Yet another medical student suicide

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It's not just Keck's problem. Med student/physician suicides are happening all over the country. Two years ago, two interns jumped off NYC buildings within days of one another and a second-year at another med school killed herself. Her mom used to post here about her daughter's suicide, until she killed herself too because of the grief.
 
This is tragic...my deepest condolences for his family and those close to him, I can't imagine what they're going through.

I don't know the details of his mental health and how much it contributed among other factors, but I really hope there are resources at that school for the students to reach out to and the environment allows them to feel comfortable doing it.
I really think one of the biggest problems in medicine (and thankfully the culture seems to be shifting) is that students feel like they can't show their weaknesses without being judged or ridiculed, and as a result are unable to reach out to peers in the class or administrators at their school when help is needed. I just hope the culture of medicine can become more open minded and willing to help it's trainees who hit rough patches, cause this should not happen.

If it's true this is the third suicide at that school, the school needs to step up.
 
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psychMDhopefully said:
Im starting to believe that 150 a year number
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I highly doubt it.
That being said, there are 20,055 students who just enrolled in medical school last year, right?
About ~80k students total in US medical schools.
Suicides are bound to happen. I distinctly remember a minimum of one suicide year at my small private school in undergrad, though the year before I got there, there were four over two semesters.
RIP to Sean Petro.
 
NontradCA said:
Yes, the culture doesn't help. Last year I was at a school where 4 students died, 1 from suicide. No one really talked about it, and I felt a palpable notion of trying to sweep some of it under the rug.
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That is horrendous...What were the causes of the other?
 
Demosthenes1 said:
I highly doubt it.
That being said, there are 20,055 students who just enrolled in medical school last year, right?
About ~80k students total in US medical schools.
Suicides are bound to happen. I distinctly remember a minimum of one suicide year at my small private school in undergrad, though the year before I got there, there were four over two semesters.
RIP to Sean Petro.
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No one said that suicides aren't bound to happen. But it is a fact, not an opinion, that suicide rates among med students/physicians are much higher than the general population.
 
Disclaimer: I'm a big advocate of culture reform, and taking care of our young/weak.

That said, medicine is an unforgiving profession. It will be stressful. When a patient dies and you realize you made a mistake, it's more stressful than an exam or a series of exams. Going to trial of a legitimate case is also terrible, and in some states can really ruin a physician. So, a certain level of resilience is prerequisite to becoming a physician. This is the reason I'm reluctant to support SDNers that say at-risk premeds should be encouraged to enter medicine if their condition is "well controlled." Medical school and the practice of medicine will envoke more anxiety and depression than most other life experiences. It breaks people who were previously well adjusted and not at-risk...

People like to say medicine is "just a job", but it's different than most others.
 
@lazymed is 100% correct. However, we can't have a conversation about increased depression and anxiety in medicine without also addressing the culture of medicine and the fact that in most other professions, some of the supervisors who get a pass in medicine would have their career ruined for creating a hostile work environment. In medicine, it's acceptable to humiliate and/or bully underlings and that truly plays a role in some of this.
 
Mass Effect said:
@lazymed is 100% correct. However, we can't have a conversation about increased depression and anxiety in medicine without also addressing the culture of medicine and the fact that in most other professions, some of the supervisors who get a pass in medicine would have their career ruined for creating a hostile work environment. In medicine, it's acceptable to humiliate and/or bully underlings and that truly plays a role in some of this.
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Yup. Although I'm sure this is prevalent in high pressure jobs (e.g. wall street). I'd be all for a zero-tolerance policy for bullying. Yet, there would still be high stakes exams/performance metrics etc, which could still provoke stress/anxiety.
 
lazymed said:
Yup. Although I'm sure this is prevalent in high pressure jobs (e.g. wall street). I'd be all for a zero-tolerance policy for bullying. Yet, there would still be high stakes exams/performance metrics etc, which could still provoke stress/anxiety.
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True, but studies show that public humiliation is one of the big risk factors for suicidality and suicidal ideation.
 
lazymed said:
Disclaimer: I'm a big advocate of culture reform, and taking care of our young/weak.

That said, medicine is an unforgiving profession. It will be stressful. When a patient dies and you realize you made a mistake, it's more stressful than an exam or a series of exams. Going to trial of a legitimate case is also terrible, and in some states can really ruin a physician. So, a certain level of resilience is prerequisite to becoming a physician. This is the reason I'm reluctant to support SDNers that say at-risk premeds should be encouraged to enter medicine if their condition is "well controlled." Medical school and the practice of medicine will envoke more anxiety and depression than most other life experiences. It breaks people who were previously well adjusted and not at-risk...

People like to say medicine is "just a job", but it's different than most others.
Click to expand...
I agree, resilience and strength is definitely needed in medicine. I've mentioned a few times in other threads, I struggled with my own mental health and personal issues which only fully surfaced after starting med school.
And I now realize I need to be realistic about how my mental health will affect me in the future. I don't fully know what's to come in this process, or how I'll overcome it, but I'm trying my best to be aware of my own abilities, strengths, and weaknesses as much as I can now, as well find ways to make myself stronger so I can hopefully cope. And truthfully, I realize that I could potentially hit a limit and not be able to handle the challenges associated with medicine any more, in which case I will need to make some adjustments on my future plans.

As for admitting "at risk pre-meds", as someone who may have been at risk and just wasn't aware of it before applying. I absolutely agree in that one should take a step back and honestly ask themselves if they want to put themselves through this and if they can handle it. But it's a tough question to know that answer to so early. MS1 when things started getting bad, I doubted if I'd make it this far in the process, and despite flubbing up a lot and struggling in the beginning, I've survived almost 3 years and am doing better now. So I do feel that many are able to keep it well controlled as long as they're realistic and actively addressing it, but it's completely case by case, and unfortunately you can't always predict the outcome from the start. Even now looking at residency, I hope I can handle the challenges ahead, I'm trying to prepare myself as best as I can and be aware of my limits now, but there's no certainty until you've done it and can look back.

For the purposes of this thread though, regards to admitted students, residents, and physicians who are struggling. I still believe the culture should change. As you mentioned, there's a lot of stress and pressure in this field and many challenges to overcome. Most of these sources of stress are out of our hands (lawsuits, losing patients, losing sleep, trying to raise a family with a busy career etc.). Thus, we should do our best to make the culture one that nurtures and takes care of it's own as best as possible. Not to say we should be coddled from the real stress we will face. More so that, we should be aware of that stress and have a culture where we're willing and able to help each other when it becomes too much.

In medicine there are so many sources of stress that are out of our control (like the ones you mentioned), that we should take more care to manage the sources of stress we can control, such as students being able feel comfortable in reaching out, reducing work place abuse and mistreatment, creating a non-judgmental environment and getting rid of the feeling that each person is on their own. We should promote resilience but in a way where we support each other through difficulties and not be as indifferent or demeaning towards each other as I sometimes see.

Sorry that was longer than I expected. You make a very fair and valid point, but I just wanted to give the context for my original message when I said the culture should change. 🙂
 
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Mass Effect said:
@lazymed is 100% correct. However, we can't have a conversation about increased depression and anxiety in medicine without also addressing the culture of medicine and the fact that in most other professions, some of the supervisors who get a pass in medicine would have their career ruined for creating a hostile work environment. In medicine, it's acceptable to humiliate and/or bully underlings and that truly plays a role in some of this.
Click to expand...


Is it the bullying that does it? I'm stressed every now and then, but not because of bullying more because of the time commitment of medicine, lack of sleep,not having as much time for hobbies that I love, not having time to date or spend time with family, the fact that 1 exam ( step 1) will determine the next 40 years of your life, the monumental debt hanging over my head, and the fact that if I quit now I would have wasted a decade of my life and would never find another job that could pay off these massive loans.
 
zeppelinpage4 said:
I agree, resilience and strength is definitely needed in medicine. I've mentioned a few times in other threads, I struggled with my own mental health and personal issues which only fully surfaced after starting med school.
And I now realize I need to be realistic about gauging what I can and cannot handle both in present times and for the future. I don't fully know what's to come in this process, or how I'll overcome it, but I'm trying my best to be aware of my own abilities, strengths, and weaknesses as much as I can now, as well find ways to make myself stronger. And truthfully, I realize that I could potentially hit a limit and not be able to handle the challenges associated with medicine any more, in which case I may need to make some adjustments on my future plans.

As for admitting "at risk pre-meds", as someone who may have been at risk and just wasn't aware of it before applying. I absolutely agree in that one should take a step back and ask themselves if they really want to put themselves through this and if they can handle it. But it's a tough question to know that answer to so early. MS1 when things started getting bad, I doubted if I'd make it this far in the process, and despite flubbing up a lot and struggling in the beginning, I've survived almost 3 years and am doing better now. So I do feel that many are able to keep it well controlled as long as they're realistic and actively addressing it, but it's completely case by case, and unfortunately you can't always predict the outcome from the start. Even now looking at residency, I hope I can handle the challenges ahead, I'm trying to prepare myself as best as I can and be aware of my limits now, but there's no certainty until you've done it and can look back.

For the purposes of this thread though, regards to admitted students, residents, and physicians who are struggling. I still believe the culture should change. As you mentioned, there's a lot of stress and pressure in this field and many challenges to overcome. Most of these sources of stress are out of our hands (lawsuits, losing patients, losing sleep, trying to raise a family with a busy career etc.). Thus, we should do our best to make the culture one that nurtures and takes care of it's own as best as possible. Not to say we should be coddled from the real stress we will face. More so that, we should be aware of that stress and have a culture where we're willing and able to help each other when it becomes too much.
In medicine there are so some many sources of stress that are out of our control, that we should take more care to manage the sources of stress we can control, such as students being able feel comfortable in reaching out to each others, reducing work place abuse and mistreatment, getting rid of the feeling that we're on our own. We should promote resilience but in a way where we still support each other and not be as indifferent or demeaning towards each other as I sometimes see.

Sorry that was longer than I expected. You make a very fair and valid point, but I just wanted to give the context for my original message when I said the culture should change. 🙂
Click to expand...

I agree: there is no good way to determine which "at risk" applicants are too high risk. I don't suggest we disqualify people with h/o mental illness. We don't have a good screening process and even if we did, it would violate some anti-discrimination law. I would however recommend that anyone with a history of mental illness considering medical school to think long and hard about it, and have insight into their strengths and weaknesses and have a low threshold to seek help in school, or even be willing to take a LOA or quit if the stress exceeded their limit. It bothers when someone posts here with a history of severe anxiety/depression or mania/psychosis that is reportedly well controlled and SDNers rally around them and say "you can do it" or "don't let this hold you back"...
 
lazymed said:
I agree: there is no good way to determine which "at risk" applicants are too high risk. I don't suggest we disqualify people with h/o mental illness. We don't have a good screening process and even if we did, it would violate some anti-discrimination law. I would however recommend that anyone with a history of mental illness considering medical school to think long and hard about it, and have insight into their strengths and weaknesses and have a low threshold to seek help in school, or even be willing to take a LOA or quit if the stress exceeded their limit. It bothers when someone posts here with a history of severe anxiety/depression or mania/psychosis that is reportedly well controlled and SDNers rally around them and say "you can do it" or "don't let this hold you back"...
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I agree and we're definitely on the same page on the topic I think. 🙂 Mental health is something to be aware of and one must be honest and realistic about it. Though when someone is honest with themselves and willing to go in with the right mentality like you said, I think it's doable.
And absolutely true. Blindly pushing through is just not a good idea, which I learned from experience. So, I almost always respond to threads like that telling the posters to get help and address the issue.
 
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Petypet said:
🙁
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Not our school, an MD one I was doing research at. Nevertheless it was pretty messed up and honestly quite odd. I found it so odd. It happened on campus and another student and I happened to be in the same building when the staff found them, but we heard nothing of it for two days.
 
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psychMDhopefully said:
Is it the bullying that does it? I'm stressed every now and then, but not because of bullying more because of the time commitment of medicine, lack of sleep,not having as much time for hobbies that I love, not having time to date or spend time with family, the fact that 1 exam ( step 1) will determine the next 40 years of your life, the monumental debt hanging over my head, and the fact that if I quit now I would have wasted a decade of my life and would never find another job that could pay off these massive loans.
Click to expand...

All of those things provide a cumulative affect. But yes, bullying most certainly contributes to it. And by bullying, I'm not talking about the attending who told you your presentations weren't good or the resident who tossed your note in the trash. I'm talking about honest-to-goodness bullying/humiliating someone in front of their peers/others by berating them and/or harassing them, especially in front of others. This doesn't happen too often on most services, but it does happen and some services are more notorious for it than others.
 
lazymed said:
Disclaimer: I'm a big advocate of culture reform, and taking care of our young/weak.

That said, medicine is an unforgiving profession. It will be stressful. When a patient dies and you realize you made a mistake, it's more stressful than an exam or a series of exams. Going to trial of a legitimate case is also terrible, and in some states can really ruin a physician. So, a certain level of resilience is prerequisite to becoming a physician. This is the reason I'm reluctant to support SDNers that say at-risk premeds should be encouraged to enter medicine if their condition is "well controlled." Medical school and the practice of medicine will envoke more anxiety and depression than most other life experiences. It breaks people who were previously well adjusted and not at-risk...

People like to say medicine is "just a job", but it's different than most others.
Click to expand...

While people with anxiety and depression have a higher tendency to be affected by medical school, that doesn't mean we should be shutting them out. A lot of the people with sub clinical depression from medical school really stemmed from reasons like "it wasn't what I thought it would be". Instead of discouraging people with tendencies for depression or anxiety, we should just not sugar coat the journey so that medical students don't keep falling asleep to the idea "things will get better." Comments like: "you're afraid of being sad from studying so much? Dude you'll be fine!" Or "bottom of the class and still want ortho? Dude just rock your boards and third year and you'll be fine!" Are honestly just poison to medical students and it's not healthy to just foster sticking their heads in the ground until the reality bomb eats them alive and it's too far in debt and time to do anything about it.

I'm not saying these are the reasons students kill themselves but these major disappointments in the journey foster the depression and anxiety. If students with depression are totally cool with the work/time/lack of forgiveness in the field deep down, then depression or not, we shouldn't discourage them from this journey.
 
Anicetus said:
While people with anxiety and depression have a higher tendency to be affected by medical school, that doesn't mean we should be shutting them out. A lot of the people with sub clinical depression from medical school really stemmed from reasons like "it wasn't what I thought it would be". Instead of discouraging people with tendencies for depression or anxiety, we should just not sugar coat the journey so that medical students don't keep falling asleep to the idea "things will get better." Comments like: "you're afraid of being sad from studying so much? Dude you'll be fine!" Or "bottom of the class and still want ortho? Dude just rock your boards and third year and you'll be fine!" Are honestly just poison to medical students and it's not healthy to just foster sticking their heads in the ground until the reality bomb eats them alive and it's too far in debt and time to do anything about it.

I'm not saying these are the reasons students kill themselves but these major disappointments in the journey foster the depression and anxiety. If students with depression are totally cool with the work/time/lack of forgiveness in the field deep down, then depression or not, we shouldn't discourage them from this journey.
Click to expand...

And I never condoned shutting them out. I said there's not a good way to filter people out. I was critizing threads on SDN where people paint a rosey picture and encourage those who have terrible anxiety at baseline to dive into medicine head first. As long as people know what they're getting into AND they have really good insight into their condition, they should be able to cope and handle it. However, the insight part is a BIG "if". People over estimate how well controlled heir condition is and how much insight they have, so they get blindsided...
 
For those who have mentioned the stress of the process, I certainly agree. We mortgage our futures, taking on significant amounts of debt. Yes, the USMLE is a major determining examination. It is not the only factor, however. Further, the process is far too much an assembly line. Students are squeezed in to their class, and are expected to advance at the same pace, and graduate after 4-years. As opposed to undergraduate education, where leaving and returning, as well as transferring institutions, is less challenging, in medical school it is all but impossible. Likewise, if someone completes 2- or 3- years of medical school, and does not finish, they have nothing to show for it but debt. Finally, the same goes for residency. You sign up for a field, having limited experience from rotations as to what the field is actually like, thus determining the next 3-7 years of your life. Changing residencies is somewhat easier, but nonetheless remains difficult. For those who are unable to complete residency (e.g. our Miami neurology colleague), there are minimal career options available. Add to this underlying pressure cooker the fact that medicine in general is a hierarchical, authoritarian system and it is no wonder physicians and medical students are committing suicide.

First and foremost, if you are anxious, feel stressed, or have contemplated suicide, please seek help. We in medicine often subvert our own needs for fear of reprisal, but I can assure you there are resources out there that can help you through whatever is going on. PM me and I will do my best to help you find resources you need if you are afraid to ask someone you know.

Second, take a step back. Look around. Take another step back. We get far too enveloped in our acute events and surroundings and react emotionally. How often have you been snarky to another physician, student, or team member for little or no reason? We are all colleagues and have our respective roles. Embracing our roles, withholding arrogance, and respecting one another is an important step.
 
psychMDhopefully said:
Is it the bullying that does it? I'm stressed every now and then, but not because of bullying more because of the time commitment of medicine, lack of sleep,not having as much time for hobbies that I love, not having time to date or spend time with family, the fact that 1 exam ( step 1) will determine the next 40 years of your life, the monumental debt hanging over my head, and the fact that if I quit now I would have wasted a decade of my life and would never find another job that could pay off these massive loans.
Click to expand...

As others have said, there are a lot of factors, but I think the biggest one is the feeling of isolation or perception of isolation many experience. A lot of people act like med school is easy, that they're doing well on everything, and that it's embarrassing to be struggling or doing poorly in relation to others. The general culture and attitude that everyone is fighting to be "the best" can make a lot of people feel like they're a failure and that they're alone. The bullying is just something that I think is the icing on the cake in terms of making people feel isolated. I've seen it at several levels already, where a person is publicly shamed and others in the group avoid the individual because they don't want to be associated with them or are too worried about their own performance (which is a legitimate concern) to reach out and help that person.

I think in many cases, the bullying and public shaming is the final confirmation that their feelings of isolation are justified. Alone, being isolated isn't necessarily the end of the world, but when you combine it with the pressures you described I don't think it's hard to see how the bullying could push a person over that edge.
 
WingedOx said:
yeah, followed that one back when it was first announced he was missing. They mentioned he was about to graduate in all the articles but never anything about what he was doing afterwards. Not a good sign, particularly for a kid at UAG, a school that isn't exactly churning out matches anymore.
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It's is mentioned he wanted to be a cardiologist
 
GroverPsychMD said:
It's is mentioned he wanted to be a cardiologist
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Yeah, it's hard to speculate. He was at Jackson Park Hospital, which has lately become a dumping ground for students from basement-tier offshore schools. I can only imagine what the stress level is in a setting like that, where a lot of the students are coming to a realization that their educations are hitting a dead end. Plus, I've worked at a hospital that UofC sent a lot of undergrads to. CC of SI with plan to drown self in the lake is something I've seen more than once (and sadly usually for seemingly small reasons like failing a test, etc).

Though the lake level has been up lately, and there's been at least one case this year where the likely cause of death was a jogger being swept into the lake by a high wave, so who knows? It's gotten to the point where I hear "CTA delay for medical emergency on the tracks" and you wonder if it's one of yours.
 
The sheer number of facts one must absorb, necesitates a lot of reading, which is a solitary activity even if you do it in a study room with your best friend
Same with lectures, it's not very "interactive"
you can only have so much "interactive" learning because you need X facts covered in X time, and that is done most efficiently reading (if you look up the numbers of words per minute that can be processed)

Conclusion:
Med school is inherently lonely if you only take how much studying/reading you must do

We did a Myers Briggs test, and overall most students test introvert over extrovert which people find surprising for a field that is all about people, but the theory is that is the type of person that you find indoors reading in undergrad enough to make it into medical school, so the selection is geared that way

Humiliation is a huge factor for suicide if you ask me.
Spending weeks going to a service where I felt every single person I looked up to for teaching hated me on top of sleep deprivation, a proven torture technique?
How we feel others feel about us is a HUGE deal for our mental well being

Medical training is torture
I never felt more incompetent, annoying, stupid, disvalued, and irrelevant in my entire existence
I have never been more miserable in my entire life
I love medicine and patients, but the culture, "business of medicine," has many frankly inhuman & disgusting elements built in

These schools should be ashamed and view every suicide as a moral failing of the institution (I say VIEW it that way so that they can approach it that way and make adjustments, I don't care if it wasn't the school's "fault", as physicians we are always expected to never stop striving for excellence, and that should go for schools re: well being of students)
 
Crayola227 said:
Medical training is torture
I never felt more incompetent, annoying, stupid, disvalued, and irrelevant in my entire existence
I have never been more miserable in my entire life
I love medicine and patients, but the culture, "business of medicine," has many frankly inhuman & disgusting elements built in
Click to expand...
Yup, Pretty much.
 
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