Study: Medical Students More Depressed Than General Population
Reader Comments
To the person living with a depressed medical student spouce:
I am a 4th year now, and I was depressed as well during my 3rd yr. I think what helped me out a lot was going outside for a run which "cleared my head". Listening to positive music will also help you get through hard times. If you have a religion then I also recommend going to church or a mosque to pray which also helps. And sometimes treat your self to something that pleases you. And always have someone to talk to that you can trust. Someone to just let out your hurt to. This will remove some of that weight. I would do a combination of these things, not just one to significantly improve your outlook on life. Also become interested in the topics of Medicine also helps to keep you interested. ohh i forgot...sex helps 2....but try not to have sex before bed. Drink a cup of warm milk before bed. In fact setting up a daily schedule is great! Exercise in the morning to release the endorphins will help a lot, that way you'll be tired when your about to go to bed and you'll have the best sleep of your life!! And try to think positive. The power of positive thinking is AMAZING.
Significant other
As a significant other of a depressed medical student who is in his 2nd year what would you suggest I do? It is very stressful on my end because I do not feel as if i can do anything to help. I love this man with all my heart and he has said out of his own mouth that he thinks he is depressed. I dont think he would use medicine and he obviously does not have the time to go and sit in an office for an hour to talk to someone about it because he could use that time studing. He has told me why he is so stressed and they are all real reasons and I think I would be stressed also. Help!
Med School Woes
First and foremost, to the first year medical student ("citizens may not know...") who is only half of a year into training, you have no clue how it is to perform without sleep. I am sure that you are very bright indeed, but you are a neophyte, and being harsh on a poster is just unnecessary. The IOM should encourage regulations on what are known as "duty hours". As an attending physician who just completed residency 7 months ago, I can ensure you that working without sleep can be downright dangerous. At the very least, being "on call" you are expected to be available at all time for 30+ hours in a row. It can be difficult to take care of stable patients, much less very sick or dying ones. Your tirade sounds more like that of an "old timer" and I wonder very much if your parent or some other elder has brainwashed you into thinking the longer you work, the more you learn. Just wait until your first very bad call night. The next day, you'll find it is hard enough to try to remember if you finished the work you were supposed to do - much less hold on to any thing "learned".
Dear first year, I am sure you are 22 years old or younger. If you ever have a family, try these 80+ hour work weeks (the current limit now) with children or a spouse. Try to have a whole weekend off, or any two days in a row, during the whole of your residency training. And just wait until your residency, your fellowship, when all your friends who don't live and breath their jobs are getting married, having children, buying homes and taking wonderful trips around the world while you earn the equivalent of 7.50 an hour with a doctorate degree (residency wages stink). Unfortunately, it's a process that only seems to be understood by those experiencing it.
To the citizens out there: I am sure if the general public understood the severity of American medical training, they would be appalled. I love my job, but I hate my hours. I have lost ten years of my life stuck inside the walls of a school or hospital, sacrificed many friendships and celebrations with loved ones, only to finish and continue at breakneck speed just to break even with my income, my mortage, my property taxes, my med school loans. Who wants that? I agree with the posters "way beyond" and "after med school". Depression is rampant in medical school , and I am sure it is much higher in incidence that a study would report, as we docs don't often admit weakness. But it continues. Being a physician is a demanding life and often it ruins lives, breaks up marriages and isolates people from what used to help define them as individuals. And now that it is very tough to make the money back (which after ten years of sacrifice, I have a right to earn) the love for my job is not enough to make it worthwhile. And that is indeed why physicians will be in short numbers very soon.
After med school
I agree with the comment that a study should be done comparing practicing physicians with the medical students and the general population. I do not want to make anyone any more depressed than they are, but the truth is it is almost impossible to practice medicine in 2009,to do your very best and still have any kind of life. Most of my colleagues (primary care and subspecialists) work from sunup until late in the evening only to get up and do it again, with no end in sight. I forsee a drop in admissions very soon, as physicians usually beget physicians, but I would not encourage my children to do this. Reimbursements are terrible, if you get reimbursed at all. Who in their right mind wants to do this for a living when you cannot even make enough to pay back your loans? The depression then will be transferred to the patients, because their will be no doctors fifty years from now.
... way beyond lack of sleep
You are encouraged implicitly and explicitly to give up most of your support networks/activities. You no longer have time for hobbies or stress relieving activities. You no longer have time to visit your family/friends. You are actively encouraged to associate your grades/evals with how good a person you are. You are judged on intangibles like how sympathetic and relatible you are (a good-person grade) and are frequently graded harshly.
People think that just because you have gone to medical school you no longer have a right to have human feelings -- like frustration, depression, or annoyance. When you DO manage to talk to friends and relatives they put everything in terms of delayed gratification, doing the right thing for others, and how great it will be at the end. You will probably be told more than once by family/friends that how you're feeling is wrong. They will then tell you how to feel. Often you arent really seen as a person anymore but as a future doctor.
The skillset we are now tested on is often very different from the ones that got us IN to medical school. Medical students are often perfectionists (stupid pre-med education) who have not failed very often. Tremendous pressure is placed on EVERY grade and eval by the med student -- when the reality is that much of the (non-test) grading is subjective and even arbitrary. Perfection is not really necessary but is often seen as necessary because of pre-med training.
You are dealing with complex issues where there is no back and white or right and wrong. Stressful events that normal people deal with once every 10 years or more, you will deal with daily. Moreover people are often on edge (due to the seriousness of the situations) and a small misstep will earn you a LOT of derision. PLUS, if you have ever had a negative personal experience with a disease, you will be asked to confront those emotions head on sooner or later. (ex: relative died of disease X? had a mental illness? a traumatic accient? ... there is no repression allowed. Sooner or later you will treat someone with this and you will have to hold it together.)
Also, even though we are selected for our abilities, during our med student years we are pretty useless. (OK, we can be more useful than a total noob but we are in training!) Everyone is pressured to get work done and we often slow the system down. the entire system of people is under stress and when you as a student are dumb (which hey, happens! you are a student and learning) expect to be yelled at. Even good students will be repremanded a lot.
So to recap:
1. Isolation from support networks
2. Removal of stress relieving activities
3. Perfectionist people meeting their first "failures" or first feelings of uselessness
4. Stressful/Unhappy circumstances
5. Stressed out mentors/coworkers who just want to get home to THEIR families and have no time for you
6. Huge weight on a grading system that is often arbitrary.
= recipe for depression.
No doubt.....Agree with you
Many of my friends experienced as such, including me. Wish finish the study as soon as possible so that the pressure ends.
Medical Student Depression
We have an excess of book studying during the first two years of medical school, which should be balanced with more practical applications or even a reduction of coursework to support more "on the job" training.
Maybe something a little more subtle
As we start our clinical training fresh out of lecture theaters, depression seems inevitable. Getting into medical school was tough enough, and then it only gets tougher each day. At least the school I am in, the burden of patient care, quite unexplainably, is shifted to the most junior members of the team, namely us interns. Seniors at every level somehow find a way to transfer their duty over us, sometimes holding our degrees for hostage. The visiting physicians don't give it a damn and are content as long as they can spend the least amount of time in the hospital and steal time for their private practice.
The danger in this is that when interns finally mature into seniors, they are already pressed enough with 60 hour stretches of duty, and they turn into the same lazy old vultures as their seniors. To have their labors worth in turns of money becomes their only goal, and they make it somehow, corrupting themselves and the society.
Tis the Genius!
fact: smart people are depressed more than the general population.
Medical schools accept genius people. so of course they will be depressed more.
Law school is the same way, I don't know the exact stats, but there are definitely anti-suicidal posters around the law school I last entered.
So if you have a brain, you're a little blue. BUT you're also smart enough to not kill yourself. Usually.
citizens may not know what is best for training doctors.
To the first commenter, what do you know about how much we sleep? I am a first-year medical student and I probably sleep a little bit more than I did in undergrad. That said, the problem is what the above poster pointed out - I spend most of my time outside of class studying, which never happened in undergrad. I used to cram before exams. Here, that's simply impossible. You get to go home from your job at the end of the day. We work all day.
And your comment about "Think we citizens could tolerate something being done about this in the structuring of the training of these people who will be taking care of us?" is simply stupid. The IOM recently came out with a recommendation that would enforce certain sleeping hours upon residents, because of citizens like you that pestered Congress. Now, your doctors are going to be more poorly trained, because they can't follow patients and their cases to the end - they have to be locked in a room for a while for a "nap." There is this absurd notion that residents don't sleep and work on zombie-mode. As a resident, you're part of a team - and when you hit your limit, you know to tag out and ask for help. Naps are allowed. We don't need to be forced to take them. And we don't need "brilliant" citizens like you trying to dictate how we are trained. When we leave residency, we are expected to be fully competent doctors who will be responsible for treating people like you. If you want to cut back on our training, good luck on your next hospital visit.
