Medical School’S Unique Challenges
For ages, medicine has been held as an honorable and noble profession. Medical students begin their education with a sense of excitement, enthusiasm, altruism, idealism and optimism.
Medical education holds a grim reality within the health care industry – a continuum of mental and physical health and emotional distress that begins in medical school.
Medical school marks one of the most pivotal periods in the life of a physician. Not only are the four or more rigorous years a time of immense learning and professional growth, but they are also a stage of great personal development.
The majority of medical students who matriculate directly out of college encounter in the new independent lifestyle of the medical student a wealth of decisions over which they previously had little control as an undergraduate—loan budgeting, dining options, living environment. Faced with academic demands and long hours unlike any they have ever before experienced, medical students are universally forced to decide what to keep in their overbooked schedules, and what to eliminate.
Tragically, the pursuit of a medical career exacts a life-altering toll on the student’s health and well-being, with a focus on technical proficiency and accumulation of information, with little to no consideration of the student’s individuality, and unique sensibilities.
Among medical students across the country, a belief exists that the best or the only way to survive and succeed amidst the intense academic pressure is to give up all other activities that compete with academics for time—even those activities of great personal importance.
Feeling as though your hands are tied whilst the pressure surmounts equate to detrimental emotions. No one wants their spirit to be shackled.
Since the 1960’s medical student abuse in the form of harassment and hostility, have been recognized as a problem in American medical schools. This important issue has remained ignored by many, despite these facts, medical school administrators (deans) continued to overlook and deny the existence of the culture of abuse in their institutions.
Medical Student Mental Health Statistics:
The statistics are alarming. Every day a medical student takes his or her life. Burn out is over 50%. Anxiety and depression have reached epidemic proportions.
Recent research suggests that medical education may actually impair students from maintaining humanistic qualities described in the profession’s oath, ultimately affecting negatively on the quality of future patient care. Physicians experiencing burnout make more accidents and have poorer patient outcomes.
A 2006 study indicated medical students entering training with a similar mental wellbeing profile as age-matched peers, but leave school with less empathy and humanitarianism than they entered.
Medical students are also more depressed and report more suicidal ideation than non-medical peers.
Other studies have shown that the documented decrease in empathy is associated with a decline in clinical performance and that the disparities in well-being are amplified in women and groups traditionally under-represented in medicine.
Among Medical Students: after accidents, suicide is the leading cause of death! More than 10 %globally report having entertained thoughts of suicide, Depression 20-30%
Anxiety and burnout rates are greater than 50%
Residents experience 60-75 per cent and higher while practicing physicians experience the highest rates of suicide for any profession and 60-90% of physicians would not recommend the field to their children.
Burnout Among Residents:
• In resident studies showed an average rates of burnout as high as 41-90%
• The burnout levels increase quickly within the first few months of residency
• Interestingly, ACGME changes to work hour duties for residents have showed decreased burnout rates moderately but…
• In a study in published in 2005* noted:
• 13% fewer residents experienced high emotional exhaustion
• There was a trend toward fewer residents with high depersonalization
• Fewer residents with a positive depression screen.
• Personal accomplishment did not change.
• The assessment of self-reported quality of care did not significantly change from 2003 to 2004.
• Residents reported attending fewer educational conferences per month.
• Overall residency satisfaction decreased 6 mm on a 100-mm visual analogue score.
This is a true health care crisis of epic proportions!
Compromised medical students, residents and physicians, lead to diminished patient care. Depressed physicians are more likely to make errors, and burnt out physicians understandably display far less empathy for their patients, which interferes with the critical doctor-patient relationship.
•A 2011 study conducted by the American Medical Association and the Mayo Clinic reported that nearly 50% of U.S. physicians report at least one symptom of burnout.
•HIGH Job Stress and LOW Personal Autonomy leads to higher chances of BURNOUT!
•Increase prevalence among medical students, residents, and physicians.
Unfortunately, we cannot control some of the pitfalls and torments that life throws at us. There is however much still in our control. The aim should not be to qualify from medical school unscathed by challenge or untested emotionally, but to develop resilience in the face of adversity and a mind for resolve, and to maintain this prosperous quality throughout life.