Mental Health in Medical School

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dsm5md

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I was very moved by the revelation that a medical student committed suicide in April 2013 at Wake Forest School of Medicine: Kaitlyn Elkins (RIP). She had finished her 2nd year of MD school and was about to start her clinical rotations.

Her mother has lovingly posted on SDN about the death of her daughter, which many of us "mourned" as best we could on SDN without even knowing her. It moved many us.

It got me to think alot about the students in my school and I wondered who else was having a very difficult time mentally, emotionally, psychologically, spiritually, etc. So I created this profile to start looking at what medical school does to us medical students, how we can cope as individuals, support each other, and/or reach out for assistance in what ever way necessary: talking to a professor, seeing the Dean, meeting with a religious cleric, confiding in a classmate, going home to talk to family, etc.

If you are comfortable in talking about your own personal struggles in medical school in an effort to help others here, this might be an opportunity to do so. There is alot of insight to be gathered from SDN. Let's create a safe environment here to talk about our mental health in medical school

Shalom

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I think it requires some depth of introspection. I feel down in the dumps sometimes, but I wouldn't consider it a chronic enough thing for it to turn into depression. Going through SIGECAPS once in a while to see if you meet any criteria (as weird as it is to ask yourself those questions) proves to me that whatever I'm feeling isn't that bad, and I'm just dealing with the crappiness that is studying for shelfs/step 2 without having anytime to just lounge/relax/vacation for more than a weekend.
 
A post that has some depth and soul. Wow. Nice to see.

I attend a Catholic parish where the priests have befriended me. They became like family for me prior to my marriage family recently coming to live with me last month. One of the Catholic priests is a few years older than me, and he is also a non-trad student, working on a PhD in another field. He has told me he was recently suicidal, is on anti-depressants, had left the Church in the past, and dealing with alot. You would never know it when you hear him preach. He's very dynamic. He says he has more to tell me but he doesn't want to disappoint me. I tell him I am too old to be disappointed in people anymore. Nothing phases me. So I just listen. He is a three time cancer survivor.

A younger friend recently came out of the closet. She is a black, petite, beautiful young woman in her late 20s, just graduated from medical school, and was recently suicidal. She asked me to meet with her parents and her over the holidays so that she could come out to them. The mother is an Evangelical "Christian" bible thumper and it has not been a good situation in their house due to my friend's hints. She tried to commit suicide - slashed wrists. I told her to call me next time she felt that way. I met her during my Post-Bacc years. We maintain a close friendship across the miles. I just listen. Encourage. Remind her she is beautiful because she is, and is going to set the world on fire as a black, female, lesbian, gifted, articulate physician. She just needs to be reminded that she is not alone, some people do care and accept her the way she is, that things get better.

A friend of mine is an MD. A former devout Orthodox Jew. Was an RN, then got his PA, then went for his MD 30 years later as a non-trad . Divorced, children ran into drugs and the law, ex-wife went Bipolar and on disability, my Jewish friend became suicidal. We met regularly when I was home. I just listen. I remind him things get better. They always do. He's alright in God's eyes even if he is no longer a practicing Jew. He's still a great Jew in my eyes.

As I get older I meet people who tell me their personal stories. I'm not a bs kind of guy, I am much more vested in people and relationships than most others today. I find that people just need to be told someone cares, that they will be OK, that things will get better. Most people who say they are going to commit suicide are crying out for help. A cry for help is a cry of someone feeling very detached from the world, and they want the pain to stop.

In our current western civilization where we are running away from each other more and more, hiding behind computers, and not breaking bread with other as much, I find Mother Terersa of Calcutta's observation more and more true: "America's poverty is loneliness".

I feel badly for people who are lonely. Being married has it perks. I think kids today have it much harder than I did.

It gets better. If you are surrounded by people whom you know love you, show up for you and care for you, you will not feel a sense of wanting to end your life. But first you have to tell them like my friends above did. Don't end it.

Salut!
 
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Without going through my whole story (it's on here in previous posts for anyone interested), I can say that I'm doing better now on 225 mg Effexor daily. I don't really recommend this drug as I have a ton of side effects that are annoying but manageable. In terms of mood, however, it did the trick.

I do find myself questioning whether this is the real me breaking through the depression, or is this a different person "created" by the drug. I do a lot of self reflecting, and I can honestly say that I'm now bolder both socially and academically, and I don't really care as much about grades, future career, even relationships. Everything just seems to slide off.

It's not something that I really feel comfortable sharing, with anyone, although I've wanted to several times. Only a couple people know besides my psychiatrist, and one of those I accidentally let slip to when I was drunk as piss.

Med school has not gone very well for me, but I haven't failed anything and I'm almost into 4th year, so I guess I can't complain too much.
 
Without going through my whole story (it's on here in previous posts for anyone interested), I can say that I'm doing better now on 225 mg Effexor daily. I don't really recommend this drug as I have a ton of side effects that are annoying but manageable. In terms of mood, however, it did the trick.
what are some of the annoying side effects?
you're allowed to drink on that dosage?
 
I now have permanent (at least on the med) hyperreflexia in all 4 limbs and clonus on one side, which is more annoying than anything. I have a fine tremor in my hands that is worst several hours after taking it. Headaches when it starts wearing off at night, increased HR, constipation, decreased appetite.

I'm not supposed to drink on it according to my doc, but I do anyway and it hasn't killed me yet so it's probably ok.
 
I now have permanent (at least on the med) hyperreflexia in all 4 limbs and clonus on one side, which is more annoying than anything. I have a fine tremor in my hands that is worst several hours after taking it. Headaches when it starts wearing off at night, increased HR, constipation, decreased appetite.

I'm not supposed to drink on it according to my doc, but I do anyway and it hasn't killed me yet so it's probably ok.

i assume you already tried it at lower dose?
 
Yeah it actually made me more depressed I guess I needed the Norepi activity as well.
 
Yeah it actually made me more depressed I guess I needed the Norepi activity as well.

Why not try combining it with Benztropine/anti-cholinergic or a B-blocker? It'd help with the tremors.

Actually...don't listen to me. I'm just a med student.
 
Depression often stems from not having to take care of someone and not having someone caring about us. Medical education is though, even if you aim for a stable path, chances are you are going to move 2 or 3 times from city to city. If you focus too much, you will end up having those moments where you think, wtf am i doing, unless you are a gunner drone, and that is perfectly fine, and actually a great asset for any hospital ceo.
 
Depression often stems from not having to take care of someone and not having someone caring about us. Medical education is though, even if you aim for a stable path, chances are you are going to move 2 or 3 times from city to city. If you focus too much, you will end up having those moments where you think, wtf am i doing, unless you are a gunner drone, and that is perfectly fine, and actually a great asset for any hospital ceo.

I think this is often a chemical or genetic problem - only mildly exacerbated by environmental factors.
 
Major depressive disorder is genetic and chemical related, it accounts for the minority of depressions. It is the one which responds better to pharms.
Reactive depression is the most common and the environment has a huge impact. The most effective treatment is behavioural changes.
 
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A common ICD9 phrase is "adjustment disorder" which applies well to the medical school situation.

http://en.wikipedia.org/wiki/Adjustment_disorder

According to the DSM IV-TR, the development of the emotional or behavioral symptoms of this diagnosis have to occur within three months of the onset of the identifiable stressor(s).[8] Some emotional signs of AD are sadness, hopelessness, lack of enjoyment, crying spells, nervousness, anxiety, worry, desperation, trouble sleeping, difficulty concentrating, feeling overwhelmed and thoughts of suicide. Some behavioral signs of AD are fighting, reckless driving, ignoring important tasks such as bills or homework, avoiding family or friends, performing poorly in school, skipping school, or vandalizing property.[9] However, the stress-related disturbance does not only exacerbation of a pre-existing axis 1 or axis 2 disorder and cannot be diagnostic as axis 1 disorder.[10]
Suicidal behavior is prominent among people with AD of all ages and up to one fifth of adolescent suicide victims may have an adjustment disorder. Bronish and Hecht (1989) found that 70% of a series of patients with AD attempted suicide immediately before their index admission and they remitted faster than a comparison group with major depression.[11] Asnis et al. (1993) found that AD patients report persistent ideation or suicide attempts less frequently than those diagnosed with major depression.[12] According to a study on 82 AD patients at a clinic, Bolu et al. (2012) found that 22 (26.8%) of these patients were admitted due to suicidal attempt, consistent with previous findings. In addition, it was found that 15 of these 22 patients chose suicidal methods that involved high chances of being saved.[13] Henriksson et al. (2005) states statistically that the stressors are of one half related to parental issues and one third in peer issues
 
This is the text of a PM I sent awhile ago, but it pretty decently sums up my own experience with depression (though it was many many years ago). Also, it dishes out my advice to any med students or people in general that might be struggling with depression, but haven't sought help yet or are just in the process of starting to seek help.

If you think that you might not have depression because you're high-functioning, from own experience, that's not true at all. I had depression in highschool (admittedly, a far less work-heavy time), and when I finally sought help (after excruciating months of 'sucking it up' and dealing with it on my own), I initially encountered disbelief because I still had good grades. There's always the possibility that you are, in fact, smart, and what's low-functioning for you might match others' best efforts.
Regarding the more practical experience of going to therapy and taking antidepressants, if you are struggling with depression or depression-like symptoms, this is ABSOLUTELY what you should do. At least, it's what worked for me. The therapy is a good place to start, to at least have a more immediate change in that you are actively undergoing treatment for what is a disease, not some inner flaw. After all, doesn't the efficacy of antidepressants indicate that there must be a chemical component to depression in the first place? I'll say this a thousand times: this isn't your fault, and you're not alone.
Next, with the antidepressants. While going to therapy was a huge, wonderful experience, initially it sucked. I stuck with it, and it helped. What helped even more in bringing me out of my depression was Lexapro. Within two weeks, I started to feel better, to my disbelief. I'd started taking an SSRI as a favor to my mom--I honestly thought I would never recover from my depression, would never experience happiness again. Physically beginning to feel happy (or at least, less horrifically sad) was initially a really weird feeling. But, after awhile, I got used to being okay. A year later, I switched to Prozac, as I was exhausted all the time on Lexapro. Why did it take a whole year of falling asleep multiple times a day in highschool to change medications? Because it felt so, so much better to not be depressed anymore, I didn't even care. After about 2 years on medication, I weaned myself off and just continued to check in with my therapist occasionally. One more piece of advice: don't even think about neglecting your treatment for financial reasons. I know that therapy and medication can be expensive. Your LIFE is worth it. Period.

Finally, the epilogue to my treatment experience:
Years later, I am happier than I've ever been. No medication. No therapy, these days. I even dealt with my dad cheating on and then leaving my mom for his girlfriend, and my mom's subsequent spiral into depression, with relative aplomb (and, reasonably, went to my college's free counseling service as a way to healthily cope with a non-mental-illness concern). Dealing with depression takes phenomenal strength. Compared to that "real life dilemma", depression was so much worse! Friends of mine that told me to "suck it up", and "think positive", and that "it's all about mind over matter" when I was depressed (for few, if any, real reasons--my depression came practically out of nowhere), were shocked at how well I handled my parents' divorce. Some people just need to see to believe. But those people either 1. have never experienced depression, or 2. are in denial about some other serious or related problem, and cannot see in others what they refuse to recognize in themselves.
Anyway, definitely give antidepressants, or at least SSRI's, a try. If that is a medication type that works for you, they should work in 4 weeks for sure, and you will probably start to feel the effects around 2 weeks. There are a variety on the market, and it's okay to switch medications if one doesn't really help you the way it should.
I was also worried about how SSRI's/medication would change me, but ask yourself if your depression hasn't already changed you. I didn't really have any side effects to speak of, and felt dramatically changed for the better when I did start taking SSRI's.
Once again, depression isn't your fault, and you aren't alone!
 
delete this one. Lost my whole message.
will type another one.
 
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Hello, I am the mother of Kaitlyn Elkins. I still check here from time to time because Med School was Kaitlyn’s love and I am still interested in what goes on.

I hope you all don’t mind my replying. I saw the title had mental health in it and I was drawn to the post. I am so happy that you are discussing the problem of depression and I certainly don’t mind your using Kaitlyn’s experience as an example of this problem. It was my hope in my original post, that it would stimulate discussion and awareness of depression even in people who show no signs. I think Kaitlyn would be happy that at least her death may stimulate action to this problem in our society. Please feel free to use her example in any way.

I wanted to emphasize that it is very important to support one another always. To show that you care for someone, to listen to their problems, make them know they are supported. Sometimes depression can be situational due to problems at home, drug use, stress, etc. However, sometimes it can be simply (or not so simply) a chemical imbalance. Kaitlyn was brought up in a very caring, loving, home with us, her parents, being married for 32 years. We absolutely adored her and supported her every step of the way in her life. We never pushed her to achieve, she did this on her own. She knew, without a shadow of a doubt, that she was very well loved. She was doing well in med school. She never once showed signs of depression to me or to anyone else. She was highly functional up until she died. The first I learned of her depression was in her suicide note. She had the world in her hands. She was SO good at everything she did. So it’s important to know, that even when someone seemingly has it all, if they are depressed, it does not matter what they have, if left untreated it can lead to suicide. Please always try to look beyond the happy face, the good grades, the achievements. What may be lurking inside is a deadly depression they don’t want to admit to.

I don’t know why she chose not to seek help. But I can guess at some of the reasons. Perhaps it was fear of the stigma still attached to it and no one would ever respect her again if they knew, or it may hurt her education and chances of a medical career, or she would be seen as weak, or she just simply didn’t want to admit she had a problem, or she thought she could handle it herself. I will never know.

It is important that you support each other in medical school. I don’t think Kaitlyn had any real friends in med school because she was an introvert and did not reach out to anyone and no one reached out to her. But she did have friends in other areas and those friends loved and supported her, even though no one knew she was depressed. I don’t know if med school exacerbated her depression or not. She always had positive things to say about it, told us that this was what she was meant to do, and working hard seemed never to be a problem for her.

What I hope for is that med school can become a place where no one fears admitting that they have a problem and can comfortably seek help without fear of harming their education or chance at a medical career. Since Kaitlyn’s death, Wake Med has put in place in her name, in their Wellness Dept., an ongoing fund that is devoted to just that purpose that will be ongoing. It is my hope that all med schools will follow suit. This is where you all come in. You are the ones that can make a change
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And yes, reach out to one another; support one another, because what you are doing is so stressful. People need support. And please, if you see a student that is quiet, reach out to them. You never know what a wonderful person is within that quiet person. Kaitlyn was quiet, but once you got to know her, her specialness as a person really shined through as told by all that knew her. She was the brightest star I ever knew and I will mourn her death the rest of my life. She would have become a great doctor which is what she wanted all her life.

I wish you all well with your education and your future careers. And I thank you so much for trying to make a difference with this post. If you continue, you will make a difference. Good luck to you all.

481004_571956116168369_1670994893_n.jpg
 
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Thank you for your beautiful post. It brought me to tears. I am so sad I never knew Kaitlyn, it would have been nice to have been her classmate. I too am quiet at times, and can come off introverted until I am more at ease and can open up more. I also feel like I don't have any "real" friends in med-school, despite having friends through other means. Medical school is extremely challenging, especially for certain sensitive personality types. Also, it can be very difficult if you are a perfectionist, as many med-students are. I am sure Kaitlyn was a wonderful student and future doctor, but she may have not seen herself the way she was in reality.

I know b/c I have been there - I have felt like I was doing everything wrong when in reality I was doing just fine. It is the med-school culture. There is little support. Students just don't admit how hard it is enough. There is an unsaid stigma that feeling stressed/overwhelmed/exhausted/or hurt makes one "weak" in medical school. I personally hate the way medical education is done. Sending third years into the hospital wards like fish being thrown into an ocean of sharks! I joke, but this is really what it is like. Also, there are so many exams and all the smartest people are competing with each other . . .it is the most cut-throat environment.

Constant critique on the rotations can be very unsettling. I have suffered what I now believe was adjustment disorder and situational depression for the past 3+ years. I am almost done now, but it is a miracle I did not give up, become severely jaded, or worse kill myself after all the abuse. Yes, it is abuse.

To Kaitlyn's mom, just know there is NOTHING that you did wrong. I am curious if there were any signs at all looking back, b/c these might help people prevent this happening again to another person/family. Unfortunately, it sounds like she did not seek support and put on a good act. I am so sorry this happened to you, but she is not alone. I understand the pain she felt, and it is very real. I hope to G-d that one day the medical field stops thinking they are all gods and that just b/c they had to work hard or work hard, all students should have to also and be tortured just for fun. I am really not joking - it is that bad at times. Medical school is so anxiety wrenching and depressing.

There NEEDS to be more support. Not just special counseling centers, but in the program real support given to all students. Somehow, schools need to be more on top of their students mental health. Please continue to share your daughter's story. You can be the voice for the future tortured souls . . . YOU can make the medical schools finally listen and support their students properly! Kaitlyn doesn't need to have died in vain. Support each other, be nice. It is so simple. If you have a classmate that is struggling, don't elbow her/him out . . . offer a helping hand. That is the way a future doctor should be.
 
Thank you for your beautiful post. It brought me to tears. I am so sad I never knew Kaitlyn, it would have been nice to have been her classmate. I too am quiet at times, and can come off introverted until I am more at ease and can open up more. I also feel like I don't have any "real" friends in med-school, despite having friends through other means. Medical school is extremely challenging, especially for certain sensitive personality types. Also, it can be very difficult if you are a perfectionist, as many med-students are. I am sure Kaitlyn was a wonderful student and future doctor, but she may have not seen herself the way she was in reality.

I know b/c I have been there - I have felt like I was doing everything wrong when in reality I was doing just fine. It is the med-school culture. There is little support. Students just don't admit how hard it is enough. There is an unsaid stigma that feeling stressed/overwhelmed/exhausted/or hurt makes one "weak" in medical school. I personally hate the way medical education is done. Sending third years into the hospital wards like fish being thrown into an ocean of sharks! I joke, but this is really what it is like. Also, there are so many exams and all the smartest people are competing with each other . . .it is the most cut-throat environment.

Constant critique on the rotations can be very unsettling. I have suffered what I now believe was adjustment disorder and situational depression for the past 3+ years. I am almost done now, but it is a miracle I did not give up, become severely jaded, or worse kill myself after all the abuse. Yes, it is abuse.

To Kaitlyn's mom, just know there is NOTHING that you did wrong. I am curious if there were any signs at all looking back, b/c these might help people prevent this happening again to another person/family. Unfortunately, it sounds like she did not seek support and put on a good act. I am so sorry this happened to you, but she is not alone. I understand the pain she felt, and it is very real. I hope to G-d that one day the medical field stops thinking they are all gods and that just b/c they had to work hard or work hard, all students should have to also and be tortured just for fun. I am really not joking - it is that bad at times. Medical school is so anxiety wrenching and depressing.

There NEEDS to be more support. Not just special counseling centers, but in the program real support given to all students. Somehow, schools need to be more on top of their students mental health. Please continue to share your daughter's story. You can be the voice for the future tortured souls . . . YOU can make the medical schools finally listen and support their students properly! Kaitlyn doesn't need to have died in vain. Support each other, be nice. It is so simple. If you have a classmate that is struggling, don't elbow her/him out . . . offer a helping hand. That is the way a future doctor should be.

Thank you for your very honest response. Everyone knows from TV and just hearing about it in real life and all the horror stories, that Med School is very hard and stressful. And I know it has to be hard, but I had wondered, why the abuse? Thank you for letting me know for sure, that it really exists. How horrible for you all!! I know you are glad it's almost over.

I have racked my brain looking back since Kaitlyn's death, to try to find some kind of signs. Since she went off to undergrad, I didn't get to see her but about once a month due to her living a few hours away, but I still saw nothing but the sweet, intelligent, driven, talented, had everything together girl we always knew. She was always driven. However, I did notice that once she got into med school, she became more of a perfectionist. She started running over a year ago, and she really got obsessed with it and entered her first marathon in less than a year and completing it. She started gym exercising as well. Then she started being very strict with the kinds of foods she ate. She ate several times a day, but ate small portions. She became upset when she came home and could not eat that way and I would then buy special foods for her. She also became a little upset when she realized there's nowhere good to run here. These things, running, diet, exercise, are really good for you, but I worried that she took it too far and drove herself too hard especially all the while having to study so hard in school. But she denied that it hurt her and said it helped with her stress release. So I shut up about it. She lost a little more weight than I thought she should too. Looking back, those are the only things I saw. I saw her 4 days before her death and she was her sweet wonderful, seemingly happy self. We had a wonderful relationship and I would have died to save her, had I only known what she was really going through.

Thank you so much for your response to me. I appreciate it more than you know. Good luck to you!
 
Although I may be called out for necromancing a thread...

I under schools offer services for mental health, but there seems to still be a lot of stigma attached to receiving help. I have two different friends in medical school who are worried about their own mental health:
-1 may have OCD and wants to seek counseling, but the counselor wants them to see a psychiatrist
-the other faced abuse before medical school and now wants to find counseling. Unfortunately, the services offered at the school only reaches out to current problems. Again, a psychiatrist was recommended for this person.

After talking to both friends, it's obvious that they need professional help in order for them to heal and move on with their lives before medical school and life in general really consumes them. They're worried about going to a psychiatrist, receiving drugs and eventually having to disclose such information for state licensing. As their friend I keep telling them they need to take care of themselves, but honestly I'd be afraid in their situation too.

Can anyone honestly answer what happens with psychiatric information while you're training to be a profession. Will this information negatively impact a person's profession anywhere down the line?
 
Although I may be called out for necromancing a thread...

I under schools offer services for mental health, but there seems to still be a lot of stigma attached to receiving help. I have two different friends in medical school who are worried about their own mental health:
-1 may have OCD and wants to seek counseling, but the counselor wants them to see a psychiatrist
-the other faced abuse before medical school and now wants to find counseling. Unfortunately, the services offered at the school only reaches out to current problems. Again, a psychiatrist was recommended for this person.

After talking to both friends, it's obvious that they need professional help in order for them to heal and move on with their lives before medical school and life in general really consumes them. They're worried about going to a psychiatrist, receiving drugs and eventually having to disclose such information for state licensing. As their friend I keep telling them they need to take care of themselves, but honestly I'd be afraid in their situation too.

Can anyone honestly answer what happens with psychiatric information while you're training to be a profession. Will this information negatively impact a person's profession anywhere down the line?


I was just about to mention this. I think the biggest thing stopping many med students from seeking help for mental health is that down the line they will almost certainly be monitored for it by their medical school/the medical profession and risk losing their license on account of it. Especially when you consider the lack of opportunity our generations has, it becomes a very risk decision to make.
 
I was just about to mention this. I think the biggest thing stopping many med students from seeking help for mental health is that down the line they will almost certainly be monitored for it by their medical school/the medical profession and risk losing their license on account of it. Especially when you consider the lack of opportunity our generations has, it becomes a very risk decision to make.

It seems the only workarounds is scheduling a visit, paying in cash and all these other "shady" loopholes. It's a pretty sad state of affairs and it's easy to see why most individuals don't seek help.
 
It seems the only workarounds is scheduling a visit, paying in cash and all these other "shady" loopholes. It's a pretty sad state of affairs and it's easy to see why most individuals don't seek help.

But they should. And like with most things in life, these things need time, positive reinforcement and leaders to address these issues.

I am in contact with Mrs. Rhonda Elkins, the mother of the recent MD student who committed suicide, Miss Kaitlyn N. Elkins (RIP). Mrs. Elkins told me she had her thread about Kaitlyn removed because of unfriendly remarks from some SDN members. Recognizing that Pro Football Player thugs in the NFL like Miami Dolphins Richie Incognito exist as well in medical schools on these boards, I am more than happy to take up where Mrs. Elkins bravely and courageously began. The internet has brought society a new level of cowardice among the young, and attacking a mourning mother who lost her daughter is unspeakable. Where are moderators when you need them?
Medical Schools need to start looking at the totality of an applicant and not just their MCAT and GPA scores.

Mrs. Elkins if you are still reading SDN, you did a wonderful thing for medical students - please disregard the SDN thugs. Getting into medical school is the only accomplishment they will ever achieve, and will eventually end up being mandated under Court order by Judges to participate in Disruptive Physician Programs. Those programs do wonders to curtail those monsters with MD Degrees.

There are quite a few students in my class who are in the throes of depression, anxiety and/or denial. I already have seen signs of the same in the first year class at my school. Mrs. Elkins did them a favor. All of them fear talking to someone at school about their problems. I convinced one to see a local psychiatrist/MD not affiliated with our school. I am not sure if he/she is doing any better but at least he/she is seeing a professional. Mrs. Elkins and I agree, and many SDN members have shared in kind, that the medical education system does not support this type of situation. Some might. All must. There aren't that many MD schools in the USA so lack of compliance is a poor excuse. Judgments / perceptions exist by medical school leaders that view students with acute or chronic emotional problems are not "cut out" or lack the "right stuff" to be a physician. It's as if somehow physicians are thought to live in a plastic bubble where nothing touches them. Clinical data indicates that physicians have a much higher incidence of the above problems compared to the population as a whole. So much for medical education leaders living in ivory towers.

The LCME states as follows in their document, "Functions & Structures of a Medical School" on page 21:

MS-26. A medical education program must have an effective system of personal counseling for its medical students that includes programs to promote the well-being of medical students and facilitate their adjustment to the physical and emotional demands of medical education.

[....]

MS-27-A. The health professionals at a medical education program who provide psychiatric/ psychological counseling or other sensitive health services to a medical student must have no involvement in the academic assessment or promotion of the medical student receiving those services.


Thus the LCME expects, nay demands, accredited MD Schools to provide counseling services for students "to promote well being"..for the ..."demands of medical education"

If for some reason an MD school does not offer these services in reality, other than rolling them out as a dog/pony show during an LCME accreditation visit, then the student needs to reach out to their community....pronto.

While I can understand "shady" loopholes and paying cash might be needed in your mind, you should not let these make you unhealthy. If you do not get help, you will get worse and eventually in a very dark situation. One of my classmates is there right now. If you have medical insurance, and most medical schools I believe require it, your insurance billing practices are not divulged to a medical school. Just pay your office visit, a small co-pay for most policies.

Thank you Mrs. Elkins for bringing up mental health in medical students. Because I'm the old one on campus, some of my classmates who are seriously hurting would rather tell me via email or text, than pick up a phone and make an appointment to see a professional. I'm glad to listen. But they need to get help.
 
Wow, very good idea for a thread, I hope this works out for people.

I certainly feel like adjusting to med school has taken a huge toll mentally. I'm not too comfortable going into details (maybe I'll share later) but the adjustment has been difficult both academically and socially. Honestly, I heard med school was difficult, and the volume of work would be high, but I had not expected the other aspects of my life to be factors in this transition as well. I'm sure many MS1s like myself are moving to a new place, being uprooted from our homes or undergrads, separated from family and friends and having to start fresh with an entirely new group of people in an entirely new place...that is a difficult thing to do for anyone, and it's definitely been one source of stress and anxiety. Not only am I worrying about classes, I'm missing my old friends, and also I'm anxious about making friends and forming new relationships with people here.

Also, one thing I learned is that the rest of our lives don't stop with medical school...which is both good and bad. Commitments to family, friends, relationship issues, car problems and anything else that we had to deal with before med school, we are still dealing with now...they don't just go away because we're medical students. Except now we're having to manage all these other other things with the intense academic rigor of med school.

All in all, it's a doozy of an adjustment, some do manage this transition okay, but I imagine most of us have some difficulty. I've been having a lot of difficulty, but thankfully I have some good folks to talk to, and I think that's key. The best thing for me was to have someone to just talk to...who understood. Thankfully my school does a big sib/little sib system, and my big sib who is an MS2 is one of the few people I was able to talk to and he understood what I was going through. Talking it out, and getting advice or at least some words of comfort from another person who understood made a big impact for me.
 
One of the things that bothers me on a constant basis is how much time and investment goes into medicine. It might be different for a lot of people, but essentially it requires single minded-dedication and lots of time spent studying/going to class/etc. throughout your 20's and your 30's. Isn't that supposed to be the prime time of your life? I guess I'm just worried that my best time is passing me by while I'm preoccupied with school, Even people starting fresh out of college will be at a minimum 29 before they get out of 'training'. That's a hell of a lot of time to give up.
 
One of the things that bothers me on a constant basis is how much time and investment goes into medicine. It might be different for a lot of people, but essentially it requires single minded-dedication and lots of time spent studying/going to class/etc. throughout your 20's and your 30's. Isn't that supposed to be the prime time of your life? I guess I'm just worried that my best time is passing me by while I'm preoccupied with school, Even people starting fresh out of college will be at a minimum 29 before they get out of 'training'. That's a hell of a lot of time to give up.

Attempt at a perspective post:

Med school is hard. Residency (for the vast majority) is harder.

This in NO WAY means you have to miss out on the "prime of life"

I made amazing friends in medical school and residency. We took spontaneous trips, hung out, went to awesome concerts, sporting events, parties.

I've also done incredibly stupid things with them, including a few stories that I will never post on this website. But that's part of the joy of being young and (despite being in a career driven by professionalism) somewhat irresponsible. I've come to work hungover and on 2 hours of sleep for a thirty hour call, and can say that it was totally worth it. The use of call rooms in Grey's anatomy is only a modest exaggeration.

But my friends and I havee also happened to share rather unique bonding experiences over medicine. Some of the most poignant and amazing memories of my life come from the unique tragic side of medicine - taking my buddy out for a beer after his first patient died; having my chief resident do the same for me after a patient of mine had an intraoperative stroke. These tragedies hit us hard and though we often rush past them and depersonalize, they are an amazing part of the medical experience. I've grown and changed as a person because of these experiences, and have had an awesome group of friends to share them with.

Med school and residency may take place in the "prime of your life" - but if you spend those years on the sidelines instead of living it, that's on you, not medicine.
 
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How much of a problem is being on psychotropic drugs? I've been on anti depressants since I was 16, and I don't exactly feel ready to stop. Is that going to be a problem?
 
Attempt at a perspective post:

Med school is hard. Residency (for the vast majority) is harder.

This in NO WAY means you have to miss out on the "prime of life"

I made amazing friends in medical school and residency. We took spontaneous trips, hung out, went to awesome concerts, sporting events, parties.

I've also done incredibly stupid things with them, including a few stories that I will never post on this website. But that's part of the joy of being young and (despite being in a career driven by professionalism) somewhat irresponsible. I've come to work hungover and on 2 hours of sleep for a thirty hour call, and can say that it was totally worth it. The use of call rooms in Grey's anatomy is only a modest exaggeration.

But my friends and I havee also happened to share rather unique bonding experiences over medicine. Some of the most poignant and amazing memories of my life come from the unique tragic side of medicine - taking my buddy out for a beer after his first patient died; having my chief resident do the same for me after a patient of mine had an intraoperative stroke. These tragedies hit us hard and though we often rush past them and depersonalize, they are an amazing part of the medical experience. I've grown and changed as a person because of these experiences, and have had an awesome group of friends to share them with.

Med school and residency may take place in the "prime of your life" - but if you spend those years on the sidelines instead of living it, that's on you, not medicine.

Agree with this completely - or at least that's been my experience with med school thus far, even during MS3.

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