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A Med School Dean Speaks Out About How the Culture of Medical Training is Fraught With Stress

3/23/2017

6 Comments

 
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Speaking out about a tragedy involving the suicide of one of their own medical students, Dr. David Muller, the dean at Icahn School of Medicine at Mount Sinai powerfully expresses how the culture of medical training programs and the expectations of those pursuing a career in medicine can be fraught with stress, leading to anxiety, depression, burnout and suicide. 

More importantly, beyond addressing some of these "root causes" of medical learner and physician mental health issues, he reminds us all of the importance of support, whether that be provided between peers and colleagues, or through more formal programs and initiatives in medical schools and residency programs. 

"All these questions will have to be addressed, and the answers incorporated into whatever plan we propose to implement. But in my opinion they will fall far short of addressing one of the root causes of this national epidemic of burnout, depression, and suicide: a culture of performance and achievement that for most of our students begins in middle school and relentlessly intensifies for the remainder of their adult lives. Every time students achieve what looks to the rest of us like a successful milestone — getting into a great college, the medical school of their choice, a residency in a competitive clinical specialty — it is to some of them the opening of another door to a haunted house, behind which lie demons, suffocating uncertainty, and unimaginable challenges. Students bravely meet these challenges head-on while we continue to blindly ratchet up our expectations.

From their very first shadowing experience to their first foray in the lab; from high school advanced-placement courses and college admissions tests to grade point averages and the Medical College Admissions Test (MCAT); with helicopter parents, peer pressure, violins and varsity soccer, college rankings, medical school rankings, medical licensing exams, and the residency Match, we never let up on them — and it’s killing them."


To read the full article, visit:
http://www.nejm.org/doi/full/10.1056/NEJMp1615141

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