saying we need to "force the one in ten Americans with anger issues into treatment" (which I realize isn't a personality disorder along with "depressive personality disorder", which is why I said the article was ambiguous and put that "disorder" in quotes)? No. What I am arguing is that there are too many cases where the condition is very recognizable or a person with a very severe personality disorder goes completely ignored. That's a problem, and that was what I was saying I was disappointed that you weren't acknowledging.

As for your point on suicide, I already made that argument but you seemed to either skim over it or ignore it altogether, so I'll re-quote myself:

Beyond violence against others, I'd argue that self-inflicted violence is an even bigger concern. From your article: "mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms–related fatalities."

Either way you look at it, it doesn't change that we both want greater awareness and an end to the negative connotations often associated with people suffering from mental illness. To get back to the original topic, if we can't recognize that this is a problem in general society, nothing is going to change in the medical world where we're put on pedestals and expected to be shining examples of intelligent, well-adjusted, and healthy individuals all-around.

 

[Mad Jack]

@Mad Jack , I'm not sure why, but you keep twisting the arguments I'm making. I never said that treating mental illness and raising awareness would end mass shootings, and I'm not sure where you got the impression that I said that. I was trying to say that greater awareness towards mental health and breaking down the stigma some people perceive would be brought against them for seeking could prevent some mass shootings, particularly the ones involving mental illnesses like severe depression or uncontrolled psychotic disorders. I'm not saying that greater awareness will end the shootings, or that these people should be stigmatized. However, if a person has a disorder/illness and is afraid to come forward, or comes forward and isn't recognized, that's a problem, and it happens far more often than it should in our society. Adam Lanza is a perfect example of someone with psychiatric problems that were known about for years but didn't receive the treatment he needed and ended up committing a heinous act of violence. So am I trying to advocate monitoring the 1% of the population with A-SPD? No. Am I saying we need to "force the one in ten Americans with anger issues into treatment" (which I realize isn't a personality disorder along with "depressive personality disorder", which is why I said the article was ambiguous and put that "disorder" in quotes)? No. What I am arguing is that there are too many cases where the condition is very recognizable or a person with a very severe personality disorder goes completely ignored. That's a problem, and that was what I was saying I was disappointed that you weren't acknowledging.

As for your point on suicide, I already made that argument but you seemed to either skim over it or ignore it altogether, so I'll re-quote myself:



Either way you look at it, it doesn't change that we both want greater awareness and an end to the negative connotations often associated with people suffering from mental illness. To get back to the original topic, if we can't recognize that this is a problem in general society, nothing is going to change in the medical world where we're put on pedestals and expected to be shining examples of intelligent, well-adjusted, and healthy individuals all-around.

My only issue was linking it to shootings, which tends to have the opposite effect of destigmatization in addition to being a fairly poor argument for mental health care in general. I take issue with such associations precisely because they are more likely to push people farther away, rather than closer to, much-needed psychiatric care.

 

[freudianslipp]

I graduated from Mount Sinai aka "ICAHN" last year and I am convinced that place is toxic. All 4 years I was there I was always saying a student would kill themselves and only then would the school change. The administration at Mount Sinai don't give a **** about the students. All they care about is money and rankings (which they want to pull out of since they aren't getting any higher on the list). The grading system is cut throat and it makes the students look terrible when applying for residency. All in all the place is terrible for students and I wouldn't let my worst enemy go to that school. The school where I'm doing my residency now is totally different--the med students are happier and less stressed and there is more support. It doesn't have to be the Sinai way.

 

[Mass Effect]

You guys can argue politics if you want, but you're missing the bigger picture here. Yes, there's stigma (only the ignorant believe there isn't). Yes, there are very real barriers to treatment. But the bottom line is, there should be nothing to barrier in the first place. Medical students and doctors commit suicide because (a) they are, for the most part, type A personalities who expect a lot of out of themselves and (b) they're surrounded by type A personalities who expect a lot of out of them. When they don't achieve to the level they're "supposed" to, they feel humiliated and in many cases, they are publicly humiliated, ridiculed, and bullied. That is a fact. Here's another fact for you: there is a direct correlation between public humiliation and suicide. And yet another fact: in no other workplace/industry would public humiliation be tolerated, condoned, or advocated. Students and residents are vulnerable because a dismissal isn't simply a firing; it's a career-ender and ticket to bankruptcy. Those in power positions know this and take advantage of it. It's a brutal field that feeds off hazing its young.

So you guys can argue mass murderers, personality disorders, and all that jazz, but the problem is much simpler, much more immediate, and much easier to fix once it's acknowledged without the red herrings.

 

[Zyra]

wow is med school and residency that bad?

This happens all the time in NYC and more often with investments bankers (who work longer hours than residents on average...)....it probably happens due to some combination of (1) extreme pressure to succeed/please others, (2) coming off of an all nighter and therefore you're out of it, and (2) inability to see the big picture in life. Life doesn't need to suck 24/7 and there are tons of other careers out there that may be more suitable.

 

[Mr Roboto]

This happens all the time in NYC and more often with investments bankers (who work longer hours than residents on average...)....it probably happens due to some combination of (1) extreme pressure to succeed/please others, (2) coming off of an all nighter and therefore you're out of it, and (2) inability to see the big picture in life. Life doesn't need to suck 24/7 and there are tons of other careers out there that may be more suitable.

Investment bankers aren't making $48,000 a year while getting **** on by everyone, though.

 

[Zyra]

Investment bankers aren't making $48,000 a year while getting **** on by everyone, though.

Yeah, but residents only have to do it for what, 4 years? You can also choose "easier" fields if you want to in medicine. Investment bankers don't really have a light at the end of the tunnel - their exit ops are jobs with bad, but less bad, hours or exiting the field. Burnout rate is really high in investment banking - the majority are gone within 2-3 years, before they start making lots of money. And I'm not exaggerating when I say they work 80-100 hour weeks on average...I've worked with lots of bankers who respond to emails within 5 minutes at 4 am. They often pull like 3 all nighters in a row and are still expected to maintain their work quality. Cocaine use is supposedly common among bankers just so they can stay up for multiple nights in a row to work.

 

[Psai]

Yeah, but residents only have to do it for what, 4 years? You can also choose "easier" fields if you want to in medicine. Investment bankers don't really have a light at the end of the tunnel - their exit ops are jobs with bad, but less bad, hours or exiting the field. Burnout rate is really high in investment banking - the majority are gone within 2-3 years, before they start making lots of money. And I'm not exaggerating when I say they work 80-100 hour weeks on average...I've worked with lots of bankers who respond to emails within 5 minutes at 4 am. They often pull like 3 all nighters in a row and are still expected to maintain their work quality. Cocaine use is supposedly common among bankers just so they can stay up for multiple nights in a row to work.

Is an 80-100 hour workweek supposed to be impressive...?

 

[Zyra]

Is an 80-100 hour workweek supposed to be impressive...?

Nah, not just ONE 80-100 hour work week. Unless you're on cocaine/other stimulants, averaging 80-100 hour work weeks for multiple years in a row is pretty impressive. I'm also not talking about just sitting there doing nothing/jacking off for 80-100 hours a week - they're actually working on detail oriented stuff and are required to perform to a high caliber.

Investment bankers have the worst hours out of anyone - I don't envy them, although if you can make it past a couple of years and close a few big deals, you can become a multi millionaire overnight.

 

[Stagg737]

Nah, not just ONE 80-100 hour work week. Unless you're on cocaine/other stimulants, averaging 80-100 hour work weeks for multiple years in a row is pretty impressive. I'm also not talking about just sitting there doing nothing/jacking off for 80-100 hours a week - they're actually working on detail oriented stuff and are required to perform to a high caliber.

Investment bankers have the worst hours out of anyone - I don't envy them, although if you can make it past a couple of years and close a few big deals, you can become a multi millionaire overnight.

Not trying to make this a d*** measuring contest, but residents averaging 100+ hour work weeks wasn't uncommon before the 80-hour work week law was implemented. Especially in the surgical fields. I shadowed a few orthos that all said they averaged 110-120 hour weeks during residency which is something that made me seriously reconsider medicine at one point. We all know the burnout is real and that it's not unique to medicine. It doesn't change how much it sucks.

 

[lymphocyte]

Yeah, but residents only have to do it for what, 4 years? You can also choose "easier" fields if you want to in medicine. Investment bankers don't really have a light at the end of the tunnel - their exit ops are jobs with bad, but less bad, hours or exiting the field. Burnout rate is really high in investment banking - the majority are gone within 2-3 years, before they start making lots of money. And I'm not exaggerating when I say they work 80-100 hour weeks on average...I've worked with lots of bankers who respond to emails within 5 minutes at 4 am. They often pull like 3 all nighters in a row and are still expected to maintain their work quality. Cocaine use is supposedly common among bankers just so they can stay up for multiple nights in a row to work.

This is such a bizarre and frankly eye-rolling discussion to me.

My mom worked as a dishwasher. My dad worked at 7-11. Both my parents graduated from the best universities in their home country overseas. My brother had a renal transplant when he was 13. We were all on food stamps. Do you really think bankers and residents are the only ones working 80+ hours a week? Do you really think they're the only ones being routinely humiliated? Lots of people work hard, miserable, and soul-crushing jobs. Most of those people are poor people, with no chance of eventually becoming an attending or a managing director at an investment bank. Being a doctor is undoubtedly high-risk, but what's much higher risk is being a forester, farmer, or general labourer. Where's the perspective here?

Still. Everybody is allowed to hurt. But comparing how much people hurt is utterly pointless. And dude, why? Why are you even bringing this up, when you're neither an investment banker nor a medical student? As somebody who happily walked away from a BB IB job offer (but with quite a few friends that didn't), I can confidently say you are exaggerating, probably as a kind of fantastical wish fulfilment (like when coach-potatoes trump up how hard-awesome it is to be a Marine or something--yeah it's pretty hard-awesome but 1) the couch-potato actually has zero clue except for what they've obsessively gleaned from the Internet, so 2) they exaggerate in proportion to their own fantasy. If you don't know what I'm talking about, wander over to the pre-med forums sometime.)

Why do I feel compelled to respond? Because we rarely get to openly talk about suicide and mental health, particularly as it affects student doctors. (This is the allopathic forum, right?) Pointing out how others have it worse (and wrongly too)... accomplishes what exactly?

 

[Ismet]

Nah, not just ONE 80-100 hour work week. Unless you're on cocaine/other stimulants, averaging 80-100 hour work weeks for multiple years in a row is pretty impressive. I'm also not talking about just sitting there doing nothing/jacking off for 80-100 hours a week - they're actually working on detail oriented stuff and are required to perform to a high caliber.

Investment bankers have the worst hours out of anyone - I don't envy them, although if you can make it past a couple of years and close a few big deals, you can become a multi millionaire overnight.

I know you're not in med school, and I'm not sure how familiar you are with medical training in general, but I'm 2 months into residency and I've worked 80 hour weeks every single week, and that's just time physically in the hospital. Work in the time spent at home finishing notes, it's well over 100. And I'm not even in a surgical specialty, I'm in what you called an "easier" field. And yeah we're not sitting there doing nothing, we're taking care of patients and we're expected to perform to a high caliber, because a mistake can mean patient morbidity or mortality.

I have no doubt that IB is crazy stressful and a lot of hard work, but I'm not about to compare it to anything because I have no experience or insight into that field. Just like you don't seem to have much insight into a career in medicine if you think it's just a once in a while 80 hour work week.

 

[Zyra]

I know you're not in med school, and I'm not sure how familiar you are with medical training in general, but I'm 2 months into residency and I've worked 80 hour weeks every single week, and that's just time physically in the hospital. Work in the time spent at home finishing notes, it's well over 100. And I'm not even in a surgical specialty, I'm in what you called an "easier" field. And yeah we're not sitting there doing nothing, we're taking care of patients and we're expected to perform to a high caliber, because a mistake can mean patient morbidity or mortality.

I have no doubt that IB is crazy stressful and a lot of hard work, but I'm not about to compare it to anything because I have no experience or insight into that field. Just like you don't seem to have much insight into a career in medicine if you think it's just a once in a while 80 hour work week.

What about the 80 hour per week cap? I have a couple residents in my family right now and none are working 80 hour weeks on average - they are generally in "easier" specialties though.

I know that the hours required for residencies vary widely. I know surgeons work a ton, and apparently anesthesiologists have comparatively chill hours.

 

[Zyra]

This is such a bizarre and frankly eye-rolling discussion to me.

My mom worked as a dishwasher. My dad worked at 7-11. Both my parents graduated from the best universities in their home country overseas. My brother had a renal transplant when he was 13. We were all on food stamps. Do you really think bankers and residents are the only ones working 80+ hours a week? Do you really think they're the only ones being routinely humiliated? Lots of people work hard, miserable, and soul-crushing jobs. Most of those people are poor people, with no chance of eventually becoming an attending or a managing director at an investment bank. Being a doctor is undoubtedly high-risk, but what's much higher risk is being a forester, farmer, or general labourer. Where's the perspective here?

Still. Everybody is allowed to hurt. But comparing how much people hurt is so utterly pointless. And dude, why? Why are you even bringing this up, when you're neither an investment banker nor a medical student? As somebody who happily walked away from a BB IB job offer (but with quite a few friends that didn't), I can confidently say you are exaggerating, probably as a kind of fantastical wish fulfilment (like when coach-potatoes trump up how hard-awesome it is to be a Marine or something--yeah it's pretty hard-awesome but 1) the couch-potato actually has zero clue except for what they've obsessively gleaned from the Internet, so 2) they exaggerate in proportion to their own fantasy. If you don't know what I'm talking about, wander over to the pre-med forums sometime.)

Why do I feel compelled to respond? Because we rarely get to openly talk about suicide and mental health, particularly as it affects student doctors. (This is the allopathic forum, right?) Pointing out how others have it worse (and wrongly too)... accomplishes what exactly?

If you read my original post, I was pointing out that this is a pretty common occurrence in NYC and it's usually about i-bankers. The lack of sleep inevitably contributes to mental health problems, which is why how many hours people work is relevant.Someone came in and compared resident pay with banker pay...

As for bankers, a lot of them abuse drugs to help them work long hours (not to mention a lot of NYC white collar professionals use them to help them work long hours in general) - which I'm sure doesn't help with improving their mental state.

I may not be a banker, but I have worked with a bunch of them and have worked for a few years on Wall Street and am generally familiar with banker culture.

Anyway, your point is valid - a lot of people in all industries work hard and work long hours. I think students fail to understand this and think that "school" is as hard as it gets...when it might be the easiest time of your life.

 

[Ismet]

What about the 80 hour cap? I have a few residents in my family and none are working 80 hour weeks on average - they are generally in "easier" specialties though.

1) Work hours are self-reported and easily fudged. They also don't take into account travel time or time working at home.

2) The "cap" is 80 hours per week averaged over 4 weeks. Our days off are averaged over 4 weeks too. So people can work 9 days straight, working 14+ hour days and be way over 80 hours for that week, but then have 2 days off the following week and come out even. As long as you say you work 320 hours or less in a 4 week period, you're under the cap.